At least two California nursing homes have been charged with habitually overmedicating elderly residents for no other reason than to staff convenience. The drugs given are known as antipsychotics, and are given to residents without any psychiatric diagnoses. Nursing home abuse lawyers at Pintas & Mullins highlight this often-fatal form of abuse against the elderly, and how to spot signs of overmedication in elderly loved ones.
The two California nursing homes with charges filed against them are Watsonville Nursing Center and Watsonville Post-Acute Care Center.
One of the charges centers on an elderly resident who was given the drugs Haldol and Risperdal without his, his family’s or his physician’s consent. Two weeks after dosing him, the patient was hospitalized for an array of ailments including infected bedsores and sepsis, which is a blood infection caused by untreated bedsores.
Without knowing anything further of this case, one can make a few guesses as to what exactly happened at this nursing home. Understaffing is a widespread problem in nursing homes like Watsonville that are run by for-profit corporations. Because the facilities are so understaffed, the employees who are working are stressed and overwhelmed by the high-needs residents, and most are untrained in mental health care. Often times, for the convenience of overworked employees, nursing homes overmedicate residents as a simple way to sedate them and make them less “needy.”
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If a bed-ridden resident is sedated they are unable to ask for help or even recognize that they are developing serious injuries like bedsores. Bedsores, also called pressure ulcers, occur when a patient with limited mobility is not moved from certain positions for long periods of time. Sores often develop on skin close to the bone, such as the back, sacrum, heels and elbows. If these bedsores continue untreated, they decay the skin, muscle and bone, ultimately causing life-threatening infections like sepsis.
Bedsores are one of the most common and indicative signs of nursing home abuse or neglect. Any resident who is immobile or unable to move around on their own is at risk of developing bedsores, which the nursing home must take all necessary steps to avoid. It is their legal responsibility to prevent bedsores from developing and to treat them so they do not progress.
In 2010, the University of South Florida conducted a study and found that more than 70% of Medicaid residents in state nursing homes received a psychoactive drug. Most of these residents did not have any psychiatric diagnoses, and were not taking such medications before entering the nursing home. Another 15% were taking four or more psychoactive drugs.
True, some nursing home residents may medically require a psychoactive drug to manage their symptoms of schizophrenia or bipolar disease – but certainly not 71%. The FDA has even
made it explicitly clear that psychoactive drugs like Risperdal are extremely dangerous in the elderly, significantly increasing the risk of premature death.
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Making matters worse, antipsychotic drugs can negatively interact with the other medications residents may be taking; the average nursing home resident is prescribed 10 or more drugs. More often than not, it is the dangerous combination of powerful drugs that cause things like falls, confusion, and repeated hospitalizations in residents.
When a resident is admitted to a nursing home, the law requires that they are assessed for mental illness. However, in many states, new residents who are admitted directly from hospitals are exempt from these evaluations. Thus, less than half of residents with major mental illnesses ever actually receive these assessments upon admittance.
Imagine this scenario: a single nurse is overseeing the night shift at an 80-bed nursing home. In the middle of the night, one of the residents starts screaming and refuses the nurse’s help, becoming more and more agitated. She is waking the other residents, who are troubled by the commotion, so the nurse decides to administer a tranquilizer without first checking how the drug will interact with the patient’s other medications.
If the nurse was not the only one on duty that night, or she had better psychiatric training, she would have more time and resources to calm the agitated resident. A medication, however, is a simpler fix for someone in her situation. The consequences of this practice (commonly referred to as “chemical restraints”) are far-reaching.
In 2013, the U.S. Justice Department brought criminal charges against Eli Lilly for illegally promoting its antipsychotic drug Zyprexa to nursing home physicians. The drugmaker was accused of encouraging doctors to prescribe Zyprexa to residents with sleep problems and dementia, even though it is only approved for schizophrenia and bipolar. The result was a $1.4 billion civil settlement.
It is important to note that overmedication practice do not stem exclusively from negligent or abuse staff – it is just one factor in the wider, systemic problems within the nursing home industry. The solution, therefore, is multi-faceted. There needs to be more mental health professionals in nursing homes who specialize in senior care, and employees need to be more heavily trained in psychiatric conditions and alternative treatments. For their part, insurance companies need to cover mental health care at the same rate as physical medical care, so treatments like behavioral therapy are not out of the question for residents on a budget.
Families with loved ones in nursing homes need to keep an attentive and constant eye on the metal and physical health of the resident. If any new drugs are prescribed, family members need to ask why and do their own research about the medication, its interactions and prescribing information. If you sense something is wrong, bring your concerns to the director of nursing, who has more authority over care, or consult an outside physician or your state’s ombudsman. Nursing homes are also required to have quarterly care planning meetings, which families are welcome to attend.
If your loved one was seriously hurt or killed by abuse or neglect in a nursing home, you have the right to file a lawsuit. Contact our team of elder law attorneys immediately for a free, confidential legal consultation. We take on clients from all 50 states, and never charge unless we are successful on your behalf.