Human Rights Report Finds Nursing Homes Using Antipsychotic Drugs To Subdue Residents
A recent report from Human Rights Watch (HRW) contends that “chemical restraints” in the form of antipsychotic drugs are commonly being administered to the elderly residents of nursing homes.
According to the report, more than 179,000 American nursing home residents receive antipsychotic medications without an appropriate diagnosis. HRW purports that the reason for this is to subdue and control them.
Federal regulations ban using drugs as a means of restraint, and still, the practice appears to be common. What’s more, researchers from HRW found that these homes are rarely penalized when the abuse is uncovered.
One of the especially worrisome outcomes of this trend is that the use of antipsychotic drugs, which include brand names such as Risperdal, Seroquel, and Abilify, doubles the risk of death in older adults who have dementia.
From the report:
“Antipsychotic drugs alter consciousness and can adversely affect an individual’s ability to interact with others. They can also make it easier for understaffed facilities, with direct care workers inadequately trained in dementia care, to manage the people who live there.”
Indeed, the Food and Drug Administration mandates a warning on these medications about the dangers of using them on dementia patients, and in fact, they have not been approved for the treatment of this illness. Rather, they are indicated for use in the treatment of other severe psychiatric conditions, such as bipolar disorder and schizophrenia.
These drugs are often administered without consent from either the patient or their healthcare spokesperson. And even then, if consent is given, it’s often because the information given by nursing home staff was misleading.
Hannah Flamm, NYU law school fellow at Human Rights Watch, from an article posted on the HRW website:
“All too often, staff justify using antipsychotic drugs on people with dementia because they interpret urgent expressions of pain or distress as disruptive behavior that needs to be suppressed.”
In interviews, nursing home staff, residents, and their families told HRW that these medications are not always used as a last resort, but rather, that they are used by default for staff convenience, such as controlling residents who are challenging to manage.
The report noted a particularly disturbing interview, in which a social worker stated that one behavior that could result in an antipsychotic prescription was someone continually crying out “help me, help me, help me.”
A Reversing Trend?
According to recent data from the Centers for Medicare & Medicaid Services (CMS), however, the number of long-term nursing home residents who receive antipsychotic medications fells from 24% in 2011 to less than 16% last year, and decreases were found in all 50 states.
About one decade ago, the Department of Health and Human Services say that about 270,000 residents of nursing homes who experienced dementia were given antipsychotic drugs.
But other advocacy groups, such as the Center for Medicare Advocacy and AARP Foundation Litigation state that while the rate of antipsychotic use on the elderly appears to be dropping, it is still excessive, especially in light of the fact that older people with dementia have an increased risk of death when treated with these medications.
These groups also purport that the enforcement of regulations on medication has been inadequate and fear that it may become even more dismissive under the Trump administration, which is seeking an agenda of deregulation.
Moreover, the report states, nursing homes received over 7,000 citations for violations of the Nursing Home Reform Act of 1987 associated with the use of antipsychotic medications over a three year period. And yet, 97% of those citations didn’t issue monetary penalties.
To reach their findings, HRW investigators examined publicly available federal data, a review of regulatory standards, government reports, and academic studies. From October 2016-March 2017, they also visited more than 100 nursing facilities in six states and conducted 323 interviews with residents, their families, nursing home personnel, and others.
The report also noted that this information is “especially relevant at this time” due to the aging U.S. population. They said that most of the residents they visited in nursing homes are over age 65 and that 1-in-7 Americans are older adults, accounting for about 50 million people. That number is expected to double by the year 2060.
Also, the number of American seniors with Alzheimer’s disease, which is the most common form of dementia is expected to rise from 5 million currently to 15 million by 2050.
From the report:
“The system of long-term care services and supports will have to meet the needs – and respect the rights – of this growing population in coming years.”
~ G. Nathalee Serrels, M.A., Psychology