If you are one of the many North Carolinians who had to make the difficult decision to place your parent in a nursing home due to his or her Alzheimer’s disease, dementia or other form of mental deterioration, you probably worry that the staff may not give him or her the compassionate care (s)he deserves. Sadly, you may have cause for concern.
Human Rights Watch recently released the results of its extensive study of nursing home abuse and neglect throughout the country. What they found is truly horrifying. Many nursing homes give their patients antipsychotic drugs, despite the fact that no doctor prescribed them. Why? Because they want to control the patients’ behavior and make them easier to manage.
The study covered 15,000 nursing homes nationwide. Of the 1.1 million elderly patients living in these facilities, staff routinely dosed over 179,000 of them with antipsychotic medications such as Haloperidol, Seroquel and Risperidone. None of these elderly patients suffered from schizophrenia, bipolar disorder or any other condition or disease for which doctors prescribe such drugs.
Rather, staff freely admitted that their purpose was to control these patients’ frequent noisy outbursts and/or combative behaviors. In extreme cases, this unauthorized dosing practice applied to 30 percent of the patients, most of whom had no idea what medications they received. Nor did their families. Elder rights advocates call this widespread practice the use of chemical restraints.
Lax federal oversight
The Nursing Home Reform Act of 1987 gives your parent and other nursing home residents many protections. The Centers for Medicare & Medicaid Services enforces the NHRA’s rules and regulations. However, the CMMS is notoriously lax when it comes to enforcing antipsychotic drug administration regulations. Between 2014 and 2017, it issued only 7,039 citations for improper nursing home administration of these drugs. Furthermore, it waived the mandatory fines for over 97 percent of the cited facilities, determining that the patients suffered “no actual harm.”
Federal law bans antipsychotic drug usage in patients suffering from illnesses for which these drugs are contraindicated. In addition, federal law requires close monitoring of any patient receiving such drugs. The CMMS, however, placed a moratorium on these regulations in 2016.
Consequently, you need to be proactive when it comes to monitoring the medications the nursing home gives your parent, especially if (s)he suffers from dementia or Alzheimer’s disease. Not only does the FDA warn against giving antipsychotic drugs to such patients, it requires their manufacturers to place a “black box” warning label on these products regarding their risks. For instance, the risk of death in elderly patients to whom these drugs are administered is twice that of younger patients.
Do not hesitate to question your parent’s caregivers about the medications they give him or her. Also do not hesitate to ask your parent’s physician which medications (s)he has prescribed for your parent and why. If you suspect that your parent is a chemical restraint victim, complain to the nursing home in writing and consider the possibility of filing suit against the facility.