Gary Tetz

My very adorable, but now elderly puppy has developed a serious problem with wandering. What started with short jaunts to my neighbor’s admittedly enticing and magical yard has turned into extended forays across busy streets and into other neighborhoods. Last time, he was almost hit by a truck. It’s rather troubling, to say the least.

It’s not like I don’t watch him, or don’t care. I’m not that dog owner. But he’s become a master of evasion — if I so much as look down to respond to a text, he’s gone. After wandering the streets and yelling until I’m hoarse, I get the dreaded call from a phone number I don’t recognize. “I found your dog,” says the stranger with the vaguely judgmental voice. “Could you please come get him?”

The last time this happened followed closely on the heels of the announcement that the off-label use of antipsychotics in nursing homes is dropping faster than expected. And because my mind works in odd and sometimes troubling ways, I couldn’t help wondering where I could get some of those amazing meds. I know they’re dangerous, but it seems like it would be so much easier to pharmacologically control his baffling behavior than it is to actually figure out what’s causing it and how to keep him safely safe.

Fortunately, like most long-term care operators these days, I know better. Even without the help of a Canine Quality Initiative, I’ll instead scrutinize his actions for clues to the unmet needs at the root of the problem, and then try to address them. Perhaps I’ll actually build a fence, rather than just drugging him up and getting on with my day. I feel so enlightened.

Facetiousness aside, it’s truly gratifying to see the remarkable success providers have achieved in reducing the inappropriate and often ineffective use of antipsychotics to deal with dementia-related behaviors. Even with so many factors out of your direct control, you’ve helped raise the consciousness of prescribers to the dangers, and have embraced a mindset that these medications should always be a last resort.

That’s a pretty incredible accomplishment, and I definitely think we should celebrate.

But first, could you help me find my dog?

Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold Medal winner in Humor Writing in the 2014 Association of Business Press Editors (ASBPE) awards program. He has amused, informed and sometimes befuddled long-term care readers worldwide since his debut with the former SNALF.com at the end of a previous century. He is a multimedia consultant for Consonus Healthcare Services in Portland, OR.