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Antipsychotic Drug Use on Decline in Nursing Homes

Nursing home abuse lawyers at Pintas & Mullins are glad to report the use of antipsychotic drug treatment in American nursing homes is on the decline. Antipsychotics, intended only for the treatment of such cognitive disorders as schizophrenia, have long been used in nursing homes as ‘chemical restraints,’ to subdue irritable residents, despite the severe and often fatal side effects.

The Center for Medicare and Medicaid Services (CMS) has been tracking antipsychotic use in nursing homes for several years, recently launching the National Partnership to Improve Dementia Care. Residents with dementia can become easily confused, agitated, or even violent if they are not cared for properly, and in nursing homes that are chronically understaffed, nurses may turn to antipsychotic drugs to subdue them.

Fortunately, between 2011 and 2013, the use of these medications fell more than 9% among long-stay nursing home residents, which translates to about 30,000 less seniors receiving unnecessary, dangerous medications. The use of antipsychotic drugs in patients who do not need them, such as those with dementia, can result in death, stroke, falls, and heart attack, among other side effects.

The Office of the Inspector General recently launched an investigation into the issue to see how often they are prescribed and the extent of their off-label use. The investigation focused on popular drugs Abilify, Seroquel, Zyprexa, and Risperdal. A similar report in 2011 found that an alarming 88% of dementia patients in nursing homes were prescribed an antipsychotic.

There are a number of alternatives for treating or dealing with dementia patients who are disruptive or cause disturbances, including enhanced nurse training, art therapy, exercise, and cognitive retraining. According to CMS, these alternative therapies promote dialogue, allow for creative expression, focus attention, elevate mood, engage residents, help trigger memories, give resident a voice, and build positive social interaction.

Families of residents in nursing homes can look out for signs of inappropriate or excessive antipsychotic use, such as poor self-care, anxiety, inattention to surroundings, nervousness or restlessness, unsociability, and wandering. Oftentimes residents are aware that the medications they are given are harming them, but are unable or discouraged from expressing their concern. When this happens, residents may become even more irritable, agitated, and uncooperative, reinforcing the dangerous cycle.

This type of situation recently occurred at a nursing home in South Dakota, leading to the abuse of a resident and subsequent arrest of the employee. The employee was charged with abuse of a disabled adult after the 76-year-old resident refused to take her medication. The employee proceeded to pull the resident’s hair, used a knee to pin down her legs, and squeezed her chest to try to get her to take the medication. The employee threw water on the resident’s face and allegedly yelled at her, saying she needed to take her pills.

In its initiative, CMS hopes to rethink the approach to dementia care, reconnect with residents via person-centered care practices, and restore good health and quality of life in American nursing homes. The states that prescribe the most amounts of antipsychotics include Louisiana, Tennessee, Texas, Utah, and Georgia.

This is a major problem for an array of reasons. One study found that residents taking antipsychotics had more than triple the risk of having a stroke compared to those not taking such drugs. Further, in 2005, the FDA issued a black box warning for all antipsychotics, noting that patients with dementia should discuss the risk of increased mortality while on the medication. It also highlighted that antipsychotics are not approved for the treatment of dementia-related psychosis (nor is there any medication approved for the condition).

Nursing home abuse lawyers at Pintas & Mullins have decades of experience advocating on behalf of those seriously injured in nursing homes. If you or a loved one was the victim of neglect or abuse at the hands of a nursing home employee, you have important legal rights, and may be entitled to significant compensation for your medical bills and emotional distress.