synergy and good front line reporting crucial: Lester
Long-term care home residents less likely to
receive ‘potentially inappropriate’ drugs: report
To reduce reliance on medications, a long-term care home must have
a great working relationship with its medical director and a proactive
front line, according to Mary Lynn Lester, administrator and director
of care at West Lake Terrace in Bloomfield.
She says both of these elements can catalyze success,
especially with OMNI’s supportive measures philosophy underpinning
Supportive measures is an individualized approach
to care that uses creative interventions to ease residents' agitation
and reduce reliance on psychotropic medications.
"Our doctor trusts us and trusts what this
home is doing," says Mary Lynn.
"He doesn’t feel threatened by different
interventions like supportive measures, and that’s a real
key," she says.
Mary Lynn points out it is the doctor who orders
the drugs based on information from nursing staff and his own observations
when he visits. "He trusts our assessments and our interventions."
The administrator and director of care says another
important means for finding success in reducing medications of all
kinds is having "good reporting" from personal support
workers (PSWs), the front line of a long-term care home.
"When they (PSWs) share what they’re
seeing to the registered staff, it helps us to have a greater understanding
of what needs there are," says Mary Lynn.
This might include "behaviour mapping,"
where documentation is kept that records certain behaviours at particular
times of the day. With this information, health practitioners can
assess when a medication is most needed, rather than recommending
it throughout the day.
Mary Lynn says it all comes down to making sure
everyone "is on the same page."
"If the evening shift is doing something
that is working but doesn’t tell the day shift, as an example,
then we wouldn’t be working effectively," says Mary Lynn.
According to a new study, residents of long-term
care homes in Ontario are less likely than seniors living in the
general community to receive “potentially inappropriate”
drugs. The recently released study, conducted by the Baycrest Centre
for Geriatric Care, found people who live in long-term care homes
were 48 per cent less likely to be dispensed a drug that is “rarely
appropriate” or should always be avoided for seniors because
the risks outweigh the benefits.
“All drugs come with some degree of side
effects,” says Dr. Paula Rochon in a news release. She is
a geriatrician and scientist with Baycrest who co-authored the study.
“The take-home message from our study is
that every effort should be made to choose a drug that will be best
tolerated in older and frailer individuals, with the least potential
for adverse side effects.”
The study says the discrepancy between seniors
in long-term care and those living in the community may be attributed
to the more regulated guidelines in Ontario long-term care homes
when it comes to prescribing practices. “The pharmacist is
required to prepare a record of each resident’s drug regimen
every three months for the primary care physician. No comparable
program exists for older adults in the community,” the press