The Prescribing Cascade

"I'm having difficulty sleeping, doc." Robert's physician prescribed a sleeping aide so Robert can sleep better at the long-term care facility he resides. Then, Robert starts to feel irritable in the morning when he awakes. Subsequently, he is prescribed an anti-anxiety medication to take in the morning and as needed. Roberts starts taking the anti-anxiety medication and then starts to feel more sleepy during the day, less productive and motivated, groggy, and having difficulty concentrating. He's isolating more in his room and not spending time doing the things he used to like to do. And because he is sleeping more during the day, he isn't sleeping much at night, even though he continues to take the sleep aide that his physician prescribed. He lets his physician know that he has been sleeping more than usual, not as sociable as he used to be, is having difficulty concentrating, and unmotivated. His physician then prescribes Robert an anti-depressant...When does it stop?!

A side...

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A Dementia Case Study in Treating Clean: My Name is Betty

"Betty was having a particularly tough afternoon. As the hours wore on, she started to become agitated with the people around her. She was wandering with an angry look, cursing, unwilling to listen, and trying to push people away if they became physically close. Betty repeated to herself, 'I want to go home; I want to go home.'

I stepped in to help calm Betty and prevent any further escalation. Approaching Betty gently, I presented myself in a calm manner with a smile on my face. I spoke to Betty in a calm, monotone voice. I played soothing sounds, used a lavender essential oil blend aromatically, and gave her a light touch so she knew that she was safe. Betty calmed down within minutes and even wanted to spend more time together."

Betty lived in a memory care facility. Appealing to Betty’s senses helped to deescalate the moment (visual, auditory, olfactory and tactile stimulation) and made her feel calm, while it made me feel confident and competent for helping her....

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Everyone Wins when Healing Clean

Using non-pharmacological techniques, whether in dementia care, mental health treatment, or practicing self-care, is a step to thinking, feeling, treating, and eventually healing clean. When we heal clean, everyone wins on both sides of those non-pharmacological techniques. How does that happen?

When using non-pharmacological techniques, we have control of what we are doing, when we do it, and how we do it. The 'what' is important to know that the things we are using are healthy for us or with whom we are treating; that we aren't filling our bodies, minds, and brains with toxins, minute killers, carcinogens, or contamination or that we won't have to deal with all these negative side effects. Actually, often times when we use non-pharmacological techniques, there are side benefits to the 'what' we are using. For example, maybe filling out crossword puzzles is stimulating and invigorating, leaving you feeling productive and ready to start the day. But a side benefit is that it is also...

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Clean Dementia Care

In the effort to think, feel, treat, and heal clean, how does this apply to dementia care. It's pretty typical that as part of the disease process, those with dementia will display a number of behavioral symptoms as a way to communicate. These behavioral symptoms mean something. The individual may be hungry, thirsty, tired, in pain, or needs to use the bathroom. Or the individual might be anxious, sad, angry, scared, or bored. However, sometimes these behavioral symptoms put the individual and their care partners at risk for injury. It's important as care providers that we help to anticipate what the individuals in our care need so they don't have to act out to show us they need something. However, when the individual with dementia does act out we need to recognize what's happening and intervene.

Unfortunately, often times an as needed psychotropic medication is used immediately at hopes to stop the behavior. Essentially it slows down the individual and sometimes even makes them...

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Clean Faster

What if we told you that you can treat clean faster? This means that non-pharmacological tools can work faster than most as needed, oral medications used to treat anxiety, excessive agitation, and more. 

In long-term care, and most other treating entities, CMS requires that healthcare providers attempt to use non-pharmacological interventions first before giving medications to treat symptoms of dementia and mental health concerns - anxiety, depression, agitation, wandering, repetitive behaviors, hoarding, aggression, and so on. Treating clean in this fashion is a Win, Win! Your organization is in compliance, it helps your 5-star rating and increases your reimbursement, while the resident or patient is not dealing with the negative side effects of these medications, like falls, confusion, irritability, and upset stomach. 

The other advantage is that you can treat clean faster. Did you know that it can take minimally 30 minutes for as needed medications to start working, and...

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Is Your Community CLEAN?

As time progresses, we think it is safe to say that we are maneuvering under a strict cleanliness guide. At the very least, it is the one thing we know for sure.

Unfortunately, COVID has presented challenges in communities that have been difficult to navigate. Each day, we struggle with deciding our next steps as the unknown is great. Emotionally and physically, we are challenged as each day passes to create a safe environment. Statistically, the vintage folks are at a much higher risk, but we believe that natural solutions can be quite effective and consoling.

We have been extremely impressed with some implementations that have been occurring in communities and facilities. Essential oils and aromatherapy have been used for thousands of years and can be added to aid in cleanliness. This tool is popping up more and more in the medical community as a way to aid them for their patient care. It is such a positive step in the direction to supporting the body and brain at being...
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Think Clean

Everyone is pretty keen on cleanliness these days! And, why shouldn't they be? We are living in a society that has relied heavily on being clean. What does that mean? Should we be concerned with over-clean? Don't we rely on bacteria and viruses to keep our immune systems strong? Is there a balance? How about being clean with your emotional and cognitive health?

We think that there is and so do other communities, like yours, that are adding additional layers of support using non-pharmacological care. We thought we would share some really great ideas that you can implement; we can even help create a program just for you and yours in mind. Here is some food for thought.

In a small study of 28 individuals with dementia, a blend of rosemary and lemon were used in the morning, and one made from lavender and orange in the evening, as summarized on Health and Healing NY. Patients who were diagnosed with Alzheimer's showed a positive change in dementia...

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The Next Pandemic: Post-Traumatic Stress

From the beeping of machines to patients gasping for air, from seeing your loved one for the last time on FaceTime to making funeral arrangements, from working in your office at work to filling your full-time hours at home while homeschooling your children, from socializing in your community groups to being isolated at home, from working on the frontlines to then developing symptoms and isolating from your family, from going to regular Tuesday BINGO group to being in your room all the time in a nursing home  and watching through the window young kids playing in their pool across the street, this pandemic has affected all of us in some way. All of our experiences might be different but what is common is the realization that this has been a traumatic, trying time etched in all of our minds. 

I believe our next pandemic will be suffering from post-traumatic stress.

Trauma is experienced differently from one person to the next. Someone may be coping well while another may feel...

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Anxiety in Dementia

Anxiety and worry will show up differently for our family, patients and clients who have dementia. It would be great if they could just say, “I’m feeling really anxious right now.” To recognize and then verbalize it is something we might expect but won’t get. If we continue to expect this to happen, then this in of itself leaves us as caregivers endlessly frustrated. I mean, many of us don’t recognize and verbalize it unless we have really good insight. How would we expect people with dementia to do this?

So why can’t they just tell us? Unfortunately, the skills needed to do just this simple task are dwindling, like insight, good judgement, problem-solving, anticipating risks and language, because the parts of the brain that manage and control these skills are affected by the disease little by little. 

Therefore, instead of words, individuals with dementia are going to show us in other ways that they are anxious. For instance, they might...

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What is Aromatherapy?

     Aromatherapy is an intervention that I not only use personally for myself and my family but also for my patients and clients. I wanted to share an excerpt from my new book that will launch an innovative dementia care model in Spring 2021, being published by Johns Hopkins University.

    ‘Aromatherapy is a relatively safe, all-natural use of essential oils to provide healing of the mind, body, and spirit. Essential oil use can be a form of olfactory, gustatory (taste), and tactile (touch) stimulation. Although research has shown that smell may decrease as Alzheimer disease progresses, the nose is still an entry way for the sensory stimuli of essential oils because the nasal cavity and nerve cells in the nasal lining are the closest entry to the limbic system. This connection between the sense of smell and the limbic system accounts for influence of essential oils on mood and memory. When using essential oils, they want to restore the body back to...

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