Antipsychotics Are Being Overused in Nursing Homes, Study Finds
Elderly resident's slurred their words and were unable to think, walk, or stay awake. Previous administrators of facilities admitted to overusing medications without the right diagnosis, patient consent, or consideration of risks. These are only a few findings that have been highlighted in a new, 157-page report from the Human Rights Watch.
Released in February, 2018, the report estimates that every week 179,000 elderly people living in a nursing home facility are being medicated with antipsychotics even though they have not been diagnosed with a psychiatric disorder such as bipolar disorder or schizophrenia. The majority of these residents are over 70 and have dementia. Staff administer the medications as a kind of "cost effective chemical restraint". Their objective, as some claim, is to suppress the behaviors associated with dementia and make the workload for staff a bit easier.
The report echos an October, 2017 investigation conducted by CNN. The story discovered an extreme misuse of Nuedexta, a drug that controls sudden outbursts of crying and/or laughing. CNN learned that the drugmaker was profitting millions from the overuse; primarily at the expense of taxpayers. An investigation into the company has been launched.
The HRW report discusses many concerns about the overuse of medications in nursing homes that extend far beyond Nuedexta. Investigators part of the HRW report visiting 109 facilities between October 2016 and March of 2017. In the six states they went to, 323 people were interviewed. These included elder residents, their family members, social workers, long term care experts, and nurses. Investigators claim that their findings were beyond disturbing. They were dangerous. Furthermore many family members were not aware of what was going on.
The FDA has not recognized any antipsychotic medication as being a treatment for dementia or dementia related psychosis. Rather the FDA cautions the use of these drugs for elderly, dementia suffering patients particularly because they can cause death. Other side effects include jerking movements, low blood pressure, blood clotting, severe rigidness in the muscles, and more. Currently many family members who had not been aware of the dangers are now assessing the medical records of their elderly loved one. Some family members are outraged, and others thought their loved one needed the drugs so as not to be evicted from the facility.
One family member had her 90 year old mother taken off antipsychotic medications. Soon after they watched the elderly woman "come back to life" after two years of being medicated.
"Lo and behold, she can talk again. She can read again ... It's not just that she can walk now ... it's her personality," the report quotes the daughter saying. "She had been sleeping all the time. She was totally incoherent. She had no memory at all. She recognized no one. On the meds, she couldn't remember if you were there while you were there.", says Laurel Cline when speaking of her mother.
The Human Rights Watch report continues to discuss practical, healthier ways to deal with dementia and it's symptoms. Routines, activity, exercise, music, and even pet therapy are options that can help an elder person to manage dementia.
The AARP also did their own research on overuse of medication in nursing homes. They found that progress was being made with regard to a reduction of antipsychotics for dementia or Alzheimer patients, up to 16 percent of elder care facilities were still misusing the drugs. Kelly Bagby, vice president of AARP Foundation Litigation, is challenging the overuse of antipsychotics in nursing homes and claims the number is still too high. “Given that these drugs can cause untold suffering and even death and do not provide any treatment for people with dementia, we should have zero tolerance for the use of these drugs.”, says Bagby.
As it stands family members are encouraged to watch for signs of overuse of antipsychotic medications, and to also review the medical records and treatment being administered to the elder. If he or she has dementia or alzheimer's and is being treated with an antipsychotic, sedative, anti anxiety medication, or other drug that inebriates or sedates a patient, it is advisable to talk with a nursing home lawyer.Why Are Psychotropic-Related Drugs Being Used in Nursing Homes?
Nursing homes, and their doctors, may prescribe psychotropics, including antipsychotics, medication for a number of valid reasons. Some of the most common medications that fall within the category of psychotropic drugs, include:
Antipsychotics - These medications are prescribed to treat conditions including schizophrenia, bipolar disorder, and psychosis. They may be given to residents with dementia, despite the FDAs warnings against doing so. Seroquel, Zyprexa, and Haldol are some of the most common antipsychotics.
Antidepressants - These medications are routinely prescribed, albeit overprescribed, in nursing homes. They reduce a person's motor skills, and increase the risk of falls. Prozac and Zoloft are two common brands.
Anti-Anxiety - Medications for anxiety also tend to be overprescribed. Like anti-depressants that can impair a person's motor skills. Ativan and valium are two common brands.
Sedatives - Patients who are known to wander, or cannot be controlled, may be sedated with Restoril or Halcyon.
Although these medications can be very beneficial, they do carry side effects. Furthermore, they can, and are often, overprescribed which increases the side effects and risks. If a doctor is recommending any of the above, you should ask:
- What is the condition that warrants the need for these medications?
- How frequent will the medication be used?
- How long will the medication be used?
- What are the risks and side effects?
- Are there alternative treatments?
- Mood swings
- Weight loss
- Cognitive impairment
- Impaired motor skills
- + More
If you notice these symptoms, and have not given the consent to any psychotropic medications, you should talk with the doctor or nursing staff. It is your right for you or a loved one to refuse medication treatment or revoke any prior consent. If you believe your loved one is being overmedicated, please also talk with the doctor, and call The Higgins Firm.