Model treatment for Alzheimer's - Sarasota Herald-Tribune

<p>The onset of Alzheimer's disease in a loved one can be overwhelming for a spouse and other family members. But, as revealed last Sunday in a poignant Herald-Tribune story by Barbara Peters Smith, a cup of tea, simple acts of kindness and a little ingenuity sometimes can make a world of difference.</p><p>Smith wrote of Bob Vago, an Osprey man so devoted to his wife of 62 years that he visits her early every morning, before she awakes, in her room at a local nursing home. He makes her tea and a jam half-sandwich and they chat.</p><p>Bob's daily routine with his wife, Kay, helps calm the anxiety common to Alzheimer's sufferers and precludes the need for the nursing home staff to administer antipsychotic drugs.</p><p>Such dedication is rare, but Bob is not alone in his struggle to forestall the use of medication that he feels is destructive to Kay's well-being but which is common in the treatment of Alzheimer's.</p><p>Efforts to replace antipsychotics with specialized behavioral therapy are underway across the nation and in our own backyard, at The Pines of Sarasota.</p><p>As Smith's article notes, the strategy that Bob Vago discovered on his own "is what specialists in the field call 'person-centered care,' which is part of a movement, underway for years in the long-term care business."</p><p>A national coalition, the Dementia Initiative, Smith wrote, has called "for a departure from treating dementia mainly as a medical condition," instead placing "a greater emphasis on social support."</p><p>Drugs carry risks</p><p>Antipsychotic drugs address troublesome behaviors that can accompany dementia, including yelling, wandering, aggression and resisting care. But studies have shown that use of the drugs in older dementia patients can increase the risk of stroke and even death.</p><p>For more than 25 years, federal law has required that antipsychotics be used in nursing homes only when necessary to ensure the safety of a resident or others. Yet, surveys have found that more than a quarter of nursing home residents are given antipsychotics. Their use can be even more pronounced in special Alzheimer's units.</p><p>Last year, the Centers for Medicare and Medicaid launched a national initiative to reduce the use of antipsychotics in nursing homes and to substitute behavioral therapy.</p><p>Many nursing homes, which are frequently understaffed and put a premium on efficient handling of patients, have been slow to adapt to the recommended changes.</p><p>But the Garden Memory Unit at The Pines of Sarasota, a nonprofit nursing home and assisted-living center, has been a pace setter. A 2011 article by Smith detailed creative treatment trends at the Pines that included karaoke, customized song playlists, painted beach scenes and other comforts to calm dementia patients.</p><p>The low-cost therapies were so successful at easing patients' agitation that dosages of antipsychotic medications dropped to less than half the state average, Smith noted. The activities also help stroke victims overcome despondency and social withdrawal.</p><p>Yet, while The Pines' success is admirable and encouraging, much of the caregiving of Alzheimer's patients is performed not in nursing homes but in private homes, and not by professionals but by family members or close friends.</p><p>Help for caregivers</p><p>For personal caregivers, help is available.</p><p>The Pines Education Institute is a regional training center for professionals and at-home caregivers. The institute provides outreach programs, support, resources and counseling to family members and caregivers.</p><p>In addition, Senior Friendship Centers hosts Caregiver Resource Centers in Sarasota and Venice, providing educational and training programs, information on caregiving services, support groups and adult day services.</p><p>The trend toward person-centered care is a heartening development in dementia care, a subject of immense significance as national and global populations grow increasingly gray. As medical advances prolong life, a rising tide of Alzheimer's and dementia patients poses an extraordinary challenge.</p><p>Bob Vago is meeting his personal challenge with tremendous dignity, patience and love. He and Kay offer a model for families and professionals to emulate.</p>