The misuse of anti-psychotic medications in nursing homes across America has fallen from about 24 percent down to 16 percent in the last seven years, but remains a serious problem, according to a recent investigation of federal CMS data by Human Rights Watch. The 157-page report details the fact that an estimated 180,000 residents in nursing homes are dosed with anti-psychotic drugs, even though:
- The patient has no diagnosis that warrants its use;
- Studies have shown these medications can be harmful in older patients (it can double the risk of death among older patients with dementia);
- Facilities often don’t first obtain informed consent of the patient and/ or relatives.
The report notes that while any decrease is welcome, there is concern that nursing homes might have found other drugs that can be used to pacify and sedate patients with conditions like dementia and Alzheimer’s disease. The title of the report begins with a quote from a nursing home industry insider pertaining to this misuse of medications: “They want docile.” Another term for this is “chemical restraints.”
Nursing homes are concerned with profits. People with dementia and Alzheimer’s disease require additional care and resources. That amounts to higher staffing levels – and less profits. Nursing homes combat this by sedating these patients, which in turn means they use less of the facility’s resources. Staffers may interpret expressions of distress or pain to be a willful act of disruptive behavior that needs to be suppressed. But using medication for staff convenience or as a means to discipline people is against federal law.
Our nursing home abuse attorneys in Fort Lauderdale know this practice can be interpreted as inhuman, degrading and cruel. And yet, facilities that routinely violate these rules are almost never punished. Anti-psychotic drugs were created in order to address real psychosis in those who suffered from conditions like schizophrenia. They were never intended to be used as a means to treat dementia, and the U.S. Food & Drug Administration has issued the highest-level “black box” warning on several of those medications for the risk of off-label use for dementia patients. These drugs have never been FDA-approved for this purpose, as they have not proven safe or effective in treating the symptoms of dementia.
Existing federal rules prohibit the use of drugs without an adequate basis for that use and also with appropriate monitoring. The CMS under Obama had announced the intention to tighten regulations around discretionary use of these medications in nursing homes, but soon after Trump took office, CMS announced there would be a moratorium on this and other more stringent regulatory plans.
The fact that 16 percent of nursing home residents still receive these medications – when we’ve known for years the danger and that such use is illegal – is quite astounding, and illustrative of the fact that the strong legal protections passed under the Nursing home Reform Act of 1987 are still weakly enforced. HRW research identified hundreds of facilities where more than one-third of patients are dosed with these drugs. To offer some perspective, Mental Health America reports about 3.5 percent of the U.S. population experiences psychosis.
Given that taxpayers offer up tens of billions of dollars annually to nursing homes with the promise of safe and adequate care, they – and of course the people in these facilities – deserve so much better.
Call Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights. Now serving Orlando, West Palm Beach, Port St. Lucie and Fort Lauderdale.
US: Nursing Homes Misuse Drugs to Control Residents, Feb. 5, 2018, Human Rights Watch
More Blog Entries:
Bill Would Allow State to Seek Injunctions, Freeze Assets in Florida Elder Financial Exploitation Cases, Feb. 6, 2018, Nursing Home Medication Misuse Attorney Blog