On March 29, 2012, CMS launched a national initiative aimed to improve behavioral health and minimize the use of medications (such as antipsychotic medications) to manage individuals with dementia. As part of the initiative, CMS is developing a national action plan that will use a multidimensional approach to improve care for individuals with dementia that includes public reporting, raising public awareness, regulatory oversight, technical assistance, provider and consumer education and research.

The Advancing Excellence in America’s Nursing Homes Campaign has offered to make available a variety of resources and clinical tools to assist nursing homes achieve the goals of this initiative. Nursing homes are encouraged to review the resources and tools and select those that will be most useful. This site will be updated regularly as new tools become available.

  • Background – Video (50 minutes) that describes the national initiative to reduce the use of antipsychotic drug usage by 15% by December 31, 2012.
  • Centers for Medicare and Medicaid Services

Recorded Webcast (58 minutes) describes the national initiative to reduce the use of antipsychotic drug usage, and provides in-depth discussion about the symptoms and various management/intervention strategies to help nursing homes work toward the national goal.
Dr. Cheryl Phillips and Tena Alonzo LeadingAge

A PowerPoint presentation that describes the state of research and effort to improve dementia care in the UK.
Dr. Clive Ballard | King’s College London & Director of Research, Alzheimer’s Society (UK)

This presentation provides an overview of the magnitude of the risks and benefits of antipsychotics for individuals with dementia residing in nursing homes; information on interpreting CMS’ quality measures on antipsychotic use; and strategies to safely reduce these medications in the long term care setting.
Dr. Dave Gifford | American Health Care AssociationInitiatives and Presentations

The Hand in Hand training was created by CMS to provide nursing homes with a high-quality training program that emphasizes person-centered care in the care of persons with dementia and the prevention of abuse.

A useful resource as a reference for long-term care teams focused on antipsychotic drugs
Co-developed by the Delmarva Foundation for Medical Care (Maryland/DC QIO) and Healthcare Quality Strategies, Inc. (NJ QIO)

A flow chart with suggested steps for implementing quality improvement efforts to reduce inappropriate use of antipsychotics.
Partnership to Improve Dementia Care in Nursing Homes

Developed by Planetree in partnership with Picker Institute, the Long-Term Care Improvement Guide was created in 2010 to propel long-term care communities in their improvement efforts.

Free article available through the Journal of the American Medical Association which includes information on characterizing common behavioral symptoms and a method for selecting evidence-based nonpharmacologic dementia treatments. Nonpharmacologic management of behavioral symptoms in dementia can significantly improve quality of life and patient-caregiver satisfaction.

A nursing home in California has built a fully-accessible community garden for residents to grow and harvest their own produce and donate it to citizens in need. This shift in culture has allowed residents to find new purpose and engage in daily activities, and has helped improve the care and quality of life among residents with dementia. Click here for a short YouTube documentary of this amazing program.

Mission View Health Center’s most recent community project is making “Helping Hands Hand Soap,” a glycerin-based soap in a variety of shapes, colors and scents. By allowing residents to become “givers” instead of just “care receivers”, Mission View has reintroduced meaning and a feeling of purpose to residents who showed significant signs of depression and withdrawal. Residents fully run this non-profit business, which sells the soaps and then donates the proceeds to various causes, including buying food which the residents prepare and serve to people at a local homeless shelter. 

A few years ago, staff members at Ecumen in Minnosota became concerned about the number of people with Alzheimer’s and other dementia-related diseases being admitted who were on antipsychotic drugs. They started exploring alternative treatments that could provide these residents with a better quality of life. These treatments emphasize human relationships and non-pharmaceutical remedies. In 2009, Ecumen piloted these alternative treatments in one of their nursing homes in Two Harbors, Minnesota. This initiative is called Awakenings because it re-awakens residents to physical and cognitive vitality that’s often been severely diminished by an inappropriate use of antipsychotic drugs. We can’t cure Alzheimer’s, but we have learned much more about how to control the aggressive and sometimes violent behaviors that accompany it without using drugs that rob residents of their personalities and energy.

The APA Office of Aging provides links to articles and postings on issues of aging and geropsychology, including links to dementia care guidelines, Alzheimer’s, and psychological care of older people.

The Eden Alternative is a small not-for-profit organization based on the core belief that aging should be a continued stage of development and growth, rather than a period of decline. 


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