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Kelsey Firsick, BSW Mitchel P. Kohnen, BS Kinesiology Jeff Loraine RN,DON NHC Healthcare of Maryland Heights.

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Presentation on theme: "Kelsey Firsick, BSW Mitchel P. Kohnen, BS Kinesiology Jeff Loraine RN,DON NHC Healthcare of Maryland Heights."— Presentation transcript:

1 Kelsey Firsick, BSW Mitchel P. Kohnen, BS Kinesiology Jeff Loraine RN,DON NHC Healthcare of Maryland Heights

2 Learning Objectives To allow for alternative programing to help reduce need for antipsychotic medications To assist care givers in developing therapeutic techniques to manage difficult behaviors To promote strategies to assist with improving cognition and decreasing depression To facilitate programs to maintain or improve functionality in dementia patients with behaviors

3 Program Development Initial program started to increase quality of life in dementia patients with behaviors Later developed to comply with CMS initiative to reduce antipsychotic usage in dementia patients with behaviors Aimed at reducing difficult behaviors Enhanced programing to combine cognitive stimulation and physical exercise

4 Cognitive Stimulation Therapy Cochrane Database concluded: 1. CST programs benefit cognition in persons with mild to moderate dementia as much as cholinesterase inhibitors 2. Shown to improve quality of life and be cost effective Professor Martin Orrell, University College of London Performed training for our center and region

5 Cognitive Stimulus Training(cont.) Two Comprehensive training manuals, Making A Difference &Making A Difference volume 2. Manual for group leaders by Aimee Spector, Lene Thorgrimsen, Bob Woods, & Martin Orrell by Hawker Publications & The Journal for Dementia Care $30 each

6 Cognitive Stimulus Training

7 Program Development Cognitive Stimulation Therapy Physical Stimulation Therapy Small groups (6-10) people Groups meet twice a week 3 groups formed Consist of a set warm up followed by a predetermined topic of interest All residents get involved Multiple visual and tactile aids Walking and exercise program performed before each meeting Residents walk an average of 10 minutes and perform 6-8 repetitions of resistance exercises

8 Program Development Appointed 2 Memory Care Liaisons Assist with memory care unit and operations as well as program development for Cognitive and Physical Stimulation Different focus for each Exercise Activity Work in conjunction and combine specialties to enhance programing

9 Efficacy Participants where assessed for baseline cognition and depression before program began and after 7 weeks

10 Efficacy SLUMS & BIMS utilized to measure baseline cognitive function PHQ-9 for depression edu/agingsuccessfully /pdfsurveys/slumsexa m_05.pdf edu/agingsuccessfully /pdfsurveys/slumsexa m_05.pdf

11 Resistance Therapy

12 Dosage Reduction Program participants reviewed for potential reduction Anti-psychotic utilization reviewed by Medical Director, Consultant Pharmacist, & Primary Physician Decrease in psychotropics done gradually

13 Dosage Reduction Occupancy NHC MH – 93% MO – 67.9% Natl Avg. – 82.2% Psychiatric DX. NHC MH- 61.9% MO- 59.8% Natl Avg. – 55.4% Antipsychotic Usage NHC MH – 14.9% MO – 28.4% Natl Avg. – 25.2%

14 Conclusion Enhanced the quality of life of the cognitively impaired Programming has allowed for increased resident and family satisfaction Allowed healthcare center to diversify its services and provided additional referral source Decreased hospital readmission rates Staff acquisition of new skill sets to assist with caring for the cognitively impaired

15 Questions?


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