CCRC subsidiary helping shape future of cannabis use in senior living

A Virginia continuing care retirement community has launched a subsidiary company to help residents and other older adults, the senior living industry and healthcare providers responsibly explore therapeutic CBD and cannabis use. The action comes as the hearing process to potentially reschedule marijuana begins at the federal level.

Westminster-Canterbury on Chesapeake Bay in Virginia Beach, VA, found that many residents were experimenting without guidance, often using unreliable content and doses, which can be dangerous. But the CCRC also understood the “dramatic” benefits of cannabis, especially for older adults. 

Cannability Consulting LLC was launched last year after three years of research and planning. 

Canability Consulting Chief Operating Officer Victoria Crenshaw, PhD, LNHA, said the company started offering consultations with residents who had ailments and issues not being addressed well with medication, or who were tired of taking several medications to assist with pain, arthritis and sleep. Residents living with dementia have especially benefited from cannabis and CBD, exhibiting less aggression and agitation, she said. 

Cannability Consulting, which provides hemp-derived products that meet federal compliance standards, has documented “surprisingly strong positive outcomes” for older adults: 97% of its 186 clients saw positive changes in their symptoms and quality of life and in some cases were able to reduce or eliminate other medications with “far more undesirable” side effects, according to Westminster-Canterbury CEO J. Benjamin Unkle Jr., who received an Agent of Change Award in the inaugural 2023 McKnight’s Pinnacle Awards.

Only 2.2% of those clients reported mild side effects, such as gastrointestinal upset or low energy.

The CCRC, recognized in the 2018 and 2022 McKnight’s Excellence in Technology Awards, previously participated in a study conducted with Eastern Virginia Medical School and Virginia Wesleyan College, using touchscreen computers with interfaces tailored to residents’ interests and abilities to show a clinically significant decrease in the use of antipsychotic drugs among those living with dementia. 

Cannability Consulting is led by Crenshaw and Chief Nursing Officer Alexandria Hill, DNP, GERO, RN-BC, who oversee a team that specializes in gerontology, person-centered care and quality improvement, with a focus on promoting cannabis literacy in healthcare. The program builds on Hill’s work, including a doctoral project that earned the Virginia Commonwealth University Ann B. Hamric Award for sustainable practice improvement.

“Our approach is ‘low and slow’ — starting with minimal doses and carefully adjusting to find the optimal balance for each individual,” Crenshaw said in a statement. “We’ve seen such positive outcomes that we feel a moral obligation to expand access and help other healthcare providers and senior living communities develop responsible programs.”

Cannability Consulting’s work is helping to shape the future of cannabis use in senior living by demonstrating the benefits of professional guidance and safe, compliant products, she added.

“By reducing reliance on medications with serious side effects, we’re improving quality of life while staying fully compliant with federal laws,” Crenshaw said, adding that the company helps individuals and healthcare providers navigate “through the weeds of hemp and medical cannabis.”

“So that means a little bit of everything, between helping an individual one-on-one learn a little bit more about how to safely use the cannabis plant in a therapeutic way to meet their health needs and their health goals, or doing group education conferences and events to raise awareness about the topic,” she said.

Responsibly dosed CBD offers an alternative to sleeping pills, medicines for chronic pain and tranquilizers, like Xanax and Valium, which can be hazardous for older adults, according to neurologist Armistead Williams, MD, Westminster-Canterbury’s Health Services Committee chair. Expert CBD consultation, along with responsibly dosed CBD products, he said, offer an opportunity to improve sleep and overall well-being while minimizing falls, confusion or sleepiness.

At the federal level, the 2018 Farm Bill legalized hemp-derived cannabis, making it widely available. But the market is not yet centrally regulated, making it a “buyer beware consumer literacy opportunity,” Hill said. 

Earlier this month, the hearing process began regarding the Drug Enforcement Administration’s proposed rulemaking to move marijuana from a Schedule I to a Schedule III drug under the Controlled Substances Act. The DEA will consider the input of organizations for and against the proposed rescheduling, along with public comments, to make a final determination. The hearing process will run through March 6.

Marijuana has been classified as a schedule I drug since Congress enacted the Controlled Substances Act in 1970. The move to reschedule it by the Justice Department follows a Department of Health and Human Services recommendation in August to reschedule marijuana, with a finding that it has medical and scientific value. The HHS recommendation considered the potential for abuse, scientific evidence of marijuana’s pharmacologic effects, and potential risks to public health.

A growing number of states have legalized cannabis for medical or recreational purposes or both. It remains illegal under federal law, however, creating a conundrum for senior living communities and their residents.

As of April 2023, 38 states, three territories and Washington, DC, allowed the medical use of cannabis products, and as of November 2023, 24 states, Washington, DC, and two territories had enacted measures to regulate cannabis for recreational use, according to the National Conference of State Legislatures.

Marijuana’s federal status is the biggest challenge for senior living providers, attorneys and industry stakeholders have said. Assisted living communities and nursing homes that accept federal Medicaid and/or Medicare funds must certify that they comply with all state and federal laws. 

After implementing policies and educating Westminster-Canterbury on Chesapeake Bay staff members and residents about the benefits of medical cannabis, Cannability Consulting expanded its services to other CCRCs by developing cannabis use policies. Its leaders also have spoken at state senior living association meetings and have met with healthcare staff members at senior living communities to educate more industry stakeholders on the benefits of cannabis and CBD.

“I think it’s important for people to know that we’ve seen folks have really life-changing results and improvements to their quality of life in ways that they had not previously seen possible,” Hill said. “It doesn’t work all the time for everybody in every circumstance, but it’s something where when we take the stigma and the barriers and the bias away from it and really see it for medicine and treat it as such, we can really see a change.” 

In Georgia, LeadingAge Georgia President and CEO Ginny Helms shared the benefits of medical cannabis in aging adults with Alzheimer’s and agitation with the organization’s board in 2018. She credited families of children with seizure disorders for bringing the benefits of medical cannabis to the forefront. 

Helms helped organize a group of thought leaders from LeadingAge Georgia member communities and organizations to develop plans and policies to support older adults who choose medical cannabis. LeadingAge Georgia received a grant from the RRF Foundation for Aging for its medical cannabis education initiative, kicking off the effort at its summer conference by partnering with the Georgia Medical Director’s Association to hold a session led by an Emory University School of Medicine palliative care physician.

Although people can get medical marijuana cards and access products themselves in Georgia, Helms told McKnight’s Senior Living that the big missing piece is having enough physicians who are educated about drug interactions and proper protocols. 

“What we want is for older adults to have help so they can use it safely,” Helms said of the education efforts targeting healthcare and long-term care professionals. “That’s the goal.”