As cough and cold season approaches, we’ve been seeing an uptick in the amount of pneumonia vaccine orders and questions. The CDC currently recommends that adults greater than 65 years old should get both the Prevnar 13 and Pneumovax 23. It’s especially important to make sure the residents with high risk diagnoses (diabetes, COPD, heart failure, chronic liver disease) receive these vaccines.

In residents with no prior pneumonia vaccinations, Prevnar 13 should be given first. This helps to improve the body’s immune response to the vaccine. After one year, the Prevnar 13 should be followed by the Pneumovax 23.

If your resident has already received Pneumovax 23 but not the Prevnar 13, that is alright. The Prevnar 13 can still be given one year after the Pneumovax. If your resident can’t remember if they have ever been given either vaccine, then it will not hurt to assume no vaccination was given and to start the Prevnar 13.

A few more pneumonia vaccine facts:

Giving both of these vaccines in seniors is estimated to prevent 230 cases of invasive pneumonia and 12,000 cases of community-acquired pneumonia in their lifetime.
Medicare Part B covers both vaccines at zero cost to the resident.
It is okay to give these vaccines at the same time as many other vaccinations, such as their annual flu shot or a shingle vaccination.

As always, if you have any questions or would like more information regarding pneumonia vaccination (or any vaccination for that matter), please contact the pharmacy.

Thanks for reading!

Drew Curtis, PharmD
Pharmacist Manager
Consultant Pharmacist

In Feb. 2015, CMS created a new Quality Measure for Antipsychotic Usage in long term care facilities. The new Quality Measure is another step in The Centers for Medicare & Medicaid Services’ (CMS) goal to improve dementia care and avoid the usage of potentially dangerous antipsychotic medications for dementia related disruptive behavior. One of the main goals of the National Partnership to Improve Dementia Care in Nursing Homes is to help us as long term care providers to start recognizing BEHAVIOR AS A FORM OF COMMUNICATION. We need to start asking "What is this resident trying to tell me with this behavior?". "What could be the underlying problem that this non-verbal resident is trying to relay to me?"

Some well-known underlying causes of disruptive behavior include hunger, thirst, constipation, being wet, hot or cold; however, a commonly over-looked cause is PAIN! And why? Because our dementia residents can’t always tell us they are in pain!!

Pain is undertreated among our seniors. Some studies have revealed that focusing on pain in dementia residents significantly reduced disruptive behavior. I have seen this result in my own facilities. Even a benign trial of routine Acetaminophen 650mg by mouth twice daily has shown positive results. I mean, who doesn’t get uncomfortable sitting for long periods of time?! Let alone having other more serious causes of chronic pain (arthritis, spinal stenosis, etc).

So let’s face it. If we want to reduce medication usage for disruptive behavior, we need to become better sleuths…investigate the underlying cause, and don’t forget about pain.

Alicia A. Timko, PharmD
Consultant Pharmacist
Long Term Care Rx