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Antipsychotic Abuse in Dementia Patients

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In 2012, the Centers for Medicare and Medicaid Services implemented new regulations in order to cut back the number of antipsychotic drugs prescribed in nursing homes. Despite their efforts, a recently released study conducted by the Human Rights Watch, and reported in The Washington Post, revealed that antipsychotics are still often misused as chemical restraints to keep patients docile and free from inconvenient behavioral disturbances. Perhaps more shockingly, they are sometimes administered without patient or familial consent.

Though some cutbacks in the drugs’ use have been made, it is estimated that nearly 179,000 nursing home residents are still being improperly prescribed the medications on a regular basis.

Antipsychotics, when used appropriately, can have profound effects for those suffering from schizophrenia, bipolar disorder or psychotic depression. However, the Food and Drug Administration never declared these drugs safe for the elderly suffering from dementia. In fact, they did the opposite.

The FDA mandates that a black box warning be placed on all antipsychotic drugs, warning that their use can actually significantly increase the risk of death in dementia patients. They go on to say, “Antipsychotics are not indicated for the treatment of dementia-related psychosis” either.

So why are they being given to nursing home residents who suffer from dementia? The Human Rights Watch cites convenience for staff, especially in understaffed facilities, as a top factor.

Antipsychotics have sedative properties that can turn agitated, confused, sometimes even aggressive residents into sedated, sleep-ridden, compliant patients, making them easier to handle. Particularly for an understaffed facility, sedated and compliant patients prove to be more convenient for an overwhelmed nursing staff.

Deficiencies in dementia care training and a false belief that the medications can actually help, without a proper understanding of the risks and dangers, also play a part in the copious rates of improper drug distribution.

The study went on to find that in many cases, antipsychotics were given without proper consent. In other instances, fear played a role. One woman recalled feeling pressured into allowing staff to administer the psychotropic drugs, fearing that if she said no, her sister would not get properly cared for and bathed.

Though the Centers for Medicare and Medicaid Services has worked to see a reduction in the administration of these drugs, 179,000 is still too far great a number of residents being given these for reasons other than their intended use.

CMS has their eyes set on a new goal, aiming to see a 15 percent decrease in antipsychotic use by the end of 2019. In addition, a drive to introduce non-pharmacological methods of symptom management for dementia patients is on the horizon.

Alternatives to managing the behavioral symptoms of dementia include therapy, determining and addressing underlying causes of loneliness and fear, and changing routines or environment.

A decrease in antipsychotic drug use over the past few years is a start, but not nearly where it should be.

At Jehl Law Group, we have too often seen the devastating effects of understaffed facilities on residents, including a lack of medication regulation.

If you or a loved one has been affected by medication mismanagement or inappropriate antipsychotic drug use, please contact us for a free consultation. We have years of experience in successfully addressing nursing home injustices and fighting for our clients.