As the population ages, the number of seniors in nursing homes and assisted living facilities continues to rise. These seniors often face a range of chronic symptoms and conditions that significantly impact their quality of life.
This article will explore these chronic symptoms, examine why medical cannabis isn’t currently an option for seniors in nursing homes, and discuss the potential advantages of allowing its use in healthcare facilities.
Chronic Symptoms Faced by Seniors in Long-Term Care
In 2023, nearly 1.4 million Americans were residents of long-term care (LTC) facilities, which include nursing homes and assisted living centers. These institutions are crucial for individuals who can no longer live on their own due to aging, chronic diseases, or disabilities. The typical age of a resident in these facilities is approximately 79 years.
LTC facilities deliver a broad spectrum of services, including medical care, assistance with daily tasks, and social interaction, ensuring a holistic approach to resident care. About 85% of those in LTC facilities suffer from at least one chronic health issue, highlighting the significant medical and personal care requirements in these settings.
Common conditions affecting these residents include arthritis, heart disease, diabetes, and dementia, all of which require continuous management and patient support.
Chronic Pain
Chronic pain is a significant concern for seniors in nursing homes, often arising from conditions such as arthritis, neuropathy, and musculoskeletal disorders. This persistent pain can significantly restrict mobility and daily functioning.
Addressing chronic pain is challenging, and it typically involves a mix of medications and therapies, which can introduce additional side effects and complications. Inadequately managed pain can lead to sleep disturbances, anxiety, agitation, and behavioral issues, further contributing to cognitive decline and reduced physical activity among residents.
Epilepsy
Cannabinoids, particularly cannabidiol (CBD), have demonstrated potential in aiding epilepsy patients by managing their symptoms. Cannabidiol is a powerful anti-inflammatory agent, and it works by engaging with the brain’s endocannabinoid system, which helps regulate neuronal activity and mitigate neuropathic pain.
Research and clinical trials have highlighted CBD’s effectiveness in reducing seizure frequency and severity, especially in drug-resistant epilepsy syndromes such as Dravet syndrome and Lennox-Gastaut syndrome.
By serving as an alternative or supplementary option to conventional anti-epileptic medications, medical cannabis offers hope for better seizure control and enhanced quality of life for individuals with epilepsy and muscle spasm disorders.
Cachexia (Wasting Syndrome)
Medical cannabis can serve as a beneficial treatment for individuals suffering from cachexia, a condition marked by significant weight loss and muscle wasting often linked to chronic diseases like cancer and advanced heart disease.
Many strains of cannabis can stimulate appetite, which may help patients increase their caloric and nutrient intake, supporting weight stabilization and muscle preservation. Furthermore, cannabis’s anti-inflammatory and pain-relieving properties can reduce overall discomfort and symptoms of swelling or edema.
By addressing both appetite and pain, medical cannabis plays a vital role in managing the severe effects of cachexia, ultimately improving patients’ quality of life.
Anxiety and Depression
Medical marijuana has the potential to ease symptoms of anxiety and depression for residents in long-term care (LTC) facilities. Cannabinoids, especially cannabidiol (CBD), interact with the brain’s endocannabinoid system, helping to regulate mood and stress responses. This interaction can lead to decreased anxiety and greater mood stability, alleviating the persistent sadness and worry common in LTC environments.
Additionally, cannabis can promote relaxation and improve sleep quality, further enhancing overall well-being. By addressing these psychological challenges, medical cannabis can notably improve the quality of life for seniors living in nursing homes or other long-term care settings.
Other Common Conditions
The incidence rate and severity of chronic health symptoms are higher among seniors aged sixty-five and older. There are other health conditions and symptoms that assisted living residents may experience that could also be improved by adding medical marijuana treatment plans.
Those conditions include but are not limited to:
- Hypertension (High Blood Pressure)
- Heart Disease
- Diabetes (and Diabetic Neuropathy)
- Chronic Obstructive Pulmonary Disease (COPD)
- Osteoporosis
- Urinary Incontinence
- Chronic Kidney Disease
- Post-Traumatic Stress Disorder (PTSD)
- Gastroesophageal Reflux Disease (GERD)
- Anemia
- Parkinson’s Disease
- Chronic Inflammatory Skin Conditions (e.g., pressure ulcers)
- Stroke and Post-stroke Conditions
Despite the fact that most states now have a medical cannabis program, seniors living in long-term care facilities do not have access. The federal government provides funding for healthcare facilities, and as such, any unapproved controlled substance (such as Schedule I drugs) cannot be dispensed to patients.
Medical Cannabis as a Treatment Option When Conventional Therapeutics Fail
Multiple chronic conditions often complicate care plans, requiring coordinated efforts from healthcare providers to effectively address the complex health needs of these individuals. Some patients may have treatment-resistant conditions or have developed a tolerance to conventional pain medications.
The National Institute on Drug Abuse (NIDA) highlights that older adults are particularly vulnerable to the adverse effects of opioids, including tolerance, dependence, and addiction. Long-term opioid use can lead to a need for higher doses to achieve the same pain relief, which places some American seniors at a higher risk of overdose and other adverse effects.
In long-term care facilities, the goal is to ensure resident safety, comfort, and care. Patients with chronic pain may not find the relief they need from pharmaceuticals. Doctor-supervised cannabis (dispensed by a healthcare provider) could be a lower-risk option for some patients.
Why Doctor-Supervised Cannabis Isn’t an Option for Seniors in Nursing Homes
In states where medical cannabis use has been legalized, you may think that it is an option for all residents. However, at the time of writing, the federal government’s classification of cannabis as a Schedule I prohibited substance prevents medical marijuana products from being dispensed to eligible patients in assisted living communities.
Here are some of the reasons why patients in long-term care facilities cannot be provided with cannabis products:
Federal Funding Restrictions
One of the primary reasons medical cannabis is not an option for seniors in nursing homes is the federal prohibition of cannabis. Since many long-term care facilities receive federal funding through Medicare and Medicaid, they must comply with federal laws and rules, which classify cannabis as a Schedule I drug.
This classification indicates that cannabis is considered to have no accepted medical use and a high potential for abuse despite growing evidence to the contrary. The discussion around rescheduling cannabis to Schedule III on the Controlled Substances Act may change that; however, when or if that happens remains uncertain.
Patient Safety Concerns
There are safety concerns about using cannabis in nursing homes. These include possible drug interactions, side effects, and the need for correct dosing and monitoring. Care facilities must prioritize the safety and well-being of all residents, and the lack of standardized guidelines for medical cannabis use makes it harder to implement.
The way individuals respond to cannabis can vary greatly, requiring careful monitoring, which adds to the challenges. For instance, cannabis can interfere with many prescription drugs, leading to potentially dangerous interactions. More research is needed.
Lack of Clinical Research
The lack of extensive clinical research on the effects of cannabis in elderly populations further hinders its acceptance. Without sufficient data from human clinical studies, healthcare providers are hesitant to recommend cannabis, fearing potential risks and also legal repercussions.
More longitudinal studies are needed to establish guidelines for safe and effective use in seniors. Recent federal law changes have now made it easier for domestic health studies to be conducted on therapeutic cannabis use.
Advantages of Allowing Medical Cannabis in Long-Term Care
Smokable or inhaled cannabis use is not an option for patient use in clinical environments. However, many other alternatives exist, including edibles, tinctures, capsules, and tablets. Clinical inhalers (similar to asthma medication devices) can also be used to provide metered doses to patients.
While administrating medical marijuana to patients in long-term care facilities is illegal and violates federal law, many potential advantages could improve the quality of life for senior living residents if it was legalized for use in healthcare facilities.
Effective Non-Opioid Treatment Options
One of the significant advantages of medical cannabis is its potential as an effective non-opioid treatment option. Opioids, commonly prescribed for chronic pain, carry risks of addiction and overdose. Cannabis, on the other hand, has shown promise in managing pain without the same level of risk.
By offering a non-opioid alternative, nursing homes could reduce the reliance on potentially harmful medications and provide better treatment outcomes for seniors.
Affordability
Medical cannabis may be more affordable compared to some prescription medications. Many seniors face financial constraints, and the high cost of pharmaceuticals can be a burden. The average annual cost of drugs for long-term care patients in the United States can exceed thousands of dollars per person annually. These costs can be even higher for individuals with multiple chronic conditions requiring complex medication regimens.
Doctor-supervised cannabis, if insurance coverage evolves as it did in Canada to reimburse some of the medical cannabis expenses, may offer a more cost-effective alternative. Lowering medication costs by authorizing medical marijuana use could help patients and family members save money.
Improvement in Mood and Mental State For Seniors in Long-Term Care
Cannabis has been noted for its potential to improve mood and alleviate symptoms of anxiety and depression. This could translate to a better overall mental state and a higher quality of life for seniors in nursing homes.
The mood-enhancing effects of cannabis could help reduce feelings of isolation and improve social interactions among residents. In some jurisdictions, state marijuana laws allow for mental health conditions such as post-traumatic stress disorder, moderate to severe anxiety, and treatment-resistant depression (TRD) as a qualifying health condition.
Excellent Pain Relief Option
Cannabis is known for its analgesic effects, which it achieves by interacting with the body’s endocannabinoid system to decrease pain and inflammation. This makes it a promising alternative to conventional pain medications.
For seniors in long-term care facilities who suffer from chronic pain, cannabis could lead to better mobility and the ability to perform daily activities with reduced discomfort. This improvement can greatly enhance the quality of life for many residents.
The Potential Benefits of Medically Administered Cannabis in Long-Term Care
Enabling seniors in nursing homes to use doctor-supervised cannabis could yield notable advantages, including effective pain management and enhanced mental health. Nonetheless, existing legal and safety concerns need to be resolved for this to happen.
As research progresses and societal views evolve, it’s important to weigh the benefits of medical marijuana for this particularly vulnerable group. Prioritizing access to the best possible treatments for seniors in long-term care is essential, and medical cannabis may be a key component in helping provide relief for patients.
Aaron Bloom, an experienced healthcare attorney, serves as the CEO of DocMJ and Medwell Health and Wellness Centers, where he has overseen the organizations’ mission and growth since 2016. In addition to his leadership roles, Aaron serves on the Board of Directors for Waterfall Bank, bringing his expertise in healthcare, compliance, and strategic growth to the financial services sector.
Aaron’s passion for improving patients’ lives stems from more than 20 years of owning, operating, and representing traditional healthcare organizations. Throughout his career, he has remained committed to finding better ways to relieve suffering and expand access to innovative, patient-centered care. As CEO, Aaron works each day to help patients achieve better health and wellness through the therapeutic benefits of medical cannabis and other evidence-based alternative medicines.