How patients are improperly drugged in nursing homes

Relationships, Family/Kids, Rights

Having a parent move into a nursing home is a stressful time. Although it may be the best (and sometimes only) option, it’s still a difficult decision to make. Furthermore, even once your parent is moved, you’ll continue to worry about their health, safety, and happiness.

Well, add this to your list of concerns: one in five nursing home patients are given antipsychotic drugs, often to keep them quiet or to control their behavior, not because they have an actual diagnosis that requires such powerful pharmaceuticals.

Why are these drugs so commonly used?

Elderly nursing-home patients are often drugged simply because it is such a simple way to make them manageable. Drugging patients lessens the demands on the staff and may even allow the nursing home to reduce staffing headcount. The drugs thus serve the same function as restraints once did – to keep patients tractable and in one place. They also quell complaints from patients, who are so heavily medicated they can no longer speak up.

While nursing home operators may perpetrate the over-medicating, the lawsuit chain indicates the problem starts with the drug makers. Johnson & Johnson, for example, was fined millions of dollars for aggressively marketing antipsychotics to nursing homes when they knew the drugs had not been proven safe for the elderly. Eli Lilly settled a similar suit.

Stay informed and be proactive

The use of these drugs is particularly common with dementia patients, who have disturbed sleep cycles and often do not respond well to rigid scheduling. If your parent has dementia, ask if the facility accommodates his or her needs by using a flexible schedule for sleeping, eating, and socializing. This approach is often referred to as the Beatitudes method, after a nursing home that implemented it.

Go over every single drug being administered to your parent. Write them down and ask what they are, then Google them yourself to be sure. Take your parent to an outside gerontologist if you aren’t sure that mom or dad is being appropriately medicated. Require notification every time a new drug is added to your parent’s regimen and follow the same procedure to double check the appropriateness of the new prescription.

An antipsychotic is often first prescribed in response to a so-called crisis, such as a patient being disruptive in the middle of the night, but it then has a way of becoming regular, continuing medication. If this happens to your parent, investigate the “crisis.” Find out what happened and why. If you suspect you are not being told the truth, ask to see the actual incident records, not an interpretation of them by a staff member. Ensure that a one-time dose does not become an ongoing prescription unless warranted.

The administration of antipsychotic drugs requires informed consent, either from the patient or from a legally designated person who acts in the patient’s best interest. So if you are the one authorized to make medical decisions and you think an unwarranted drug has been administered, tell the nursing home that you do not consent to this. Put it in writing if necessary.

Attend all planning meetings for your parent. Get involved with the nursing home’s parent council, where you can interact with other family members and determine if there are widespread problems.

Obtain medical authority

If you do not already have the authority to make medical decisions for your parent, contact an attorney to determine what you need to do to obtain it. You will also want to review whatever existing documents exist around health care directives or health care power of attorney; your parent may have designating you to step in when he or she is unable to make decisions, but your parent needs to be declared incompetent for it to take effect. If your parent is considered able to make decisions, obtain his or her written authorization allowing you to make decisions on their behalf.

Filing complaints

If you believe your parent is being drugged without consent, first complain to the staff and administration at the nursing home. Next contact your state long-term care ombudsman. These representatives ferret out nursing home abuse and advocate for patients. An elder law attorney can also help you. If you cannot reach a satisfactory solution, you may want to consider moving your parent to a facility that does not use antipsychotics on a regular basis. Careful research and visits will be needed to determine this.

Above all, stay involved. Be an aggressive advocate on your loved one’s behalf.

More information: