Families must play a key role in preventing overmedication of seniors suffering from dementia, state and local officials said Monday.
Increased communications among patients, their families and hospital staff, particularly care-giving aides and nurses, can go a long way toward cutting down on the overuse of drugs, they said during a two-and-a-half-hour field hearing of the Senate Special Committee on Aging led by U.S. Sen. Richard Blumenthal.
Overmedicating is one issue facing seniors seeking medical help. Seniors are disproportionally affected by medical errors, with one in seven Medicare beneficiaries harmed in the course of care, according to federal health officials.
Alice Bonner, director of the Division of Nursing Homes Survey and Certification Group at the Centers for Medicare and Medicaid Services, said it's important for those closest to patients to participate in planning their care.
"Dementia care is like cracking a code sometimes," Bonner said.
She stressed that it's important for families to give health care staff information about coping mechanisms they can use to help quell anxiety in patients who might otherwise become targeted for drugs they might not need.
In recent years, more ahospitals and nursing homes have been cited for unnecessary use of such medications, including more than 19 percent in 2011. In data collected during 2010, more than 39 percent of nursing home patients nationwide had cognitive impairment and behavioral problems, but not a diagnosis of psychosis, yet they received anti-psychotic drugs.
This year, the CMS announced a new national partnership to improve dementia care, with the goal of reducing the use of anti-psychotic drugs by the end of the year.
"There is really a need to address this issue more aggressively," Blumenthal said, noting that there is growing evidence that anti-psychotic drugs may not be appropriate for those with dementia and Alzheimer's.
Susan L. Davis, a registered nurse who is the president and CEO of St. Vincent's Medical Center in Bridgeport, said that advances in information technology are slowly improving the exchange of patient information, although proprietary computer issues remain obstacles. She also stressed the need to develop standardized definitions to help measure treatments and outcomes for patients.
"We need to be able to transfer information and data across the continuum," Davis said. "As health care providers, we think we know what patients want," she said. "We don't."
Jean Rexford, executive director of the nonprofit Connecticut Center for Patient Safety, said that in one recent year, 950 elderly residents died in state hospitals and another 22,000 patients acquired infections that were preventable.
"Behind each statistic there is a name, a family, a story of sorrow,'' she said. "For some it's medical bankruptcy, for others, it is unemployment. We are determined not to be forgotten collateral damage in a terribly broken healthcare system."
Blumenthal said that Connecticut is ahead of most of the nation in working for better patient support.
"The more we can add to this movement, the better," he said.
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