Overmedication

Of all the different potential abuses of nursing homes, the one that has the greatest stranglehold on the American imagination is overmedication. We all fear that nursing homes excessively use antipsychotics and other drugs to pacify their patients and keep them sedated. We all have a friend or neighbor who has a horror story about an older relative who entered a nursing home still lucid, but quickly changed once inside. The depressing truth is that this stereotype is partly right. Though this is not true of all nursing homes and all patients, there are nursing homes that clearly overmedicate and use drugs to make their residents easier to manage. Here are some of the most important facts:

  • More than 300,000 residents take antipsychotic drugs.
  • More than half of those who receive them lack medically accepted reasons for taking them.
  • 17% of residents receive greater than the recommended daily levels of antipsychotics.
  • 15,000 nursing home residents die each year due to un-prescribed antipsychotics.

Why Do Nursing Homes Overmedicate?

The nursing homes that do overmedicate do so for a variety of reasons. In some nursing homes, they just do not have enough staff to adequately take care of all of their patients. The caregivers at understaffed locations are more likely to make mistakes when administering medications because they are often overstressed and exhausted, and the excessive medicating may be unintentional.

Intentional Overmedication

There are also situations where patients are intentionally overmedicated. The patients who are aggressive, emotional, or uncooperative demand the most attention, but some facilities lack the time and human resources. Instead of having a caregiver who can work with each patient individually when they act out emotionally, these nursing homes have to resort to pacifying these patients using antipsychotics, tranquilizers, and other drugs. In better staffed nursing homes, a caregiver would be able to work with a patient and slowly wean him off these drugs, but that is sadly not the case everywhere.

Though not the norm, some nursing homes follow a caretaking philosophy that relies on excessive medication. Using drugs to keep patients sedated for long periods of time is called “chemical restraint.” If you observe that a large percentage of a nursing home’s residents receive antipsychotic drugs, it might be a sign that the facility is not concerned about overmedication.

How Do I Tell if a Nursing Home Is Overmedicating?

In the United States, fewer than 20% of nursing home residents medically require antipsychotic medication; however, you will find nursing homes where a much higher proportion of the population is on this type of medication. For example, in the state of Florida, over 70% of nursing home residents are on antipsychotics. When you see a nursing home with such a high use of antipsychotics and other sedatives, it is a good sign that they are using these drugs excessively.

If you have a loved one in a nursing home, there are usually a few signs that suggest that your family member is being overmedicated. These signs include:

  • Mood swings and unusual changes in personality and behavior
  • Reclusive actions from caregivers and family
  • Excessively tired, oversleeping, or lack of energy
  • Confusion or unresponsiveness
  • Unexplained medical complications and sudden changes in health

What to Do if the Facility Is Overmedicating?

Typically, you will be able to notice these types of changes very easily. If your family member is acting very differently, you should ask to see a log of the medications that have been administered. If you see antipsychotic or sedative drugs that you are unfamiliar with, you should ask why they are being administered, how long has the patient been on the medication, and when the treatment will be over. No one wants a member of their family to spend their remaining years heavily sedated in a nursing home. Not every nursing home fits the stereotype, but it is up to you to make sure that they are caring for your loved one appropriately and without the excessive use of drugs.

Sources:

“Information on Conventional Antipsychotics.” U.S. Food and Drug Administration. U.S. Department of Health and Human Services, 29 Mar 2011. Web. 2 Mar 2014. <http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm107211.htm>.

Ruiz, JG. “Avoiding Overmedication of Elderly Patients.”PubMed. 3(11).November (1996): 784-788. Web. 2 Mar. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/11862238>.

http://www.insideeldercare.com/health/how-to-spot-overmedication-in-nursing-homes/

https://oig.hhs.gov/newsroom/testimony-and-speeches/levinson_051011.asp

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