Helping to Treat Agitation, Behaviors, and Delirium?
Those who work in skilled-care settings are intimately familiar with the limitations of current pharmaceuticals in managing resident behaviors. Our aging Western cultures are facing a massive crisis involving the overuse of anti-psychotics, with 1 in 5 nursing home residents currently subjected to this class of drugs to treat agitation, behaviors, and delirium.
Whereas anti-psychotics have proven largely ineffective and quite dangerous, it has been proposed that micro-doses of psychedelic treatments that disrupt ego and allow temporary unbinding from acute physical/mental suffering (as well as inflexible, habitual patterns of cognitive activity) could theoretically help foster greater calmness in people living with dementia.
In light of the deleterious consequences of anti-psychotics, investigating the potential mood-altering effects of psychedelics—which are generally well-tolerated, non-addictive, and non-hallucinatory at low dosages—would appear a valuable direction for inquiry.
Enhancing the Benefits of the Arts?
One irony in the dementia field is that while drugs have failed spectacularly despite billions of dollars of investment, one consistently effective “intervention” in long-term care is the arts. Storytelling, music, dance, gardening, pet therapy, and other activities we often jokingly call “socialceuticals” (since they are almost comically superior to current drugs for dementia) connect to the quintessential humanity of the cognitively frail, allowing for rich expression, the forging of bonds with caregivers, and improved QOL.
Psychedelics, of course, are known for their capacity to enhance sensorial experiences, elicit feelings of the sacred, sublime, and numinous, and deepen a sense of unity and inter-connection. It is thus worthwhile considering whether micro-dosages of psychedelic compounds could, in long-term care settings, help deepen the qualitative experience of “socialceuticals” like listening to or singing songs, observing nature, engaging with art works, interacting with animals, or bonding with other residents.
Obviously, in the absence of data, the promise of psychedelics is, at present, mostly speculative or theoretical. Much must be learned about proper dosages, safety and supervision protocols, ethics around consent, how to address adverse reactions, staff training, and other questions that crop up around modern treatment regimens for these ancient compounds.
We must also be cautious of market forces—specifically, companies, entrepreneurs, and bad actors with vested interests who hype treatments as quick-fix commodities. Thankfully, rigorous studies are being undertaken internationally, and what we learn in the next decade should help light the path forward (or not).
In the meantime, we can still, as citizens, bring the arts into long-term care environments—and also to our elder relatives in general—and help provide the “altered states” that we know are protective, enjoyable, and supportive of QOL for all of us.