Are Nursing Homes Over-Drugging Their Residents?

According to the San Francisco-based organization California Advocates for Nursing Home Reform (CANHR), more than 25,000 California nursing-home residents are being given anti-psychotic drugs. That’s about a quarter of the state’s nursing-home population, and according to CANHR and other elder-rights activists, it’s a figure that’s way too high — particularly considering the negative side effects these medications can have.

“They’re being sedated into zombie-hood,” says CANHR staff lawyer Tony Chicotel.

Two High Ranking Senators – Grassley & Kohl – Question Use of Psych Drugs in Nursing Homes

WASHINGTON — Two high-ranking senators have urged the Centers for Medicare and Medicaid Services (CMS) to take a closer look at potential over-prescribing of atypical antipsychotics to nursing home residents. Atypical antipsychotics are not approved to treat dementia, and must carry black box warnings that elderly people who take atypical antipsychotics have an increased risk of death, compared with those who take placebo pills for dementia. Still, it’s clear that these drugs are being used in nursing homes to control behavioral problems related to dementia. A 2011 report from the Department of Health and Human Services Office of the Inspector General (OIG) found that 14% of all nursing home residents with Medicare had claims for antipsychotics and 88% of the atypical antipsychotics prescribed off-label were for dementia.

And in 2009 Elli Lilly, the makers of olanzapine (Zyprexa), pled guilty and paid $1.4 billion to the federal government for allegedly targeting doctors who worked in nursing homes and assisted living facilities to prescribe olanzapine off-label to elderly patients with dementia. In their letter, Sens. Charles Grassley (R-Iowa) and Herb Kohl (D-Wisc.), urged CMS administrator Donald Berwick, MD, to examine the issue of overuse of antipsychotics in nursing homes more closely. The letter is a follow-up to one the senators sent in May after the release of the OIG report, which the senators themselves requested.

Use of chemical restraints in nursing homes called an epidemic

Nearly 25 percent of the residents in California’s nursing homes are placed on antipsychotic drugs, often used as sort of a chemical leash to control behavior in a trend a watchdog called an epidemic Thursday at a symposium. The drugs can double the risk of death for seniors with dementia and cause side effects ranging from stroke to delirium, according to speakers at an Oxnard conference called “Toxic Medicine.”

The Way Antipsychotics Are Used in Nursing Homes Called “A form of elder abuse” by Patient Advocates

Patricia McGinnis, executive director of the California Advocates for Nursing Home Reform, said nursing homes must be “accountable” for the drugs they administer. “The way anti-psychotic drugs are used in nursing homes is a form of elder abuse,” McGinnis told the forum. “Instead of providing individualized care, many homes indiscriminately use these drugs to sedate and subdue residents.”

Nursing homes are seeking to end the psychiatric drug stupor

The dangers of [psychiatric ] drugs: The drugs are especially hazardous to older people, raising the risk of strokes, pneumonia, confusion, falls, diabetes and hospitalization. “There’s a bunch of problems, not least of which is those drugs can kill you,” said Dr. Mark Kunik at Baylor College of Medicine in Houston who spoke last month at the Gerontological Society of America’s annual meeting in New Orleans. Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms, he said, because “It’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.” Federal regulators are cracking down on homes that don’t routinely reassess residents on psychotropic drugs. But use remains widespread.