Medicating Elders in Long Term Care: Is It Necessary?

If your fragile elder parent is in long-term care or assisted living and memory issues are ongoing or developing, take a few minutes to read or listen to a December 9, 2014 National Public Radio (NPR) broadcast, This Nursing Home Calms Troubling Behavior Without Risky Drugs. The piece, by Ina Jaffe, describes a long-term care community, Pathstone Living in Mankato, Minnesota and how the staff went about lowering the use of antipsychotic drugs.

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CMS graph depicting state-by-state drug use in long-term care. Click for a larger version. Link to CMS graph is below in the resources section.

The nursing home aimed to reduce the number of residents who were taking antipsychotic medications. Although they set modest goals for the first year, they experienced great success, discovering that they could take most people off the medications.

By extending the policy to other long-term care communities, the non-profit organization that runs Pathstone along with other long-term care communities, the organization set a new goal to reduce the drug use by 20% in the first year, but instead they reduced it by 97%. These communities achieved their goals by looking at each patient and seeking ways to directly address the reasons that the medication was given to each person in the first place.

I was struck by how many people are put on an antipsychotic for a specific reason but then ever taken off. I was also struck by the number of falls that occur to people taking these drugs,

After my mother-in-law’s stroke she experienced some post stroke dementia as well as frightening nightmares. Her doctor suggested an anti-psychotic, and we took a long time to decide whether or not she should take it. Because of her night-time fears, we finally decided to try the smallest dose possible. And then we asked the doctor to cut that in half. Mother took it right before bed and slept well, finally free of the frightening images. However, we carefully monitored her and the drug to be sure that there were no side effects and especially no effects that made her less active during the daytime.

A Few Additional Resources About Elders and Antipsychotic Medications

So How Does Music Connect With the Brain?

I’ve watched in wonder as music changes people — kids, adults, people who are ill, elders, and caregivers. Of course, the movie Alive Inside visually documents how music can affect people, even those with substantial memory loss. But what exactly is happening in the brain?

In the process of wondering, I came across an excellent video from TedEd (where cool lessons and videos reside). It explains  how the brain processes music when a person listens and how even more complex activity occurs when an individual actually plays an instrument.

Check it out below. 

The Alive Inside Documentary Is Now Available at iTunes

Screen Shot 2014-11-24 at 8.38.01 PMLast summer my husband and I saw the documentary Alive Inside, and we were amazed at the power of music. Well actually we already knew a fair amount the power of music, but seeing people with advanced dementia become more articulate and communicative — and even feel better — made us realize how powerfully music can relieve at least some of the symptoms of severe health problems.

I wrote a post after seeing the movie, Alive Inside: This Movie is Extraordinary! Please check out my review.

Now the documentary is available at iTunes$14.99 to purchase or $4.99 to rent. This is an extraordinary movie that should be shared with adult children, their families, and friends, whether or not a close family member suffers from dementia or Alzheimer’s, so please check it, out and then share your thoughts with others, here on AsOurParentsAge, or on other blogs.

Thanksgiving: A Time To See Older Relatives

Yes, Thanksgiving is a time for adult children to pack up and pay a visit to parents, where ever their homes may be.

Today’s Washington Post, it’s the last Sunday before Thanksgiving 2014, features an interesting article, Thanksgiving: A Rare Holiday That’s Isn’t All About Kids. The short piece, appearing in the Post’s Outlook section, points out that although Thanksgiving celebrations include lots of multigenerational activities, the holiday itself has not become as kid-centered or commercial as other holidays such as Christmas and Easter.

01-Jan-2012_to_31-Dec-2012-1According to author Jack Santino, a folklorist at Bowling Green State University, the holiday is geared toward important concepts like giving and thanks, but it also recognizes our need to go home — and sometimes considerable distances — to reconnect with parents and other relatives. Thanksgiving Day celebrations emphasize traditions of families, extended families, and country.                              Continue reading

My Grandfather, a Small Church, and Italian Immigrants

The playground where this story took place is behind the Silver Lake Baptist Church (as it used to look) in Belleville, New Jersey.

The church in Belleville, New Jersey.

(A memoir written with the assistance of my father, Reverend Elmo Pascale.)

A  church in Belleville, New Jersey, will celebrate its 100th anniversary in November 2014, and my grandfather, Benedetto Pascale, founded that church in 1914. Several years earlier, in 1909, he had traveled from Naples, Italy to Boston and eventually to the mills in Lawrence, MA, where he labored just in time for the Bread and Roses workers strike (I’ll be writing more on this later in a later post).

The manifest from the White Star Line ship Canopic, which brought my grandfather to the United States. arriving on March 23. 1909.

The manifest from the White Star Line ship Canopic, which brought my grandfather to the United States, arriving on March 23. 1909.

Immigrants arriving from Italy and looking for a Catholic church often found their way blocked by large Irish congregations (I learned this at a Lawrence Massachusetts Museum that focuses on the textile mills and the immigrant experiences).

One of the old mills in Lawrence, Massachusetts. My Grandfather worked in one of these buildings (and today  there dozens of them still stand).

One of the old mills in Lawrence, Massachusetts. My Grandfather worked in one of these buildings (and today  there dozens of them still stand).

When northeastern United States evangelical Baptist leaders observed this situation they took action. They began welcoming immigrants into their churches, identifying young men with leadership potential. They helped the men learn English and finish high school, guiding them through the naturalization process, and encouraging a select few  to go into the ministry. Grandpa Pascale was one of these men, eventually attending seminary at a small Colgate University storefront on Deitz Avenue in Brooklyn.                                       Continue reading

Cyber Seniors Documentary: Well Done!

This afternoon at the Family Online Safety Institute (FOSI) conference in Washington, DC, I saw clips from a documentary, Cyber-Seniors, about teenage volunteers in Toronto who work with elders — people in their mid to late 80s and older — and the rich clarity of their interactions. Many of these people retired before computers appeared in any significant way into the workplace.

The movie, which travelled around film festivals, has already screened in more than 80 viewings around Canada and the United States — with more to come. It shares special moments, difficult moments, looks of wonder, moderate shock (usually at what grandparents see on their grandchildren’s pages), and the excitement we all feel when we learn something new. And yes, sometimes it’s funny. Cyber-Seniors has garnered lots of good press. (I do wish, however, that people in the media would stop calling elders “cute.” You media folks will grow older some day andhttp://www.mercurynews.com/business/ci_26931356/magid-exclusive-amazon-fire-phones-fight-ebola-west-africa you WILL NOT appreciate being labeled as cute.)

Here’s a clip of a teenage mentor teaching a woman to take a selfie.

Continue reading