Powerful anti-psychotic medications are being prescribed at alarming rates in nursing home settings – often to patients who do not need them.
Many Louisville families recognize a failure to prescribe or to give needed medication as an example of nursing home abuse or neglect. But fewer realize that just because a drug is prescribed does not mean it is necessary or appropriate, and that giving these drugs to patients can also become a form of abuse.
More public scrutiny about the use of physical restraints on nursing home residents in cognitive impairment has led to a reduction in the use of physical restraints and more reliance on chemical restraints, according to a 2014 study in the Journal of the American Geriatrics Society.
According to a researcher at the University of California, San Francisco, up to 20 percent of nursing home patients receive anti-psychotic drugs. The purpose of these drugs in many cases is to act as a “chemical restraint,” slowing patients down and making them easier for nursing home staff to handle.
The problem is that restraining patients by any means is intended to be used only as a last resort for patients who are combative or a constant flight risk even when less-extreme measures are used to calm, contain, or redirect them. But many patients who do not need restraints are being given anti-psychotics for the convenience of the nursing home staff.
These medications can be particularly dangerous for elderly adults. They can cause agitation, confusion, disorientation and death. Antipsychotics carry a warning label that they are not intended for patients with Alzheimer’s or dementia.
Recently, a nursing home in Ventura County, California agreed to a settlement in a class-action case for the use of anti-psychotic medications on patients who did not need them and who died as a result of the treatment. Attorneys in that case say it is only the first in a wave of desperately needed nationwide reforms.
Toby Edelman, an attorney with the Center for Medicare Advocacy in Washington, D.C., said the use of antipsychotics as restraints is one of the most common forms of harm to nursing home patients. In some cases, drug manufacturers have marketed their medications including antipsychotics to nursing homes and pharmacies that serve the long-term care residents.
In most cases, anti-psychotic medications must be administered only after “informed consent” is given. If a nursing home patient is able to give this consent, he or she must provide it. If the patient cannot consent, his or her family members or the person with healthcare power of attorney must provide consent.
However, this consent is frequently not sought or obtained when nursing homes use anti-psychotic medications to restrain patients. Instead, family members are kept in the dark about what medications their elderly loved ones are receiving.
Nursing home patients typically require a high level of care. According to the AARP, approximately 60 to 70 percent of residents have some form of dementia. Many are incontinent or incapable of feeding, dressing, or bathing themselves.
Yet too many nursing homes are understaffed, and nursing assistants hired to care for patients typically lack the training required to give proper care. Overworked, exhausted, untrained assistants may begin to see their patients’ ordinary needs as “behavior problems” instead of natural responses that occur when the patient’s basic needs are not being met.
This combination of factors makes chemical restraint with anti-psychotics seem much more tempting – and much more likely to occur without proper attention or oversight to dosage, prescription, or consent rules.
If you suspect a loved one is being abused or neglected in a nursing home setting, don’t hesitate to contact the experienced Kentucky elder abuse attorneys at the Becker Law Office for a free and confidential consultation.