Elopement, Dementia and Winter - A Fatal Combination

A tragic story from Portland, Oregon, underlines the unspeakable consequences when a resident of an adult care home elopes from the facility. The resident, Mr. Koller, age 69, suffered from severe dementia.

According to the report, the care center's staff noticed he was missing and notified the authorities. Heartbreakingly, Mr. Koller was found dead in a backyard near the care facility. He was not dressed for the cold weather. 

From my perspective, there is critical information missing from the report. For example, what was the elapsed time from when staff last saw Mr. Koller and when they noticed he was missing? How long after the facility knew Mr. Koller was missing before someone contacted the authorities for outside assistance. Finally, what precautions did the facility have in place to prevent such a tragedy.

A close eye needs to be kept on people who suffer from severe dementia. Adequate precautions need to be taken to prevent elopement by these folks. A facility should have the staff and resources to ensure all residents, including those who suffer from severe dementia, are kept safe.

If adequate steps are not taken, a fatal tragedy can occur.  

Dementia And Antipsychotic Medications In Nursing Homes

A recent story by , addresses the use of antipsychotic medications in treating dementia in nursing home residents. The story begins with the story of Hazel Eng, a resident of the Ecumen home in North Branch, Minn. "Day after day, Hazel Eng sat on her couch, a blank stare on her face. The powerful antipsychotics she was taking often cloaked her in sedation. And when they didn't, the 89-year-old lashed out at her nursing home's aides with such anger and frequency her daughter wondered if her mother would be better off dead." When Ms. Eng was transferred to another section of the facility and was removed from her antipsychotic medications, there was a dramatic change. "She now beams as she ambles the hallways, reads the newspaper, tells stories and constantly laughs."

According to Mr. Sedensky: "Antipsychotics are meant primarily to help control hallucinations, delusions and other abnormal behavior in people suffering from schizophrenia and bipolar disorder, but they're also given to hundreds of thousands of elderly nursing home patients in the U.S. to pacify aggressive and paranoid behavior related to dementia."

The use of antipsychotic medications to treat dementia is an "off-label" use. According to a 2007 government audit, approximately 83% of Medicare claims for antipsychotic drugs were for purposes including the treatment of dementia.

So what, you might ask. Isn't it better to medicate a resident suffering from dementia so they do not harm themselves or others? The answer is an absolute and resounding: NO! Use of antipsychotic medicine to "treat" the symptoms of dementia creates its own set of issues. "The drugs can limit seniors' ability to effectively communicate, socialize or participate in everyday life."

Thankfully, according to the article, the off-label use of antipsychotic medications to treat dementia in the nursing home setting has decreased over the past decade.

If you have a loved one who suffers from dementia and is receiving antipsychotic medicine, you should speak with your physician. Make sure the medications are necessary and are being used correctly. If your loved one seems "out-of-it" during visits, it may very well be the result of the medications he or she is receiving. It is up to you to make sure each and every medication prescribed to a loved one is absolutely necessary.

September 21 - Today Is World Alzheimer's Day

According to the Center for Disease Control's website, September 21 is World Alzheimer's Day. Here are some disturbing facts about Alzheimer's disease:

  • It is currently estimated that approximately 2.6 million to 5.2 million Americans currently have Alzheimer's disease, depending upon the approach used for identifying individuals with dementia.
  • If no cure is developed and present population trends continue, as many as 16 million individuals may have Alzheimer's disease by the year 2050.
  • Alzheimer's disease ranks as the 6th leading cause of death among adults aged 18 years and older, and is the 5th leading cause of death for adults aged 65 years and older.
  • For people with Alzheimer's disease and other dementias, the total payments for health care, long-term care, and hospice are projected to increase from $183 billion in 2011 to $1.1 trillion in 2050 (in 2011 U.S. dollars).

Indeed, Alzheimer's disease is "the most common form of dementia among older adults.

If you or someone you know has Alzheimer's, take a look at the CDC website. It has more interesting and informative information and links to other sources.