comaok

Having been "told" that my 60 bed "Dementia" unit was flagging high for Antipsychotic use in 2008, I fought tooth and nail (and thought I'd get fired at one point) the whole GDR idea. I sited most of the reasons you and other stated. When told it HAD to be done, I picked the worst residents with the most behaviors and met with my team. Honestly I assumed we'd try it and it would fail and I could say, "Yeah we tried it, you were wrong, now leave me alone." Instead what we found was that by learning a lot more about the residents and their needs we were able to go from 33% to 2% in four years and the only residents still on antipsychotics, also have a diagnosis of Schizophrenia. Everyone with "Dementia with behavioral Disturbance" as a diagnosis was gradually reduced and eventually completely antipsychotic free. It took a lot of work, a lot of tears and a lot of arguing and was not an easy road. It is in the end better for the residents and the staff and in most cases when we looked at the resident on the medication, they were still exhibiting the same behaviors we put them on the drugs for in the first place. The rational was - if they still have the behavior, the drug isn't working anyway. Along with a whole lot of other interventions and personalized care. Not every story was a success, but for the most part my staff did great work and I have become a believer.