Antipsychotics: Robbing the Elderly?

Elderly hands receiving different medications from the doctor – medicine abuse concept.

An article in the Kansas City Star reports that government officials and advocates are speaking out against the horrific practice of nursing homes overmedicating residents.

According to the article, Kansas has always ranked near the top percentage of medicated residents. This means that thousands of residents in nursing homes are being given drugs that are not necessary and actually puts them at risk of harm.

Former Secretary of Aging, Kathy Greenlee, says that the practice of utilizing drugs or chemicals to restrain nursing home residents is the result of the removal of physical restraints in nursing homes and care facilities in the 1980s and 1990s.

Now when people visit nursing homes they’ll no longer see residents strapped to beds and wheelchairs. But they will likely see some under “chemical restraint,” through the use of anti-psychotic medications like Haldol and Seroquel, which Charlene Wagner said have caused her husband to deteriorate.

The Wagner’s are one of thousands of families that are experiencing the devastating effects of this practice. Allen Wagner has Lewy Body Dementia and Parkinson’s disease. His wife Charlene claims that she is not sure how many of his symptoms are because of his disease or from the medications. She states:

“I’ve seen a change since he went to the nursing homes,” Charlene Wagner said. “Not because of the care. The care is good. I believe it’s the medicines.”

According to the article, Charlene claims that her husband hardly reacts to visitors, he is sleepy and does not communicate, and overall he is in a state of sedation.

 If someone you love is in a care facility and you notice that they are not acting like themselves, it is important to attempt to ask them how they are feeling. It is also important to question the care facility as to the change. Have they changed medications? What medications are they giving your loved one? And why? What are the purposes and diagnoses required of certain medicines?

One thing to keep in mind, is the complications that can arise when residents who have dementia are given antipsychotic medications. Antipsychotic medications are not suggested to be used by people with dementia. The Food and Drug Administration warns that the use of such drugs increase the risk of falls, strokes, and other fatal side effects.

“There’s something about that dementia coupled with the anti-psychotics,” said Margaret Farley, a board member for Kansas Advocates for Better Care, a group that represents nursing home residents. “This is not just us saying, ‘Gee, that’s not very good, you’re robbing them of their personality, they won’t talk, they’re not active, etc, etc.’ This is hardcore. This is a 1.6 to 1.7 times increase in deaths that most of the time is related to cardiovascular changes or it’s related to the development of pneumonia.”

Robbing the elderly of the right to live with dignity is so horrible. Putting people in chemical restraints, is not only dangerous, it violates people’s rights. If you are concerned about your loved one, it is so important to ask questions about the medications they are on, when they began to receive them, the side effects, and if they are on antipsychotics, when should they be taken off of them.

According to an article in AARP, Charlene Harrington, professor of nursing and sociology at the University of California, San Francisco, states that as many as 1 in 5 patients in the nation’s 15,500 nursing homes are given antipsychotic drugs that are not only unnecessary, but also extremely dangerous for older patients. The problem, experts say, stems from inadequate training and chronic understaffing, as well as an aggressive push by pharmaceutical companies to market their products.

Kansas, much like the rest of the country, is experiencing difficulties with money and staffing. The article reports that the state is having trouble finding qualified staff. It also states that like many facilities throughout the U.S., many of the facilities rely on Medicaid and it is difficult to count on payment under the programs because of bureaucratic issues.

Human Rights Watch released an extremely critical report identifying issues in the overmedicating crisis:

• Failure to adequately enforce the right to be fully informed and to refuse treatment or to require free and informed consent requirement. The Nursing Home Reform Act of 1987 grants residents the right “to be fully informed in advance about care and treatment,” to participate in care planning, and to refuse treatment without penalty. If it were enforced fully, these protections would not differ substantially from the right to free and informed consent. However, without adequate enforcement, current practice falls far short of this protection.

• Lack of minimum staffing regulations. Adequate numbers of sufficiently competent staff are at the crux of nursing facility care. Yet government regulations do not set a minimum staffing requirement for nursing facilities, instead requiring that facilities determine for themselves what amounts to “sufficient” and “competent” staff for their residents. While experts put minimum adequate nursing staffing time at 4.1 to 4.8 hours per resident per day, most facilities self-reported to the government providing less than that; almost one thousand facilities self-reported providing less than three hours of staff time per day.

• Weak enforcement of federal regulations specifically banning chemical restraints and unnecessary drugs. Federal regulations prohibit chemical restraints—drugs used for the convenience of staff or to discipline residents without a medical purpose—and unnecessary drugs: a technical term meaning drugs used without adequate clinical indication, monitoring, or tapering. The regulations also provide for the right to refuse treatment. However, federal and state enforcement of these regulations is so weak that the drugs are routinely misused without significant penalty. Almost all antipsychotic drug-related deficiency citations in recent years have been determined to be at the level of causing “no actual harm,” curtailing the applicability and severity of financial sanctions.

There are several signs to watch for if you are afraid that your loved one is being over medicated. Here are several signs to watch for:

• Drowsiness
• Physical complications (for example, dry mouth or ulcers)
• Confusion
• Withdrawal from family and friends
• Hallucinations
• Dizziness or falls
• Fractures
• Seizures
• Sudden changes in behavior

If you are concerned that your loved one is the victim of “chemical restraints,” being robbed of their personalities, their right to age with dignity,

and you have questions, please feel free to comment below. I am here to help. This is a complicated and extremely frightening practice, and you are not alone.

If you would like more information from this article, you can read it here.