Over medicating in care facilities, and self-medicating, or in some cases, over- self-medicating at home is not new and it’s not confined to the elderly, who are often thought to be forgetful and not ‘checking it twice’. Medication over-use and misuse is sadly, and often tragically a growing problem amongst all age groups.
Thankfully, when it comes to seniors and those of significantly advanced age, clinical staff in many care facilities are addressing the issues head-on and hands-on, examining what patients are taking and why. Very often, the ‘why’ is taken care of right away when drugs are no longer ordered as the condition for which they were required no longer exists. That should beg another question - why, in some cases, was a drug no longer required still being prescribed and dispensed? Along with that is learning how drugs interact with each other and how some drugs offer the same benefit as other drugs and taking away one cuts into ‘duplication of services’.
The rationale of prescribing drugs that serve only to sedate should be examined more closely via conversations with the patient, as he is able, and anyone attached to him who has regular contact who knows how the patient lives/copes on a day to day basis. Once in assisted care, a lot of the routine tasks normally undertaken by the elderly person are charged to someone else - a nurse or other caregiver. That being so, some of the previously ‘required’ drugs, like those for pain management, may not be indicated. Again, conversations about the ‘why’ of pharmacological intervention is critical.
In the clinical care setting, there has to be an admission of culpability by hands-on clinicians that some patients are sometimes or even frequently sedated for the convenience of staff. If asked, I’m sure some frontline health care workers will admit to wanting to sedate ‘so-and-so’ ‘because s/he’s too needy, too demanding’, ‘always ringing the nurse’, and so on.
Nashwaak Villa and many other such facilities, with the Planetree model in place, have gone a long way to enhancing quality of life of their residents. Inviting the community to ‘come on in’ has been a huge success. Seniors in care have lost access to a big part of themselves and their identity - the community in which they live. They’re now relegated to a life behind brick walls. Certainly, facilities are high tech, but they’re still ‘facilities’, and they are sterile no matter how much of ‘home’ is brought in to ‘pretty up’ a room. It’s the ‘people connection’ that will ultimately make a huge difference in the life of an older person in care, even if dementia plays a role in their daily interactions. Wouldn’t it be great if a hug could be pulled out of a bottle and dispensed at will? It’s long been demonstrated that a touch, a hug, a kind word, and a smile go a long way to lifting the mood. Make no mistake, a senior, even those lost in dementia, need all of that and more. Their need for connection doesn’t disappear the moment they pass through the doors of a care facility. In fact, it’s even more critical that they be made not to feel abandoned and forgotten.
Planners of primary and elementary education are developing programs that include ‘friendly visiting’ at local nursing homes. Young school children are often removed from what goes on with the older persons in their community by virtue of age, certainly, but also because lots of children are still functioning in the ME mode, which is to be expected. But, at some stage, they have to be guided into more WE activities and what better way to do that than to get them acquainted with serving the community, serving those who have lived and worked in the community for decades. The young meeting the old must be part of the circle of life, to coin a popular phrase. No one should live in isolation at the end of their days. That’s not humane.
Youngsters, if given the opportunity, would enjoy spending time with older people, hearing their stories, listening to and singing their songs, sharing a meal. The daughters of my former mail carrier are testament to that, thoroughly enjoying their time with the folks at Nashwaak Villa - breaking bread together.
Imagine what the lost art of actually making bread together could accomplish? Dough kneading has been proven to help persons recovering from stroke with the repetitive motion of hands and arms communicating with the brain to restore function. As well, on many levels, persons with dementia will ‘remember when’, if they are given opportunities to ‘get back in the kitchen’. The mutual benefits to a 7 year old and a 70 year old rolling up their sleeves to work together for a few hours a week are many and will create cherished memories. No pills required.
Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with her aging Australian silky terrier and a rambunctious Maltese. She can be reached via email at carmacrockwell@xplornet.ca
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