Recent data shows that approximately 185,000 nursing home residents were treated with antipsychotic drugs in 2010, despite recommendations against the use of such potent drugs unless absolutely necessary. The problem with antipsychotics is serious; these drugs are known to cause death. Recently, federal regulators upped the ante to reduce antipsychotics via a multi-year initiative.
The first steps set the bar low at a 15% reduction of antipsychotic medications by the end of this year. Future reductions are unclear. What is clear is the need to address this drug problem. In early May the Boston Globe obtained data on the use of antipsychotics nationwide with nursing home patients.
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According to the Globe’s findings, 16.7 percent of nursing home residents without a psychotic illness are treated with antipsychotics nationwide. The drugs are commonly used to target behavioral problems when nursing home personnel do not have the time or patience to address behavior differently. Not surprisingly, the use of unnecessary antipsychotics is higher in homes where residents rely primarily on Medicaid funding.
Medicare and Medicaid services paint a more startling picture with the statistic that more than 40% of dementia patients improperly receive antipsychotics. Overuse of these drugs poses a severe threat to patients. Since 2005, the Food and Drug Administration (FDA) has released multiple warnings cautioning doctors and nurse against the dangers of these drugs.
Amongst these reports, a black box warning (the most serious kind) cautioned care providers that antipsychotics can increase the chances of death. Warnings also indicate that antipsychotics increase the risk of heart attack and stroke. For dementia patients, the drugs may worsen confusion or mobility symptoms.
FDA warnings indicate that the drugs are particularly risky for patients with dementia. Unfortunately, many doctors and family members of those with dementia often believe that the drugs are beneficial or necessary to patient treatment.
Antipsychotics drugs have a sedative effect and in some instances they are used to immobilize patients who demonstrate aggressive behavior. Instead of using antipsychotics, caretakers could try to use alternative calming techniques such as massage music and one-on-one attention.
One chain of homes that performs above national care standards uses alternative methods successfully. The caretakers there take patients to a black room with black lights and soothing music. If a patient is particularly worked up, a caretaker may stay one on one to monitor their progress.
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One-on-one attention is hard to come by in nursing homes. According to data from the Globe, some of the worst performing homes spend as few as three or four minutes a day with each individual patient. Probably not by coincidence, these homes also have the highest rates of unnecessary medication use.
Take the Rainbow Pavilion Nursing Home in Chicago for example. According to the Chicago Tribune, proceedings are currently pending to revoke the license of this home. Closure is no surprise when you see the shocking data about this home.
Boston Globe data shows that 100% of the residents without psychosis or related diseases receive antipsychotic medications. Furthermore, registered nurses only spend about 4.1 minutes per day with each of the 166 residents in the home. About 93% of these residents have behavior problems unrelated to psychosis.
Columbus Manor Residential Care is another frightening example of a home slated to lose its license in pending revocation proceedings. Globe data on this home shows 100% use of antipsychotics on residents without diagnosed psychosis or related conditions. Of these 134 residents, only 53 even have behavioral problems!
It is clear that patients should never be endangered by unnecessary medication. Our experienced nursing home lawyers want homes to provide the elderly with the loving care they deserve. Improper medication is simply unacceptable.