Massachusetts Senior Care Foundation

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Reducing Off-Label Use of Antipsychotics in Nursing Homes:  OASIS

Numerous studies have demonstrated serious health risks associated with the use of antipsychotic medication in older adults with dementia. In September 2012, Massachusetts Senior Care Association in collaboration with the Massachusetts Department of Public Health (DPH), launched the first of three one year initiatives aimed at safely reducing the off-label use of antipsychotic medication in treating nursing facility residents with dementia through implementation of OASIS, a curriculum authored by Dr. Susan Wehry, a geriatric psychiatrist and former Vermont Commissioner of the Department of Disabilities, Aging and Independent Living. The OASIS curriculum and training equips frontline nursing home staff with the knowledge, skills and attitudes to meet the needs of residents with dementia using non-pharmacologic approaches rather than medication.

The statewide initiative built on the success of an 11 facility OASIS pilot project in 2011, funded by the Commonwealth Corporation, which demonstrated positive outcomes for residents and statistically significant declines in antipsychotic use. Funding for the statewide OASIS trainings was made possible by a grant from the Massachusetts Department of Public Health, Bureau of Health Care Safety and Quality.

From 2012 – 2016, staff from 363 Massachusetts nursing facilities have participated in one or more of three rounds of statewide OASIS training, with additional participation from Massachusetts Department of Public Health surveyors, and nursing home ombudsmen from the Massachusetts Executive Office of Elder Affairs. Since OASIS training was first implemented, there has been a 29% total statewide drop in the rate of antipsychotic drug use for long stay nursing home residents from 2011 (baseline) through 2015. 

 
  

 
OASIS Training Materials

Please click the following links to download training materials from the OASIS 2.0TM curriculum. 

OASIS Curriculum Manual 

Introduction 
How to Use This Curriculum

Training Manual
A Guide for Facilitators and Champions

 Module I
• The Evolving World of Long Term Care (PowerPoint - allow time to download)
Basic Human Needs
• Creating OASIS 2.0TM Moments
• Language Matters
• Power of Labels Exercise

Module II
• Walking the Walk (PowerPoint - allow time to download) 
Suzanne's Story
• Strength-Based Case Planning
• What People with Alzheimer's Can Do

Module III
Dementia (Part I) Lookng from the Outside in (PowerPoint - allow time to download)
The Six Domains of Habilitation
Responding to the person with Dementia
• Activity Based Care
Fact Sheet: Ten Tips for Talking with a Person with Dementia
The Brain and its Functions
Supporting Personhood Attachment
• Supporting Personhood Identity

Module IV
• "So that's what you're trying to tell me!" (PowerPoint - allow time to download)
Worksheet - Huddle
Guided Imagery: The experience of being afraid 

Module V
• Creating Positive Conditions (PowerPoint - allow time to download)
Guided Imagery: Moving In
• Maslow's Hierarchy of Needs Worksheet
Basic Human Needs Worksheet

Families Module
• OASIS 2.0TM  for Families (PowerPoint - allow time to download)

Resources
 Get to Know Me Poster 
• VIPS Facility Self Assessment Tool
VIPS Powys Tool 
Trigger Cards 
• OASIS 2.0 References

 Please click here to access the OASIS curriculum videos.

This Massachusetts program to reduce off label use was featured in Provider Magazine, published by the American Health Care Association. Click here to see a copy of the article.

To learn more about OASIS or the OASIS curriculum, please contact Carolyn Blanks, Executive Director, Massachusetts Senior Care Foundation at cblanks@maseniorcare.org.