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Nursing homes and chemical restraints: a continuing problem

If you are a Pennsylvania resident who had to make the difficult decision to place your parent in a nursing home because of his or her deteriorating physical and/or mental condition, it probably was one of the most heart-wrenching decisions of your life. You know you cannot care for him or her yourself due to your family situation, your work schedule, and all the other things you must deal with on a daily basis, but (s)he nevertheless is always on your mind. You worry that (s)he may not be receiving the care (s)he needs and deserves.

You may have more to worry about than you realize, especially if your parent suffers from Alzheimer’s disease or dementia. A new Human Rights Watch investigation found that nursing homes across the nation routinely administer antipsychotic drugs to patients who do not need them, often without their knowledge or consent.

Investigation findings

In a massive 157-page report, Human Rights Watch released the findings of its investigation of nursing home drug abuse. It found that approximately 1.1 million elderly people were living in 15,600 nursing homes across the country in 2017. Over 179,000 of these patients, about 16 percent, routinely received antipsychotic drugs even though they did not have a diagnosis of schizophrenia, bipolar disorder or any other disease or condition for which health care providers prescribe antipsychotic drugs. In some nursing homes the rate was over 30 percent.

Many of these patients, however, did suffer from some form of dementia. Nursing home staff freely admitted that giving these patients such antipsychotic drugs as Haloperidol, Risperidone and Seroquel controlled their often combative and noisy behavior. Elder rights advocates call them “chemical restraints.”

Federal regulations

The Nursing Home Reform Act, passed into law in 1987, gives strong legal protections to nursing home residents. Its regulations regarding antipsychotic drugs, however, are seldom enforced. Between 2014 and 2017, the Centers for Medicare & Medicaid Services issued only 7,039 drug-related nursing home citations. Nevertheless, since 97 percent of the violations caused “no actual harm,” the facilities cited did not have to pay the law’s “mandatory” financial penalties.

Federal regulations also ban the use of such drugs when their usage is not indicated. In addition, nursing home staff must properly monitor patients receiving these drugs. However, the CMS announced last November that it has placed a moratorium on these and other regulations.

The Food and Drug Administration, which regulates antipsychotic and other drugs, has never approved them as either effective or safe for dementia treatment. In fact, it requires manufacturers to give them a “black box” warning about their risks. Their usage nearly doubles the risk of death in elderly dementia patients.

If you suspect that your parent’s nursing home is giving him or her antipsychotic drugs for purposes of controlling his or her behavior, your best strategy is to contact an experienced elder abuse attorney. (S)he can assess your parent’s situation, suggest ways for you to gather evidence, and determine if you and/or your parent have a valid complaint against the nursing home for which you can file suit. 

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