b'ALTERNATIVE THERAPYpush-back, recalls Batson. Our goal was to talk about theNow, adds Batson, Families and residents are actually potential benefits this treatment posed to residents whoseeking Dr. Pearson out because they see the positive werent having optimal results, and how we needed to tryresults of the cannabinoid medicine in thissomething different. particular setting.Next, Batson adds, the team consulted on how theCommon questionscannabis oil would be administered and how the resultsAccording to Dr. Pearson, one the most common would be monitored. We measured it and handled it likequestions about cannabinoid medicine is simply how to it was a narcotic, which made everyone feel comfortable.determine when it can (and should) be given to residents. From there, we began administering and tracking the Its important to be realistic about cannabinoid-based data that long-term care normally would track using medication because it doesnt work for everybody. Its a the MDS (Minimum Data Set) tool, pain scores, medication, and like any medication, there has to be a solid DOS (Dementia Observation System) tracking, and justification, whether youre using it to address chronic different assessment tools. pain, anxiety, or other related issues.This calculated approach helped position cannabis asAs for how it may be administered, there are options. For a viableand in many cases, preferredtreatmentsome, the solution may be to mix cannabis oil in with a alternative for Trillium Villas residents. It also went a longresidents foods (e.g., applesauce), while others may prefer way towards boosting engagement among staff to ingest the oil by itself. As for the dosing, Dr. Pearson and residents.explains, Many of our residents are on a CBD (cannabidiol) dominant preparation and we have the ability to dose to It grew organically from there, says Dr. Pearson. Bythe milligram for the residents.going through that process, establishing our policies and procedures, and working with people like Dr. OMahonyIts also common for families to have concerns about the and myself who had experience with this medication, weside effects. But according to the team, there are a number were able to get everyone on board.of positive, unintended consequences. Weve seen it help some of our residents with dementia regain their appetite and get a good nights sleep, says Batson. That is a lovely thing to see, and its led to staff actually coming to me or Dr. Pearson with requests to try it with other patients. Measuring successAs with all care and pain management initiatives, its the results that count. To that end, the team at Trillium Villa have used several measures to quantify success. However, one of the more compelling arguments for the use of cannabis has been its role in reducing residents reliance on more potent alternatives. A lot of families are interested in cannabis medication because of its potential to get their loved ones off of opiates or antipsychotics, says Batson. As they and the residents themselves become more educated about cannabis alternatives, theyre the ones really leadingthe charge. For the last 50 or 60 years, cannabis was viewed as a bad thing, and as physicians, we didnt learn about cannabinoid medicines in medical school, says Dr. Pearson. Many of us dont have that initial knowledge base to work with, but as the body of evidence continues to grow, more practitioners are interested in learning about thisemerging therapeutic.Dr. Pearson adds: Cannabinoid medicine is a natural fit for long-term care given the diagnoses its able to treat. Im looking forward to continuing to share my learnings with physicians across Ontario and training homes to institute policies and processes to be able to offer this therapy to their patients. LTCT18 LONG TERM CARE TODAY Fall/Winter 2019'