Anti-psychotic drug abuse in nursing homes remains a major problem, according to a new report released by U.S. non-profit Long-Term Care Community Coalition to the United Nations and the Human Rights Council. This analysis was a mid-term update of an earlier report submitted in 2015 concerning the inappropriate use of antipsychotic drugs in nursing homes, which essentially amounts to a “chemical restraint,” intended not for the benefit of the patient, but for the convenience of the staff, usually to keep patients docile. It’s also sometimes used a form of discipline.
Excessive control of behavior through medication has proven dangerous to patients, particularly those with dementia and Alzheimer’s disease (those to whom it is most often prescribed). The medications in question are intended to treat conditions like schizophrenia. But in the majority of cases where these drugs are being prescribed in nursing homes, these are not patients who suffer from psychosis. Their symptoms are not alleviated with the use of these medications. Further, overuse of such drugs erodes a person’s autonomy, as they may not think clearly or might exhibit less interest in self-care. As noted by researchers at Marquette University, they may be at increased risk for:
- Falls/ gait disturbances
- Functional decline
- Movement disorders
- Heart attacks
Note that federal law requires each nursing home resident’s drug regimen should be free from unnecessary use of drugs.
The LTCCC reports that since its initial submission on the issue three years ago, it’s continued to monitor the problem, with data revealing only very modest change in the prevalence of these drugs in elder care facilities. The initial report revealed nearly 23 percent of residents in U.S. nursing homes were receiving some type of antipsychotic medication, too often used to sedate residents so their behaviors and the underlying causes of those behaviors could be ignored by nursing home staffers.
Nursing home abuse attorneys in West Palm Beach know that misuse of these medications was what prompted the U.S. Food and Drug Administration (FDA) to issue a “black box” warning (the most severe the agency gives) to warn against using these medications to treat elderly patients who suffer from dementia, noting that the practice is “associated with a significantly increased risk of death.” A report by the Office of the Inspector General for the U.S. Department of Health and Human Services in 2011 found that 83 percent of antipsychotic drug use in nursing homes was off-label and nearly 9 in 10 nursing home patients receiving them had a condition outlined in the FDA’s black box warning.
CMS launched a partnership with nursing homes to slash the rate of inappropriate use of antipsychotic drugging by 15 percent in nine months. That goal failed, and it took a whole entire year to reach that point. LTCCC estimates the result of that failure is that 80,000 additional residents in these nursing homes were still given these medications – at great financial and personal cost. Further, neither the states nor CMS are consistently enforcing this directive, the non-profit researcher is accusing CMS of mischaracterizing its successes, with reductions being insufficient and the use of antipsychotic drugs still being widespread.
For example, in December, LTCCC published an alert indicating 20 percent of residents in nursing homes were still receiving these medications, based on quarterly federal reports. That’s only about 2 percent less than what was reported in 2014.
Earlier this year, Human Rights Watch published a report called, “They Want Docile,” revealing that nearly 180,000 nursing home residents are given these powerful, dangerous drugs for off-label purposes every week.
Another recent report concluded that while there was a slight reduction in the number of patients with dementia receiving antipsychotic drugs, there was a 12 percent increase in psychosis diagnoses among nursing home patients.
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LTCCC Mid-Term Report to United Nations: U.S. Nursing Home Antipsychotic Drugging, April 2018, LTCCC
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Analysis: Corporate Ownership of Nursing Home Affects Care Quality, March 23, 2018, Nursing Home Abuse Attorney Blog