GDR's, what has been your experience?

[terraqueous]

I work in LTC and am just appalled at mandated gdr's (gradual dose reductions) on psychotropic drugs for our residents. They are truly my pet peeve right now, maybe in part because the powers to be at my facility are so zealously reducing medications at every turn. These are people who are stable on their current regimen--why subject them to possible worsening symptoms, depression or anxiety? Should they not tolerate the reduced dosage well, it is hard sometimes to get them back to their previous level of functioning and balance. Their physicians can deny a proposed dose reduction but it seems too often they sign off on the reduced dosage for no other reason than its mandated for the NH to attempt gdr's. I understand there is some good reasoning behind the plan, but in reality, it just seems like experimenting with these peoples' well being. What has been other experiences with gdr's?

[RN&mom]

I feel your pain with GDR's! My facility actually does very well and only has residents that truly need them on these meds (not sure exact percentage but its low). There are some diagnosis that exclude a pt from GDRs (they probably have to have tried at least once and failed, I'm not sure about that though)... Yet the physicians will just sign off anyway, I fight this, and just got a pt back to regular dose after several days of increased behaviors. I have a GDR book so when the doctor tries to do reductions too soon I can show him its not necessary, it hasn't been 6 months... Some pts do well with these but 1 failure should be enough, we should not keep torturing our pts by repeatedly putting them through this!!!