NORTH BRANCH, Minn. -- Contentment lives with the family albums of Hazel Eng. Hundreds of times since her Alzheimer's diagnosis she has studied her life in the black & white photos she keeps tucked in a dresser drawer. Yet each day they seem new to her.
"Who is that?" asks Eng's daughter Jean Lynch, as her mother fixes her eyes on a picture of herself as a girl.
"I don't know," answers Eng.
"Yesterday it was you," smiles Lynch as she gently guides her mother through pages, so unfamiliar to her mother, yet at the same time a source of contentment.
It's a state of mind, Lynch will gladly take. "Two years ago it was not happy days."
Two years ago Hazel was heavily drugged with antipsychotics - prescriptions designed to treat mental illness - but often prescibed "off label" as chemical restraints to calm dementia and Alzheimer's patients like Hazel.
"She would hit the people and she was not happy at all," says Lynch about the time her mother spent in another wing of the Ecumen senior community in North Branch. "I would just die every time the phone would ring."
Day and night Eng ground her teeth as the pills kept coming. "It just constantly zoned her out, but the agitation never left," said Lynch.
Then Hazel Eng had her awakening. "We honestly saw a change in three days," says Eng.
"Awakenings" is the one-year-old pilot project at 15 Ecumen skilled nursing facilities, funded by a $3.7 million dollar grant from the state of Minnesota.
That precious healthcare dollars are being spent on such an initiative is a response to a growing awareness nationwide of the overuse in nursing homes of antipsychotics.
"Government, taxpayers, nursing home residents as well as their families and caregivers should be outraged and seek solutions," said Daniel Levinson, inspector general of the U.S. Department of Health and Human Services, in releasing results of a 2007 audit that showed one in seven nursing home residents are given antipsychotics.
In contrast, the 15 North Branch patients in the Awakenings program are either off antipsychotics, or being weaned. Instead they receive more one-on-one attention from caregivers trained to make drugs a last resort, rather than a first call.
Taped to the wall of each resident's room is an "in-the-know board," a chart that lists the resident's favorite subjects, activities and colors. It is information that can come in handy when a dementia patient is acting out, says Pat Voelker, Ecumen's North Branch administrator. "If your favorite color is blue, then, 'Let's put on the blue dress. You look so pretty in blue.'"
That's just one example of the strategy behind Awakenings. Another can be found in the dining area, where meals are now served without a rush to finish so tables can be cleared. Instead caregivers sit ready to help, but give residents time to feed themselves, regardless of their pace.
As Hazel Eng picked up food with her fingers, her daughter sat at her side. "When she was on the drugs she would just not pick up any food and put it in her mouth," Lynch points out.
"We try to look at the behaviors as more of a way of them trying to tell us what they need," says Stephanie Johnson, a registered nurse and one of three part-timers hired to work specifically with residents in the North Branch Awakenings program. Johnson isn't sure antipsychotics can ever be completely eliminated from patient care, but reducing their use when possible is the goal.
Another Alzheimer's patient, Melvin Babcock, is propelling himself in his wheelchair again, while gradually being weaned from antipsychotics. His son Gary recently bought him new bicycle gloves to replace the pair his dad wore out.
Gary Babcock says the change came quickly after the drugs were reduced. No more finding his father slumped in his chair. "He was just too tired to stay awake," says Gary Babcock.
Babcock keeps a notepad of his father's words, the first he'd heard him utter in two years. "He said, 'That's our son Gary.' I heard that as I was leaving the room and I couldn't believe it."
As a younger man, Melvin Babcock was a mechanic who drove school buses. Aware of that, his caregivers made sure Babcock got a good close-up look at the bus that dropped off student volunteers at the Ecumen facility.
"It's really easy to pick up the phone and say, 'Doctor, so and so is calling out, could we have medication?' versus, you know, 'Mary, let's talk about what you did when you were younger.'"
Hazel Eng takes only one daily drug now: her aspirins.
"She's content in her own little brain," says her daughter. "In her own little mind, she's fine - and she is fine."
(Copyright 2011 by KARE. All Rights Reserved.)