Instead of treating behavioral problems with antipsychotic drugs, Ecumen, a chain of 15 nursing homes, uses strategies including aromatherapy, massage, music, games, exercise, good conversation, personal attention, better pain control and other techniques. The project was started by Eva Lanigan, a nurse and resident care coordinator at Ecumen’s Sunrise Home in Two Harbors, Minnesota. The entire staff was trained and encouraged to interact with residents with dementia. Within six months, they eliminated antipsychotic drugs and cut the use of antidepressants by half. The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.” After seeing the results, the Ecumen company started a project called “Awakenings” and implemented it throughout its 15 long-term care nursing homes. The project is based on Lanigan’s work and is funded by a two-year, $3.7 million state grant.
A similar program to Ecumen’s is being carried out under the direction of psychiatrist Dr. Miguel Rivera, where caregivers at the Pines of Sarasota nursing home in Florida have set up using simple spa comforts such as music, massage and calming colors to help reduce agitation. As a result, dosages of antipsychotic medications have dropped to less than half the state average for this patient population. Medicare payments for services to dementia patients are expected to total $172 billion in 2010. So low-cost interventions such as Rivera’s could save tax dollars.
Laura Gitlin, PhD, Director of the Jefferson Center for Applied Research on Aging and Health in Philadelphia, said non-pharmacological approaches can help, such as personal counseling, education, skill training of family members, and simple and engaging activities. Gitlin described an occupational program at her university that developed meaningful activities for dementia patients based on their capabilities. The program cost $941.63 per family per year, compared with $1,825 for drug treatment programs. The program also saved caregivers about five hours a day in time they would have otherwise spent in hands-on care.