This section contains detailed information about psychopharmacological
management for persons with dementia and other forms of mental illness.
All practice recommendations are compatible with OBRA guidelines for nursing
home care. Medication advisories are available for distribution to your
family caregivers.
| 1. | Dementia afflicts 10% of people over the age of 65. |
| 2. | Alzheimer’s disease causes most dementia in older persons
(60-70%) and cholinesterase inhibitors significantly improve patient
outcomes. |
| 3. | Adverse drug reactions account for 10-20% of hospitalizations for
older persons. |
| 4. | Many older persons self-administer more psychotropic medications
than prescribed. |
| 5. | Polypharmacy is a serious problem for older persons. |
| 6. | Federal nursing home regulations govern the prescription of all
psychotropic medications. |
| 7. | Anti-psychotic dose reductions are not required for nursing home
residents with serious mental illnesses, e.g., schizophrenia, and
other serious mental illnesses. |
| 8. | Newer anti-psychotics are the first line treatment for psychosis
or severe behavioral problems as opposed to older medications. |
| 9. | Older persons should use one pharmacist who checks all over-the-counter
and prescription medications for drug-drug interactions. |
| 10. | Avoid long-acting benzodiazepines in older people. |
| 11. | Many (10-20%) elderly patients admitted to hospitals have unrecognized
delirium. |
