Overuse Of Antipsychotic Drugs In Nursing Homes. An Insidious Form of Abuse
As their very name implies, antipsychotic drugs are used to manage and treat severe psychological conditions such as bipolar disorder and schizophrenia. But in staggering numbers at nursing homes and assisted living facilities across the country, staff are administering these powerful medications inappropriately – and often without the consent of residents or their families – as a “convenient” means of making residents easier for staff to manage. This is a particularly insidious form of elder abuse, depriving vulnerable seniors of agency, diminishing their quality of life, and potentially causing catastrophic psychological, emotional, and physical harm.
Two reports in recent years have shed light on the scope of the problem, revealing that this form of abuse is rampant, widespread, and rarely the subject of any regulatory or governmental action.
Resorting To Harmful Medications In Lieu of Proper Staffing
The title of a July 2020 report by the U.S House of Representatives Ways and Means Committee Majority summed up the issue: Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes. The report found that approximately 20 percent of all nursing home residents in the United States – about 298,650 people every week – were given some form of antipsychotic medication in the fourth quarter of 2019, even though only about two percent had qualifying conditions for such drugs.
The report’s authors noted that while citations against nursing homes for improperly prescribing antipsychotics increased 200 percent between 2015 and 2017, such disciplinary action plummeted dramatically from 2017 to 2019. The authors concluded that:
“The high rate of antipsychotics use across our nation’s nursing homes show that many facilities continue to resort to the use of these potentially dangerous drugs — in lieu of proper staffing — which has the potential to harm hundreds of thousands of patients,” the report concluded.
Catastrophic Health Risks From Inappropriate Antipsychotic Use
This harm can take many forms. Sedation, a common side effect of antipsychotics, can make nursing home residents less able to communicate symptoms and health problems, leading to delayed detection and treatment. Additionally, the off-label use of antipsychotics can be particularly harmful for frail, elderly patients, leading to injuries, hospitalizations, and even death. These drugs carry severe potential side effects, including blood clots, diabetes, dyskinesia, fall risk, irreversible cognitive decompensation, pneumonia, severe nervous system problems, stroke, and visual disturbances.
Cruel, Inhuman, and Degrading
The House report followed a 2018 report by Human Rights Watch that found nursing homes in the U.S. unnecessarily give antipsychotic medication to an estimated 179,000 residents every week. The report’s authors found that the inappropriate administration of these drugs is particularly troubling for the large number of nursing home residents dealing with dementia or Alzheimer’s disease, conditions for which antipsychotics are not usually appropriate.
Human Rights Watch attributed the problem to several factors that the House report also cited, including insufficient staffing, inadequate caregiver training, and a lack of regulatory enforcement.
Not only are nursing homes administering antipsychotics as a way to make residents docile and easier to manage, but they often do so without the required informed consent of residents or their family members. As the report notes, “facilities that purport to seek consent fail to provide sufficient information for consent to be informed; pressure individuals to give consent; or fail to have a free and informed consent procedure and documentation system in place.”
The unnecessary and improper administration of antipsychotic drugs without the consent of the resident is a form of nursing home abuse. As succinctly put in the Human Rights Watch report, “the drugs’ use as a chemical restraint—for staff convenience or to discipline or punish a resident—could constitute abuse under domestic law and cruel, inhuman, and degrading treatment under international law.”
If you or a loved one believes that a nursing home or assisted facility is improperly administering antipsychotic medication, those substituting dangerous drugs for proper care should be held accountable.
Compensation may be available for such abuse. Please reach out to me today at 816.931.1400 to arrange for a free consultation. I welcome the opportunity to help you.