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"caption": "Diane Schoenfeld (left) and her aunt, Lillie Manger, look at old family photos in the dining room of Berkeley's Chaparral House, the nursing home Manger lives in. ",
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"bio": "\u003cp dir=\"ltr\">Rachel Dornhelm has worked as a reporter, editor and producer in public radio for the last twelve years. She got her start in New York City at WNYC and went on to work with the national business program Marketplace, WBUR’s “On Point” and KQED News in San Francisco. Her work has been honored by the LA Press Club and the SF-Peninsula Press Club.\u003c/p>\r\n\r\nRachel has a BA with honors in anthropology from Rice University and did graduate work at NYU.",
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"disqusTitle": "Calming Dementia Patients -- Without Powerful Drugs",
"title": "Calming Dementia Patients -- Without Powerful Drugs",
"headTitle": "State of Health | KQED News",
"content": "\u003cp class=\"\">Diane Schoenfeld is a weekly visitor at the Chaparral House nursing home in Berkeley.\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She comes every Friday to spend time with her aunt, Lillie Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, an homage to the dancer she used to be.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s me?” asks Manger\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s you,” her niece confirms.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Am I supposed to remember?” says Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld smiles at her encouragingly. \u003c/span>\u003cspan class=\"\">“I don’t know if you’re supposed to. It’s OK either way.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger has dementia. Schoenfeld is her \"surrogate decision maker\" meaning that, legally, she is the person who makes decisions about Manger's health care. Schoenfeld has filled me in on her story. This is the second nursing home where Manger has lived. The first was 45 minutes away, and Schoenfeld wasn’t able to visit as often. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At that first nursing home, staff had recommended antipsychotic sedatives for Manger’s behaviors, like crying out and outbursts. Schoenfeld shared staff notes with me about the recommendations. She says she wasn’t thrilled but agreed. She thought her aunt might get better care, \u003c/span>\u003cspan class=\"\">“rather than (staff) being unhappy with her behavior.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>\u003cspan class=\"\">Coming Out of a Fog\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Two years later Schoenfeld had moved her aunt to Chaparral House, to have her closer. By this time, Manger appeared to be in a fog. Eventually, Schoenfeld broached the idea of weaning her aunt from the medication with Chaparral House. As soon as they did, she says things turned around. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“I could see her personality again, I was so happy,\" Schoenfeld said. \"My sister came to visit and (Lillie) used my sister’s name and clearly recognized her, which we had not seen in the years that she was on the medication. I only wish I had done that sooner.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld says it just didn’t feel right to have her aunt sedated.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If a baby is crying, I mean most people will go to a baby and comfort them. They won’t try to ignore them and drug them,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">[soundcloud url=\"https://api.soundcloud.com/tracks/206401562\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">KJ Page, administrator of Chaparral House, shares that philosophy. Page says in many cases dementia patients came to their facility with a prescription to be given antipsychotics half an hour before bathtime. Then, a number of years ago she read a book called \u003ca href=\"http://bathingwithoutabattle.unc.edu/\" target=\"_blank\">Bathing Without a Battle\u003c/a> about bathing dementia patients and why it can be such a challenge.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She asks people to imagine putting yourself in the place of the nursing home resident. “A person they didn’t know, couldn’t recognize, comes to take off their clothes,\" she says. \"Ah! No wonder they’re screaming and fighting and kicking!”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says after that “Aha!” moment, the staff came to a new agreement. The residents were not out running marathons, for instance, or other sweat-inducing activities, so regular showers weren't necessary. Instead, residents would have a regular caregiver do simple sponge baths. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says the results inspired further changes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“It just rolled into what else are they fighting for, and why do we need to have a fight?\" Page says, \"What can we do to make it easier for people and the staff? And that’s how we approached it from there on.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It worked. While Page says antipsychotics do have a place for some people, not one of Chaparral House’s dementia patients is currently taking the medications. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Grading Nursing Homes on Avoiding Antipsychotic Drugs\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Federal Changes Chaparral House's experience is unusual. In California nursing homes, just over 15 percent of dementia patients are on these drugs. That’s far more than advocates say is necessary. But that number is actually down from almost 22 percent just three years ago. That’s when the \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-07-08-00151.pdf\" target=\"_blank\">federal government \u003c/a>began regulating \u003c/span>\u003cspan class=\"\">their use for dementia in nursing homes. This came in response to several studies warning the medicines had \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124830.htm\" target=\"_blank\">serious risks\u003c/a> including, strokes, falls and even death.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The new guidelines stipulate that nursing homes are graded on the percent of their dementia patients receiving antipsychotic medications. That figure becomes part of their rating on \u003ca href=\"http://www.medicare.gov/NursingHomeCompare/About/HowWeCalculate.html\" target=\"_blank\">Nursing Home Compare\u003c/a>, a tool from Medicare that helps consumers compare information about nursing homes. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The drugs are traditionally deployed to control what is seen as problem behaviors. Reducing the medication requires new approaches and retraining staff to deal with people with dementia. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Enter Caroline Stephens, a\u003c/span>\u003cspan class=\"\">ssistant professor at the UCSF school of nursing, who specializes in psychiatric care for the elderly and long term care policy.\u003c/span>\u003c/p>\n\u003cp class=\"\">She says that the new regulations have had a positive impact on staff. \"\u003cspan class=\"\">They’re now realizing we don’t have to reach for the medication and they’re getting to think creatively about what we can do for this resident.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Clinicians Become 'Good Detectives'\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">I meet Stephens at the Hayward Healthcare & Wellness Center nursing home, where she consults. She helps train nurses and staff on person-centered care, being attentive to the cues that people give and trying to understand what is bothering them, even if they can’t communicate it directly.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens tells me the new regulations have given more credence to this medical approach. She describes one of her success stories helping a dementia patient who was always fighting to leave the facility at the end of the day.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“They felt they needed to catch the bus, they had to get home because they need to take care of their daughter,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Instead of physically restraining the person or prescribing medication, Stephens says they put a sign on the door that said, simply, \"It’s a holiday; buses aren’t running today.\" The sign worked. The person stopped fighting to leave and there was no need for antipsychotic medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At another nursing home, Stephens consulted with staff about a resident who was disruptive and constantly wandered at night -- including into other patients’ rooms. He had been given an antipsychotic to control his behavior. But in a deeper look at his background, staff learned that he’d worked as a night security guard for most of his adult life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The staff came up with a new plan. They gave the resident a badge and clipboard and walked with him on an abbreviated set of “evening rounds.” Sure enough, after that he’d willingly go to bed, and they were able to take him off medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens says when the patients themselves can’t communicate it’s vital to talk to family, to find out what the person did for a living, what they enjoyed in life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">\"It is our job as clinicians to be good detectives,” she explains.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">This is especially important as nursing homes serve an increasingly diverse clientele. Stephens says the nursing home model was built around an older, white, female patient. Today, the demographics have changed.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At Hayward Healthcare and Wellness, she says, \"There are probably 15 different racial groups and a minimum of five languages spoken.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cb>Risk of Cherry-Picking Patients\u003c/b>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">One of the big advocates for the federal regulations was Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. He welcomes the guidelines, but says he has noticed a concerning unintended consequence. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">While across the state the overall rate has dropped, he says he has noticed that several hundred nursing homes have rates that have either stayed the same or increased, in some cases almost doubled.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says that in an effort to decrease their patients on antipsychotics to get better ratings, some facilities may be cherry-picking patients, essentially warehousing the hardest to wean from anti-psychotics in the bleakest facilities.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says for families and caregivers can look up a nursing home’s antipsychotic drug use rates as well as other drug usage on websites including \u003ca href=\"https://www.medicare.gov/nursinghomecompare/?AspxAutoDetectCookieSupport=1\" target=\"_blank\">Nursing Home Compare\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Still, these guidelines and ratings only cover nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says increasingly he is fielding calls from families worried about the use of antipsychotics in assisted living and home care settings, which don’t fall under the regulations.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“We need to be more proactive about trying to get data for assisted living facilities and reconfiguring our message so it’s more applicable to assisted-living facilities,” Chicotel says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It seems likely, though that that is coming. Earlier this year, the GAO released \u003ca href=\"http://www.gao.gov/products/GAO-15-211\" target=\"_blank\">a report\u003c/a> urging HHS to expand their regulation of antipsychotics in dementia patients to settings other than just nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">UCSF professor Stephens says this points to retraining ever more medical professionals in patient-centered care, eliminating the need for patients to be medicated as a form of restraint.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If we can train generalists I think we can make some headway,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cem>\u003cspan class=\"\">Rachel Dornhelm wrote this piece with support from the \u003ca href=\"https://www.geron.org/press-room/journalists-in-aging-fellows-program\" target=\"_blank\">Journalists in Aging Fellows Program\u003c/a> of the Gerontological Society of America and New America Media, sponsored by the AARP.\u003c/span>\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "\"I could see her personality again, I was so happy,\" a niece says of her 97-year-old aunt. ",
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"description": ""I could see her personality again, I was so happy," a niece says of her 97-year-old aunt. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"\">Diane Schoenfeld is a weekly visitor at the Chaparral House nursing home in Berkeley.\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She comes every Friday to spend time with her aunt, Lillie Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, an homage to the dancer she used to be.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s me?” asks Manger\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“That’s you,” her niece confirms.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“Am I supposed to remember?” says Manger.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld smiles at her encouragingly. \u003c/span>\u003cspan class=\"\">“I don’t know if you’re supposed to. It’s OK either way.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Manger has dementia. Schoenfeld is her \"surrogate decision maker\" meaning that, legally, she is the person who makes decisions about Manger's health care. Schoenfeld has filled me in on her story. This is the second nursing home where Manger has lived. The first was 45 minutes away, and Schoenfeld wasn’t able to visit as often. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At that first nursing home, staff had recommended antipsychotic sedatives for Manger’s behaviors, like crying out and outbursts. Schoenfeld shared staff notes with me about the recommendations. She says she wasn’t thrilled but agreed. She thought her aunt might get better care, \u003c/span>\u003cspan class=\"\">“rather than (staff) being unhappy with her behavior.”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>\u003cspan class=\"\">Coming Out of a Fog\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Two years later Schoenfeld had moved her aunt to Chaparral House, to have her closer. By this time, Manger appeared to be in a fog. Eventually, Schoenfeld broached the idea of weaning her aunt from the medication with Chaparral House. As soon as they did, she says things turned around. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“I could see her personality again, I was so happy,\" Schoenfeld said. \"My sister came to visit and (Lillie) used my sister’s name and clearly recognized her, which we had not seen in the years that she was on the medication. I only wish I had done that sooner.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Schoenfeld says it just didn’t feel right to have her aunt sedated.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If a baby is crying, I mean most people will go to a baby and comfort them. They won’t try to ignore them and drug them,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/206401562&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/206401562'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">KJ Page, administrator of Chaparral House, shares that philosophy. Page says in many cases dementia patients came to their facility with a prescription to be given antipsychotics half an hour before bathtime. Then, a number of years ago she read a book called \u003ca href=\"http://bathingwithoutabattle.unc.edu/\" target=\"_blank\">Bathing Without a Battle\u003c/a> about bathing dementia patients and why it can be such a challenge.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">She asks people to imagine putting yourself in the place of the nursing home resident. “A person they didn’t know, couldn’t recognize, comes to take off their clothes,\" she says. \"Ah! No wonder they’re screaming and fighting and kicking!”\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says after that “Aha!” moment, the staff came to a new agreement. The residents were not out running marathons, for instance, or other sweat-inducing activities, so regular showers weren't necessary. Instead, residents would have a regular caregiver do simple sponge baths. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Page says the results inspired further changes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“It just rolled into what else are they fighting for, and why do we need to have a fight?\" Page says, \"What can we do to make it easier for people and the staff? And that’s how we approached it from there on.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It worked. While Page says antipsychotics do have a place for some people, not one of Chaparral House’s dementia patients is currently taking the medications. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Grading Nursing Homes on Avoiding Antipsychotic Drugs\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Federal Changes Chaparral House's experience is unusual. In California nursing homes, just over 15 percent of dementia patients are on these drugs. That’s far more than advocates say is necessary. But that number is actually down from almost 22 percent just three years ago. That’s when the \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-07-08-00151.pdf\" target=\"_blank\">federal government \u003c/a>began regulating \u003c/span>\u003cspan class=\"\">their use for dementia in nursing homes. This came in response to several studies warning the medicines had \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124830.htm\" target=\"_blank\">serious risks\u003c/a> including, strokes, falls and even death.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The new guidelines stipulate that nursing homes are graded on the percent of their dementia patients receiving antipsychotic medications. That figure becomes part of their rating on \u003ca href=\"http://www.medicare.gov/NursingHomeCompare/About/HowWeCalculate.html\" target=\"_blank\">Nursing Home Compare\u003c/a>, a tool from Medicare that helps consumers compare information about nursing homes. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The drugs are traditionally deployed to control what is seen as problem behaviors. Reducing the medication requires new approaches and retraining staff to deal with people with dementia. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Enter Caroline Stephens, a\u003c/span>\u003cspan class=\"\">ssistant professor at the UCSF school of nursing, who specializes in psychiatric care for the elderly and long term care policy.\u003c/span>\u003c/p>\n\u003cp class=\"\">She says that the new regulations have had a positive impact on staff. \"\u003cspan class=\"\">They’re now realizing we don’t have to reach for the medication and they’re getting to think creatively about what we can do for this resident.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cstrong>Clinicians Become 'Good Detectives'\u003c/strong>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">I meet Stephens at the Hayward Healthcare & Wellness Center nursing home, where she consults. She helps train nurses and staff on person-centered care, being attentive to the cues that people give and trying to understand what is bothering them, even if they can’t communicate it directly.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens tells me the new regulations have given more credence to this medical approach. She describes one of her success stories helping a dementia patient who was always fighting to leave the facility at the end of the day.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“They felt they needed to catch the bus, they had to get home because they need to take care of their daughter,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Instead of physically restraining the person or prescribing medication, Stephens says they put a sign on the door that said, simply, \"It’s a holiday; buses aren’t running today.\" The sign worked. The person stopped fighting to leave and there was no need for antipsychotic medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At another nursing home, Stephens consulted with staff about a resident who was disruptive and constantly wandered at night -- including into other patients’ rooms. He had been given an antipsychotic to control his behavior. But in a deeper look at his background, staff learned that he’d worked as a night security guard for most of his adult life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">The staff came up with a new plan. They gave the resident a badge and clipboard and walked with him on an abbreviated set of “evening rounds.” Sure enough, after that he’d willingly go to bed, and they were able to take him off medication.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Stephens says when the patients themselves can’t communicate it’s vital to talk to family, to find out what the person did for a living, what they enjoyed in life. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">\"It is our job as clinicians to be good detectives,” she explains.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">This is especially important as nursing homes serve an increasingly diverse clientele. Stephens says the nursing home model was built around an older, white, female patient. Today, the demographics have changed.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">At Hayward Healthcare and Wellness, she says, \"There are probably 15 different racial groups and a minimum of five languages spoken.\"\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cb>Risk of Cherry-Picking Patients\u003c/b>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">One of the big advocates for the federal regulations was Tony Chicotel, staff attorney with California Advocates for Nursing Home Reform. He welcomes the guidelines, but says he has noticed a concerning unintended consequence. \u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">While across the state the overall rate has dropped, he says he has noticed that several hundred nursing homes have rates that have either stayed the same or increased, in some cases almost doubled.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says that in an effort to decrease their patients on antipsychotics to get better ratings, some facilities may be cherry-picking patients, essentially warehousing the hardest to wean from anti-psychotics in the bleakest facilities.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says for families and caregivers can look up a nursing home’s antipsychotic drug use rates as well as other drug usage on websites including \u003ca href=\"https://www.medicare.gov/nursinghomecompare/?AspxAutoDetectCookieSupport=1\" target=\"_blank\">Nursing Home Compare\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Still, these guidelines and ratings only cover nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">Chicotel says increasingly he is fielding calls from families worried about the use of antipsychotics in assisted living and home care settings, which don’t fall under the regulations.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“We need to be more proactive about trying to get data for assisted living facilities and reconfiguring our message so it’s more applicable to assisted-living facilities,” Chicotel says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">It seems likely, though that that is coming. Earlier this year, the GAO released \u003ca href=\"http://www.gao.gov/products/GAO-15-211\" target=\"_blank\">a report\u003c/a> urging HHS to expand their regulation of antipsychotics in dementia patients to settings other than just nursing homes.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">UCSF professor Stephens says this points to retraining ever more medical professionals in patient-centered care, eliminating the need for patients to be medicated as a form of restraint.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cspan class=\"\">“If we can train generalists I think we can make some headway,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"\">\u003cem>\u003cspan class=\"\">Rachel Dornhelm wrote this piece with support from the \u003ca href=\"https://www.geron.org/press-room/journalists-in-aging-fellows-program\" target=\"_blank\">Journalists in Aging Fellows Program\u003c/a> of the Gerontological Society of America and New America Media, sponsored by the AARP.\u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"info": "Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. Download Chris’s Song of the Week plus other highlights from the broadcast. Produced by American Public Media.",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"id": "mindshift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 13
},
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"order": 12
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
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"our-body-politic": {
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"title": "Our Body Politic",
"info": "Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.",
"airtime": "SAT 6pm-7pm, SUN 1am-2am",
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},
"link": "/radio/program/our-body-politic",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw",
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"order": 15
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"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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