Reducing Anti-Psychotic Medications starts with reducing the external causes of resident distress, which manifests itself in what we may classify as “behaviors”, but which we really need to understand instead as distress signals.
If we see “behaviors” as distress signals, rather than stop the behaviors, we need to stop the distress. To do that, we need to discover what is causing the distress.
In the first video below, Susan Wehry, MD, explains that agitation means HELP and aggression means STOP. Once we understand this, we can then begin to figure out what distress needs to be addressed. The second video, a graphic excerpt from Bathing Without A Battle, illustrates how aggression means STOP.
Key external causes of distress include whether we are following a resident’s customary routines, whether a person feels rushed or uncomfortable in care, noises such as alarms or clanging, and a person’s need for a sense of safety, connection and well-being. The answer will come when we know that the “behavior” is not just a natural extension of a person’s dementia or mental illness but a call for us to change our behavior and help make things right for them.
To reduce use of anti-psychotic medications, use consistent assignment so staff know residents well. Have huddles to share information and problem-solve. Ask about residents’ customary routines and honor them from day one.