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Geriatric Practice pp 441–451Cite as

Managing Medications and Addressing Polypharmacy

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Abstract

Restraints have been used in the care of older adults in healthcare settings and at home for many years. Restraint use in the United States of America has been under national scrutiny since the 1980s, when federal regulations regarding their use were issued.

Indications for use across all healthcare settings are regulated by the Centers for Medicare and Medicaid Services (CMS). The prevalence of physical restraints in the healthcare setting is highest in intensive care units. Pharmacological restraints are still widely used in older adults for the treatment of behavioral and psychological symptoms of dementia, and for the treatment of delirium, throughout healthcare settings, despite Food and Drug Administration (FDA) warnings regarding the associated risks. Nursing homes have been targeted by regulatory agencies due to their history of high off-label usage of antipsychotic medications. Despite CMS initiatives, psychotropic use as a form of pharmacological restraint remains prevalent in nursing homes nationwide. National quality campaigns have developed educational and organizational guidelines and strategies to reduce use of both physical and pharmacological restraints.

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Author information

Authors and Affiliations

  1. Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai Hospital, New York, NY, USA

    Ruth M. Spinner

  2. The New Jewish Home, Manhattan, New York, NY, USA

    Ruth M. Spinner

  3. Department of Family Medicine/Geriatric Medicine, Archbold Memorial Hospital, Thomasville, GA, USA

    Savitri Ramdial

Authors
  1. Ruth M. Spinner
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  2. Savitri Ramdial
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Correspondence to Ruth M. Spinner .

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Editors and Affiliations

  1. Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Audrey Chun

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Spinner, R.M., Ramdial, S. (2020). Managing Medications and Addressing Polypharmacy. In: Chun, A. (eds) Geriatric Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-19625-7_35

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  • DOI: https://doi.org/10.1007/978-3-030-19625-7_35

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19624-0

  • Online ISBN: 978-3-030-19625-7

  • eBook Packages: MedicineMedicine (R0)

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