The use of antipsychotic drugs has been linked to a handful of lasting side effects, including weight gain, type II diabetes, hyperlipidemia and depression, among others. Antipsychotics are occasionally used to treat behavioral problems in older patients with aggressive mental illnesses, such as Alzheimer’s and dementia. However, these prescriptions often do more harm than good – significantly increasing the likelihood of patient depression and mortality.
The Quality Improvement Organization (QIO) Program aims to reduce the use of unnecessary antipsychotic medication in Medicare beneficiaries with mental illnesses. As part of their quality improvement activities, the QIO Program’s 14 Quality Innovation Network-QIOs (QIN-QIOs) are tasked with spreading successful innovations and evidence-based practices to other health care providers for maximum regional and national impact. The Great Plains Quality Innovation Network (QIN) – the QIN-QIO for Kansas, Nebraska, North Dakota and South Dakota – recently contributed to the spread of a successful quality improvement program among nursing homes that are part of its Nursing Home Quality Care Collaborative (NHQCC) in South Dakota.
The Sanford Care Center Vermillion (SCCV) in Vermillion, South Dakota has been working to reduce antipsychotics and improve dementia care of residents by using arts engagement activities for the past three-and-a-half years. In October 2015, SCCV began pilot testing the “Music & Memory” program. Originally founded in 2006 by social worker Dan Cohen, Music & Memory gained significant traction and awareness among nursing homes across the country after being featured in the 2012 documentary “Alive Inside.” During the SCCV pilot program, facility staff members downloaded music onto donated iPods and headsets, and periodically played music as a form of care for its residents. Family members helped identify songs and music that residents enjoyed.
Observations of the five SCCV residents participating in the program showed that music treatments significantly decreased agitation and increased responses of joy during and after music sessions.
Since early 2013, SCCV has decreased its long-stay antipsychotic medication quality measure on its Certification and Survey Provider Enhanced Reports (CASPER) by 74%, going from a 23.5% facility rate to a 6% facility rate. The nursing home’s Music & Memory program is one of several contributors to that reduction. As a result of this success, the nursing home is expanding the program to other residents.
The Great Plains QIN publicized SCCV’s success story to other long-term-care facilities via its monthly NHQCC e-newsletter. This coverage led another nursing home in South Dakota to express interest in the program. That nursing home currently is securing the necessary technology and funding to start its own Music & Memory program.