April 2023 Newsletter
The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) provides mental health and substance use evidence-based training, customized technical assistance, and resources to certified Medicare and Medicaid nursing facilities who care for residents with a variety of behavioral health conditions at absolutely no cost. To submit a request for assistance, complete the online request form at https://nursinghomebehavioralhealth.org/.
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In This Issue
- April is Alcohol Awareness Month
- Signs and Symptoms of Unhealthy and/or Excessive Alcohol Use
- Action Steps & Interventions to Address Unhealthy and/or Excessive
- Alcohol Use by a Resident
- Did You Know?
- Register for the May COE-NF Training Sessions
- You Matter
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April is Alcohol Awareness Month
The month of April which is Alcohol Awareness Month is coming to a close. This month of awareness began in 1987 as a public health program, organized by the National Council on Alcoholism and Drug Dependence (NCADD). Use of alcohol by residents in nursing facilities presents a unique challenge to staff who must balance the responsibility of caring for the safety of their residents, while also ensuring that all residents’ rights are protected.The use of alcohol by residents can range from mild to moderate use (such as social drinking) to unhealthy and/or excessive use that puts residents’ health and safety at risk. Some residents may even have a history of alcohol use disorder and may be struggling with their addiction.
For many, denial is a prevailing characteristic among those struggling with alcoholism or alcohol abuse. Denial is also common among friends and family members who are uneasy acknowledging the seriousness and reality of the situation. Residents may:
- Conceal how much they drink
- Play down and/or lie to others about their alcohol consumption
- Underestimate the duration of their drinking problem and/or make light of the impact it has had on their life
- Overestimate their power to control their drinking and/or to quit
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Signs and Symptoms of Unhealthy and/or Excessive Alcohol Use
As a nursing facility staff member, you can observe and monitor your residents for any changes in their behavior or appearance over time. Following are several signs and symptoms of unhealthy and/or excessive use of alcohol to watch out for.
- Increased and/or unexplained drowsiness
- Lack of coordination which could lead to falls and injuries
- Slurred speech
- Mood changes
- Loss of consciousness
- Smell of alcohol on breath
What can you do today?
- Educate all staff on the signs and symptoms of unhealthy and/or excessive alcohol use. (See list above.)
- Encourage staff to take action and report when they observe the signs and symptoms of unhealthy and/or excessive alcohol use.
- Prepare now by identifying effective interventions that can be put in place when a resident is using alcohol in an unhealthy and/or excessive way. (See examples below.)
Source: Adapted from CMS Appendix PP State Operations Manual (page 20)
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Action Steps & Interventions to Address Unhealthy and/or Excessive Alcohol Use by a Resident
Hold an interdisciplinary care planning meeting to assess the situation. Set goals and plan necessary healthcare adjustments to address the resident’s unhealthy and/or excessive alcohol use. Potential interventions may include:
- Assessing the resident for any adverse reactions from alcohol usage.
- Reviewing resident’s medications for any contraindications with alcohol use and determining if any medications must be temporarily held or discontinued.
- Engaging the resident in a conversation about their behavior and staff concerns.
- Using a screening tool to evaluate the resident’s alcohol use (for example, the Alcohol Use Disorders Identification Test (AUDIT)).
- Referring the resident (and friends and/or family members, if applicable) to Alcoholics Anonymous (AA) or peer support groups.
- Identifying the root cause of excessive alcohol use and developing a plan to address it. (For example, have there been any recent life changes such as a new loss, illness, etc.?)
- Restricting or supervising visitation if the resident’s visitor(s) are deemed a danger to the resident, other residents, and/or staff.
- Obtaining permission from the resident to test their blood alcohol level using a breathalyzer if there are concerns that suspected alcohol use could adversely affect the resident’s condition.
- Obtaining permission from the resident to inspect their person and/or belongings if there is reasonable suspicion of possession of unauthorized alcohol which could endanger the resident or others.
- Increasing monitoring and supervision in the facility to maintain the health and safety of the resident suspected of excessive alcohol use, as well as all residents.
The COE-NF is available to support your facility
in any of these guidance areas.
Contact the COE-NF today. Click HERE to request assistance.
in any of these guidance areas.
Contact the COE-NF today. Click HERE to request assistance.
Source: Adapted from CMS Appendix PP State Operations Manual(pages 336-337, 500-501)
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Did You Know?
Drinking too much, whether it’s on a single occasion or over time, can compromise your health. The brain, heart, liver, pancreas, immune system, and other bodily organs and systems may all be affected by over drinking. Over drinking may also put you at a higher risk of developing alcohol-associated cancer. Here are ways in which alcohol affects your brain and immune system.
Brain:
Alcohol impedes the brain’s communication pathways and can change the way the brain looks and works, thus changing mood and behavior and making it more difficult to think clearly and move with coordination.
Immune System:
Drinking too much can weaken your immune system, making your body more susceptible to diseases, such as pneumonia and tuberculosis. Over drinking, even on a single occasion, slows your body’s ability to fight infections and this may last up to 24 hours after over drinking.
Print and share this flyer with your team or post in a staff break room to educate them about effect of alcohol on the body. Click HERE to download and print.
Source: Adapted from https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
Brain:
Alcohol impedes the brain’s communication pathways and can change the way the brain looks and works, thus changing mood and behavior and making it more difficult to think clearly and move with coordination.
Immune System:
Drinking too much can weaken your immune system, making your body more susceptible to diseases, such as pneumonia and tuberculosis. Over drinking, even on a single occasion, slows your body’s ability to fight infections and this may last up to 24 hours after over drinking.
Print and share this flyer with your team or post in a staff break room to educate them about effect of alcohol on the body. Click HERE to download and print.
Source: Adapted from https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
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Register for the May COE-NF Training Sessions
There will be two (2) QPR sessions held in May.
Audience: All nursing facility staff
Duration: 90 minutes
Description: QPR is an evidence-based suicide prevention training that teaches three simple steps that anyone can learn to help save a life from suicide. QPR is the most widely taught Gatekeeper Training (GKT) in the world.
Certification Details:This session provides a QPR certification for two years.
Registration is limited to 35 participants.
Friday, May 5, 2023
2 – 3:30 p.m. EST
2 – 3:30 p.m. EST
Monday, May 15, 2023
2:30 – 4 p.m. EST
2:30 – 4 p.m. EST
Tuesday, May 10, 2023
2 – 2:30 p.m.
Audience: All nursing facility staff
Duration: 30 minutes
Description: This training will provide key components to creating a trauma informed approach in nursing facilities.
Friday, May 19, 2023
11 – 4:30 p.m. EST
Audience: All nursing facility staff
Duration: 90 minutes
Description: Mental Health First Aid (MHFA) gives you the skills to reach out and provide initial help and support to someone who may be developing a mental health or substance use challenge or experiencing a crisis.
Certification Details: This session provides a MHFA certification for three years.
To register to attend the Mental Health First Aid training,
please email your name, email address, agency and training date to coeinfo@allianthealth.org two weeks prior to the date of interest.
Registration is limited to 15 participants.
A minimum of five (5) participants is required for the session to occur.
Wednesday, May 24, 2023
2-3 p.m. EST
Audience:All nursing facility staff
Duration:60 minutes
Description: Topics covered in this presentation will include the definition of a co-occurring disorder, how substance use disorders and mental illness interact, person-centered recovery, integrated co-occurring disorders treatment and more.
Duration:60 minutes
Description: Topics covered in this presentation will include the definition of a co-occurring disorder, how substance use disorders and mental illness interact, person-centered recovery, integrated co-occurring disorders treatment and more.
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You Matter
Experiencing ongoing stress can take a toll on your mind and body. When you find this happening to you, take a moment to help yourself refocus and get grounded.
Click HERE for a helpful grounding exercise. By taking just a few minutes to practice this grounding exercise, you can calm your worried thoughts and your body.
Be sure to share this information with staff or post it in the facility break room. Staying grounded can also be a helpful technique for residents.
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Contact us:
For more information, please call 1-844-314-1433 or email coeinfo@allianthealth.org.
To submit a request to inquire about substance use and/or mental health training options for your facility, complete the inquiry form.
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Alliant Health Solutions (AHS) was awarded a three-year cooperative agreement from the Substance Abuse and Mental Health Services Administration (SAMHSA), in collaboration with the Centers for Medicare & Medicaid Services (CMS), to create a COE-NF. AHS has over 50 years of experience working with nursing homes and behavioral health in nursing homes.
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This newsletter was made possible by grant number 1H79SM087155 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Substance Abuse and Mental Health Services Administration.
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