Antipsychotic Drugs and Alzheimer’s: Why Better Training is Needed

It’s not uncommon practice for Alzheimer’s patients to receive antipsychotic drugs as sedatives, but it appears they are doing more harm than good. A study conducted by Professor Clive Ballard of King’s College in London concluded that “the medication nearly doubles the risk of death over three years” for patients with Alzheimer’s disease.

At first, antipsychotic medications seem to help by reducing aggression and making patients easier to deal with, but over time the drugs were shown to cause a rapid decrease in cognitive function as well as increase the risk of death. Regardless, many healthcare facilities continue to prescribe them to patients with Alzheimer’s.

“Way too many patients in nursing homes are treated with antipsychotics purely to sedate them or to control behaviors that are difficult for the staff,’’ said Robert A. Stern, an Alzheimer’s specialist and brain researcher at Boston University School of Medicine. Indeed, antipsychotic drugs are often given instead of proper behavior management training—a concerning fact which Stern attributes to understaffing and a lack of training about behavioral changes in patients with Alzheimer’s and dementia.

The best way to reduce the use of antipsychotic drugs for Alzheimer’s patients is by providing proper training on the signs and symptoms, behavioral changes, and non-narcotic treatment methods available. Paul Raia, vice president of clinical services for the Massachusetts/New Hampshire chapter of the national Alzheimer’s Association, says that in nursing homes and other senior care facilities lacking proper training, “as many as 80% of  residents are on antipsychotic drugs,” but in homes with training, “2 to 3% are on these medications.”

For more information on the care and treatment of patients with Alzheimer’s disease and related disorders, visit the Care2Learn ADRD course library.

Celebrate through Education: National Nurses Week 2012

How will you celebrate National Nurses Week 2012 through education? Drop us a line at editor@care2learn.com and let us know, and we’ll post your response!

May 6 marks the beginning of National Nurses Week, which begins on National Nurses Day and comes to an end on May 12—the birthday of Florence Nightingale. The celebration honors the more than 3 million nurses in the U.S. who work tirelessly to ensure the health and well-being countless individuals.

This year’s theme is “Nurses: Advocating, Leading, Caring” and it focuses on the many roles nurses play in our daily lives—from “staff educator to nurse practitioner and nurse researcher”. Indeed, education is an integral part of the nursing profession. It encompasses not only the years spent learning to become a nurse, but also the importance of continuing education as well as mentoring our fellow nurses and caregivers, and promoting awareness about the value of nursing in the clinical setting and beyond.

According to the annual Gallup poll ranking professions for their honesty and ethical standards, Americans voted nurses “the most trusted profession in America” for the 12th time in 13 years, and the honesty and ethics of nurses were rated "very high" or "high" by 84 percent of poll respondents. The American Nurses Association (ANA) says:

“Now more than ever, RNs are positioned to assume leadership roles in health care, provide primary care services to meet increased demand, implement strategies to improve the quality of care, and play a key role in innovative, patient-centered care delivery models. The nursing profession plays an essential role in improving patient outcomes, increasing access, coordinating care, and reducing health care costs.”

On their site, the ANA offers a list of ways in which nurses and other healthcare professionals and support staff can celebrate National Nurses Week 2012, such as working with local hospitals, schools and libraries to set up a display, or hosting a hearing before city council to discuss concerns about recent trends in healthcare (including safety and quality of care issues).

Test Your Knowledge: Health Care Reform

In light of recent Supreme Court discussions regarding health care reform, CNN Health recently released a list of interesting facts entitled “10 Lesser Known Effects of Health Care Reform Law”. While the nation continues to discuss specific provisions of the Patient Protection and Affordable Care Act, signed into law March 23, 2010, take a look at CNN’s list and see how much you know!

10 Lesser Known Effects of Health Care Reform Law (Source: CNN.com)
1. How many goodies your doctors get
The Physician Payment Sunshine Act under health care reform requires drug, device or medical supply companies to report annually certain payments or things of value that they've given physicians and teaching hospitals. This could be speaking fees, consulting fees, meals and travel.

2. More breastfeeding rooms and breaks
Employers [with 51+ employees] must provide “a place, other than a bathroom, that is shielded from view and free from intrusion from co-workers and the public, which may be used by an employee to express breast milk.” Nursing mothers also can take “reasonable” breaks during the workday to express milk, as frequently as the mother needs.

3. Caloric reality at every major chain restaurants
The law requires restaurants with 20 or more locations to list calorie content information for standard menu items on menus and drive-through menus. Other fun facts like fat, saturated fat, cholesterol, sodium, total carbohydrates, sugars, fiber and total protein would have to be made available in writing upon request.

4. Abstinence-only education
The health care legislation renews $50 million per year for five years for abstinence-only education. According to the Department of Health and Human Services, “programs that receive this funding must teach that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems.”

5. Flexible spending accounts stiffen
Flexible spending accounts previously could be used to buy over-the-counter drugs and vitamins. As of 2011, the accounts became restricted to prescription drugs. Health care related purchases that still qualify include condoms, contact lens solution, home diagnostic tests and bandages. But note that in 2013, your contribution amount to these accounts will have an annual limit of $2,500; previously there was no limit.

6. Tanning will cost you
You've been paying a 10% tax every time you've visited the tanning booth, thanks to health care reform. The UV-emitting tanning devices have been classified as “carcinogenic to humans” by the International Agency for Research on Cancer, which is part of the World Health Organization.

7. Support for wellness programs at work
The health care reform law gives companies incentives to start wellness initiatives. Small business got incentives in 2011, when companies with fewer than 100 employees working at least 25 hours per week became eligible for wellness program grants. The law sets up a $200 million grant program from 2011 to 2015. As of 2014, participants in wellness programs generally can get discounts or rewards from their employers of up to 30% of the cost of their health care premiums (currently, the maximum discount is 20%).

8. Free preventive care
Mammograms, physical exams, colonoscopies, vaccinations—these are among the preventive care services that will be fully covered by insurance companies. This requirement kicked in for new health insurance plans that began on or after September 2010. Examples of preventive care include screenings for cholesterol, diabetes, HIV and sexually transmitted diseases, which are covered without a co-pay.

9. Home visits to expecting families
The law also includes funding support for early childhood home visitation for people expecting children and families who have young children. Professionals come to the home to provide information and support. The aim is to reduce child abuse and neglect, promote the health of mothers and their children and prioritize high-risk populations. The health care law provides $1.5 billion for related state-based initiatives over five years.

10. Health plans you can read
The health reform law requires health insurers and health plans to provide concise and understandable information about the plan and its benefits. Patients have a right to two key documents to understand and compare their health insurance choices: a comprehensible summary of benefits (which is standardized similar to nutrition facts on packaged foods) and a glossary of terms of health insurance coverage.

March 27 is Diabetes Alert! Day

Does someone in your care have diabetes? Or do you have a friend or family member who is affected by the disease? As healthcare professionals we understand that education is the key to helping people live longer, healthier lives. The more we know—and the more we share with our patients, friends, families and colleagues—the more we can bring about change.

March 27 celebrates the 24th Annual American Diabetes Association Alert! Day—a one-day “wake-up call” asking the American public to take the Diabetes Risk Test to find out if they are at risk for developing type 2 diabetes. Because more than 25 million U.S. children and adults—8.3% of the country’s population—have diabetes, and because nearly 2 million new cases are reported each year, understanding the disease is now more important than ever.

This year the ADA will be encouraging people to learn, communicate and share information about diabetes using Facebook as well as adding motivational incentives for people to take the test and spread the word via their social networks.

Want to learn more? Visit the Care2Learn diabetes education library for a complete list of courses on diabetes care and management—including diabetes complications, nutrition therapy for diabetics, and understanding barriers to behavior change in diabetes self-management and education.

High Demand for Therapy Jobs in 2012

It seems everywhere you turn these days you hear more bad news about the U.S. job market, but a recent Forbes.com article provides a silver lining for at least one group of professionals: rehabilitation therapists.

Currently the demand for physical therapists and occupational therapists is “critically high,” and experts say the trend is likely to continue as the need for PT and OT services outweighs the number of therapy professionals presently working. Not only that, but because the average age of therapists is 57, analysts worry the shortage will increase as those individuals retire and fewer new therapists take their place.

Physical therapists in particular are “among the most secure professionals in the healthcare industry,” the article states, citing a report from online job search leader Monster.com, and according to the U.S. Bureau of Labor Statistics employment of physical therapists is expected to grow by 30 percent from by the year 2018—significantly faster than the overall average. Similarly, employment of occupational therapists is expected to grow by 26 percent.

New Therapy CE for 2012

Care2Learn kicks off the New Year with four new accredited Therapy CE courses on key topics like video modeling, conflict resolution and negotiation to improve patient outcomes. Let’s get learning!

Video Modeling: A Research-Based Approach (1430A)
Author: Laurie Jacobs, MA, CCC-SLP
CE: 1 hour
Accreditation: Approved for OT

This Intermediate Level course will help learners discover the effectiveness and high motivational levels found in students when using video modeling to increase social skills. Students will learn the ins and outs of creating their own videos and ways to use wisely what is on the market today.

Conflict Resolution: Working with Advocates (1433A)
Author: Deborah Adamczyk Dixon, M.A. CCC-SLP
CE: 1.25 hour
Accreditation: Approved for OT

This Introductory Level course provides an overview of the tools available to manage conflict. Working with parent advocates can be a challenging situation. However, given the right skill set, it can also be an opportunity to enhance relationships, collaborate and be innovative.

Best Practices for Empowering Adolescents to be Partners in the Learning Process (1435A)
Author: Vicki Lord Larson, PhD, CCC-SLP
CE: 1 hour
Accreditation: Approved for OT

This Intermediate Level course will discuss best practices and guiding principles to empower adolescents to join in the learning process. Emphasis will be on developmental issues during adolescence, assessment approaches to foster adolescents’ participation, and learning principles and strategies for achieving academic progress, interacting in personal-social situations, and reaching vocational potential.

Conflict Resolution: Exploring and Identifying Areas of Interest for the OT (1444A)
Author: Nicholas R. Martin, M.A.
CE: 1 hour
Accreditation: Approved for OT

“Interests” refers to the good intentions and anticipated benefits that drive the positions that participants at IEP meetings may take. One of the keys to team success is knowing how to explore and clarify these interests. In this Introductory Level course, participants are provided with easy-to-follow and practical steps to guide them through the four elements of “principled negotiation,” of which the exploration of interests is the key ingredient.

Look What's New!

Care2Learn is continually expanding its online education library to meet the needs of our healthcare professionals. Here are six new Inservices and four new Therapy CE Courses added in December:

INSERVICES:

Medical Device Reporting (P1226A)
Author: Kimberly A. Mulquin, BSN, MBA, RN, CPHQ
NON CE: 1 hour

This course is designed to help staff identify and report medical device-related incidents as soon as possible after their occurrence in order to initiate corrective action, prevent or minimize the occurrence of similar incidents, and to comply with the Federal Medical Device Safety Act.

Cardiovascular: Conditions and Treatment for Non-Clinical Professionals (P1218A)
Author: Kimberly A. Mulquin, BSN, MBA, RN, CPHQ
NON CE: 1 hour

The purpose of this course is to introduce the non-clinical professional to the anatomy of the cardiovascular system, common diseases that affect proper functioning, and treatment options.

Respiratory System: Conditions and Treatment for Non-Clinical Professionals (P1219A)
Author: Kimberly A. Mulquin, BSN, MBA, RN, CPHQ
NON CE: 1 hour

The purpose of this course is to introduce the non-clinical professional to the anatomy and physiology of the respiratory system, common conditions that compromise proper function of the respiratory system, and treatment options.

Musculoskeletal: Conditions and Treatment for Non-Clinical Professionals (P1220A)
Author: Kimberly A. Mulquin, BSN, MBA, RN, CPHQ
NON CE: 1 hour

The purpose of this course is to introduce the non-clinical professional to the anatomy of the musculoskeletal system, common diseases and conditions that affect proper functioning, and treatment options.

Safe Transportation of Passengers (P1224)
Author: Marilyn Weese
NON CE: 1 hour

This course examines basic concepts of safe driving techniques. There is emphasis on the danger of aggressive driving, ways to prevent road rage, and the issues involved in safely transporting passengers.

Abuse of the Elderly on the Job: Don’t Let it Be Me (P1225)
Author: Barbara Acello, RN
NON CE: 1 hour

The goal of this inservice is to help staff members understand how their actions can be seen as abuse and what to do to prevent abuse of residents in their care.

THERAPY CE:

Achieving Communication Competence: Assessment for Intervention with Multimodal Communication including AAC (1422A)
Author: Yvonne Gillette, Ph.D.
CE: 1 hour
Accreditation: ASHA registration effective 12/7/11 (SLP)

This Intermediate Level course acquaints the student with the concept of Achieving Communication Competence, a clinical protocol SLPs can follow to assess communication for interventions addressing severe communication disabilities. The protocol considers environmental factors—communication settings, opportunities, and partners—as well as communication skills-interaction and message sending/receiving. SLPs and daily communication partners assess, plan and implement the plan together.

Conflict Resolution: Building a Bridge across an Impasse (1423A)
Author: Nicholas R. Martin, M.A.
CE: 1 hour
Accreditation: Approved for OT/OTA

“Failure is not an option” when children’s educations are at stake, yet very few of the many people participating in adult individualized education program (IEP) meetings have been trained in how to work through disagreement and strong emotion so as to maintain collaboration and achieve consensus. This Introductory Level training provides practical steps that can lead through impasse to success or minimize the damage if agreement will not be reached.

Conflict Resolution: Exploring and Identifying Areas of Interest (1424A)
Author: Nicholas R. Martin, M.A.
CE: 1 hour
Accreditation: ASHA registration (SLP and AUD)

“Interests” refers to the good intentions and anticipated benefits that drive the positions participants at IEP meetings may take. One of the keys to team success is understanding how to explore and clarify these interests. This Introductory Level course provides easy-to-follow and practical steps to guide participants through the four elements of “principled negotiation,” of which the exploration of interests is the key ingredient.

Educational versus Clinical Evaluations: What’s the Difference? (1425A)
Author: Elizabeth Wall, MS, OTR, BCP
CE: 1 hour
Accreditation: Approved for OT/OTA

This Intermediate Level course addresses the differences between educational and clinical evaluations in occupational therapy. The differences are rooted in the contexts in which these evaluations are performed. Those contexts as well as resulting implications for evaluation are discussed in detail.