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In recent years, the national conversation around cannabis has evolved significantly. As Americans hear more about the legalization of cannabis across the United States, the stigma diminishes, and public perception shifts. Once taboo, many people are now embracing its benefits for medicinal purposes, including older adults in nursing homes.
As our aging population continues to grow, nursing homes are exploring the potential benefits and challenges of incorporating cannabis into their care regimens.
Let’s discuss the advantages and drawbacks of cannabis use for nursing home residents and shed light on the complex considerations to be made.
Please understand all of the content that follows should not be considered medical advice or recommendations of any kind. There are a myriad of anecdotes, evidence (or lack thereof), and regulatory environments in which medical prescriptions for marijuana are carried out. This blog does not seek to cover every possible scenario, simply to provide insights into the ways cannabis in nursing homes is currently in use and what future trends could be.
Almost all medical professionals would agree that cannabis could have some medicinal benefits for some elderly adults.
Here are some of the ways that medical marijuana has been used for those living in long-term nursing facilities.
One of the most widely recognized uses for cannabis is pain relief. Many elderly residents in nursing homes suffer from chronic pain due to conditions like arthritis, neuropathy, or injuries. Cannabis compounds–CBD and THC–may be used by physicians to alleviate pain and improve overall comfort.
Some practitioners consider cannabis to be an alternative to opioid use for pain management.
From the Canadian Medical Association Journal: “Although cannabis use is neither risk-free nor a panacea, the risks it poses of physical dependence and accidental overdose compared with opioid use are substantially lower.”
Insomnia and sleep disturbances are common among the geriatric population. Certain strains of cannabis may have a sedative effect that could help elderly residents sleep better, leading to improved overall health and well-being.
Loss of appetite is a common issue in nursing homes and can lead to malnutrition among residents. Some cannabis strains are known for stimulating appetite–this could be especially beneficial for individuals struggling to maintain a healthy weight.
Mental illness is a significant concern in nursing homes. Cannabis, particularly CBD, has been studied for its potential to alleviate symptoms of anxiety and depression without the severe side effects associated with some traditional medications.
Preliminary research suggests that certain compounds in cannabis might have neuroprotective properties that could potentially slow down the progression of neurodegenerative diseases like Alzheimer's and dementia. However, more research is needed in this area.
Cannabis is not currently legal at the federal level. This poses legal and regulatory risks for nursing home directors who want to explore the implementation of a medical marijuana program.
As a Schedule I drug under the Controlled Substances Act (CSA), there is no federally accepted medical use for marijuana. Even if the nursing home is located in a state where marijuana is legal, compliance with state law does not protect the parties involved from a CSA violation.
Due to accreditation through the Centers for Medicare & Medicaid Services, hospitals and nursing homes could face penalties, lose federal funding, and/or be excluded from participation by allowing patients to use medical marijuana.
While liability for healthcare providers appears to be shrinking, with no guidance from the Department of Justice or Health & Human Services that providers who are compliant with state law will not be prosecuted, the remote possibility for legal action exists.
It is important to have a balanced perspective on cannabis use in nursing homes. It comes with some risks.
Despite the potential benefits, the scientific research community is still detangling the complexities of cannabis. Limited research exists on its long-term effects, especially in the elderly population. Nursing homes need evidence-based guidelines to ensure residents' safety and well-being.
While some compounds in cannabis might aid cognitive function, others could lead to cognitive impairment, memory issues, and confusion—concerns that are particularly pertinent for an elderly population already at risk of cognitive decline. While this risk may increase with THC rather than CBD, more research is necessary.
Many nursing home residents are on multiple medications. Cannabis can potentially interact with these drugs, leading to adverse effects. Health professionals must carefully consider potential drug interactions before incorporating cannabis into a resident's care plan.
In a study by the Canadian Coalition for Seniors’ Mental Health on cannabis and older adults, physicians, nurse practitioners, pharmacists, nurses, and other healthcare providers were polled. 89% of physicians and nurse practitioners reported they are aware of older adults in their practice using cannabis, but only 39% felt that they had sufficient knowledge to address older patients and their caregivers’ questions about cannabis
Nursing home staff should be properly educated to ensure proper dosage and administration and should be aware of any signs and symptoms of adverse reactions in older adults.
There are several best practices that should be followed in nursing homes implementing cannabis programs.
In a study funded by the Ontario Ministry of Health and Long-Term Care, an Ontario-based long-term care facility tested the benefits and challenges of a medical marijuana-use program.
A 90-year-old resident was diagnosed with delirium, dementia, delusional disorder, and post-traumatic stress disorder. After 60 days in a specialized behavioral neurology unit with no improvement in symptoms, the patient was prescribed a cannabis regimen. Soon, she gained weight, was able to feed herself, and showed a decrease in responsive behaviors and hallucinations. She fell less often, was better able to communicate her needs, and her mood stabilized.
A resident with multiple diagnoses suffered from dementia, delusional disorder, and neuropathy. After starting a medical marijuana program, her neuropathic pain was reduced, her appetite and sleep routine improved, and her mood stabilized.
Another nursing home resident struggled with mental illness, including paranoia, delusions, suicide attempts, and delusions. Her pain management was a struggle due to a history of opioid dependence and reluctance to medication changes.
With some encouragement from the healthcare staff, she tried a cannabis program. Overall, she showed improvement in all symptoms, and further, staff were able to reduce and even discontinue some opioid medications.
After seeing positive results for residents, the care home organization implemented a policy for the use of cannabis for medically prescribed purposes. Dozens of residents were prescribed medical marijuana–the results showed improved pain and symptom management, leading to a better quality of life for those residents.
Nursing homes considering the incorporation of cannabis must weigh the current scientific evidence, regulatory environment, and the individual health needs of their residents. Collaborating with medical professionals, researchers, and legal experts is crucial in making informed decisions prioritizing resident safety and well-being. Nursing home directors should also ensure the cannabis products provided to their patients is safe and regulated.
As our understanding of cannabis continues to evolve, further research, open dialogue, and regulatory compliance will be essential in shaping responsible and effective cannabis use practices within nursing homes. Qredible’s mission is to increase trust and transparency across the cannabis industry. Get in Qredible today.
