Non sedating anti psychotics

LTC Facilities Struggle to Support New Populations The lack of focus on mental health issues would be bad enough if the population of long-term-care facilities was composed solely of the “traditional” elderly residents that such facilities were designed to accommodate. These days, a variety of other residents share space with traditional populations and these new populations have an even greater need for robust mental health care.

Although it may be less obvious, we should expect that neuroleptics have similar effects on people regardless of the diagnosis.

When we learn that individuals diagnosed with Schizophrenia who take these drugs over several years are less likely to be working, we need to be worried about everyone who takes these drugs over an extended period.

At times, overwhelmed by caring for and managing these “challenging” residents, anti-psychotic medications are deployed to sedate residents, even when there are more effective long-term strategies that would better help these people to successfully adjust to the facility.

The use of anti-psychotics as a first-line intervention for difficult behaviors is declining, but it remains too prevalent, and when anti-psychotics are reduced or eliminated, most long-term-care facilities lack a non-pharmacological behavioral intervention to support residents.

Such a strategy must include the following: • Training of long-term-care staff so front-line workers become adept at recognizing and caring for the predominant issues in the long-term care population—depression and anxiety; • Developing a preference for and expertise in the non-pharmacological treatment of mental health challenges so that psychotropics, especially sedating agents such as anti-psychotics and benzodiazapines, are used as sparingly and for as short a time as possible; and • Prioritizing behavioral healthcare on an equal basis with medical interventions, and routinely incorporating evidence-based mental health interventions, performed by licensed providers, in residents’ care plans.

Nothing less than a broad culture change will be required before long-term-care facilities can adequately address the emotional needs of the populations they are routinely called upon to care for.I am not sure child psychiatrists or adult psychiatrists who prescribe these drugs for depression will read the literature on schizophrenia.In a recent report, it was noted that there was a three-fold increase in the incidence of diabetes in children who are prescribed these drugs.Various other groups with special clinical needs—people with PTSD, patients on ventilators, those with long-standing personality disorders—also are a part of the fabric.For all of these residents, admission to long-term care involves not only those adjustment issues true of all admissions, but also additional challenges that long-term-care facilities may not be capable of supporting.Yet so many medications, which often include an array of sedating psychotropics, have a blunting effect on residents’ opportunity to energetically explore the life challenges confronting them.

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