Maine Partnership to Improve Dementia Care in Nursing Homes
The Centers for Medicare and Medicaid Services (CMS) initiated a national campaign in 2012 to reduce the use of antipsychotic drugs in nursing home residents with dementia. CMS led the efforts
to establish dementia partnerships in each state to support nursing homes to achieve an initial reduction of 15% and a 30% reduction by the end of 2016.
In response to the initiative, the Ombudsman Program, the Maine Culture Change Coalition and the Maine Health Care Association joined forces in July 2012, to create the statewide Maine Partnership
to Improve Dementia Care in Nursing Homes. The goal of the Partnership is to provide education and support to all nursing homes across the state as they provide care to residents with dementia.
The Partnership is assisting nursing homes by providing inspiration, training and support in their efforts to reduce the use of antipsychotic medications for residents with dementia.
Training and support provided by the Partnership focus on person-centered care as well as non-pharmacological interventions.
Throughout the initiative, Maine nursing homes have consistently been among the most improved in the country, exceeding the goals set by CMS.
Brenda Gallant, Executive Director/State Long-Term Care Ombudsman
Nadine Grosso, Vice President, Maine Health Care Association
Dr. Jabbar Fazeli, Maine Geriatrics
Music & Memory Project
With approval from the Maine Department of Health and Human Services (DHHS) Division of Licensing and Certification and CMS, the Partnership received grant funds in 2016 to implement the Music
and Memory Project in up to 50 nursing homes across the state. All participating homes were required to complete dementia certification training provided by the Music and Memory Foundation.
Each nursing home chose 10 residents with dementia who would benefit by utilizing a personalized music playlist that could be listened to on an iPod. Residents with dementia receive many
benefits from this program including: reduced depression, increased interaction with others and reduced agitation.
In addition, Dr. Jabbar Fazeli, a Fellowship Trained and Board Certified Geriatrician provided consultation to nursing home staff and Medical Directors as requested regarding the care of residents
with dementia. Dr. Fazeli also provided education to Medical Directors through his membership in the Maine Medical Directors Association.
In 2017 the grant was renewed to add an additional 20 homes to implement Music and Memory across the state. Click here to review the report on the first year of the
Music & Memory Project.
Direct Care Staff Training
In 2014, training in dementia care was provided across the state for over 200 direct care staff employed in nursing homes. The "Hand in Hand" training program developed by CMS was utilized by
staff from the Northeast Health Care Quality Foundation. In addition, a train the trainer training session was held so that additional staff could benefit from the dementia care training.
In 2017, Dr. Susan Wehry, a nationally recognized Geriatric Psychiatrist provided Oasis training for direct care staff. This evidence based training focuses on person-centered care and understanding
all behavior as communication.
The Maine Partnership to Improve Dementia Care in Nursing Homes plans additional training for direct care staff in 2017.
Resident and Family Education
The Partnership members understand the great importance of educating families about anti-psychotic drugs. With this in mind, the Partnership developed a fact sheet to provide information about
potential side effects and risks of these drugs.
Beginning in 2016, nursing homes with low utilization of antipsychotics volunteered to serve as mentors to provide support for homes with higher utilization of these drugs. This project was
implemented with enthusiasm and effort with telephone consultation as well as onsite visits between participating homes. Though no additional resources were provided for this project, a real
benefit to resident care was derived by this approach.