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U.S. NEWS Tuesday 6 February 2018

American Living:

New report details misuse of antipsychotics in nursing homes

release of a detailed report of government regulations,
by Human Rights Watch often administer antipsy-
urging federal and state chotic drugs without ob-
authorities to take tougher taining consent from resi-
measures against improper dents or the relatives who
use of antipsychotic drugs. represent them.
"On paper, nursing home Hannah Flamm, the re-
residents have strong legal port's lead author, said
protections of their rights, the recent data showing
but in practice, enforce- a decline in antipsychotic
ment is often lacking," said usage demonstrated how
the report, based on inter- extensive the overmedica-
views with more than 300 tion problem had been. In
people and visits to 109 an interview, she said the
nursing homes in six states. lower numbers don't im-
Ten years ago, accord- press her.
ing to the Department of "Would you want to go
Health and Human Servic- into nursing home if there's
es, roughly 270,000 nursing a one in six chance you'd
home residents suffering be given a drug that robs
from dementia were re- you of your ability to com-
ceiving antipsychotic drugs municate?" she asked. "It's
even though such medica- hard for me to applaud the
This Aug. 3, 2017 photo provided by Human Rights Watch shows Laurel Cline during a visit to her
mother Lenora, who has Alzheimer's disease, in a nursing home in Whittier, Calif. Laurel says her tions are not approved to reduction when it's inexcus-
mother, during stays at three different nursing homes in recent years, was sometimes left neglect- treat that condition. The able to ever misuse these
ed for hours at a time in her wheelchair after being given antipsychotics. "Instead of seeing what's powerful class of drugs is drugs."
wrong with her, they just want to drug her up," said Cline. intended, instead, to treat The American Health Care
(Ed Kashi/Human Rights Watch via AP) serious mental illnesses such Association, which repre-
By DAVID CRARY cent last year. Decreases Foundation Litigation — say as schizophrenia and bipo- sents more than 13,000 U.S.
AP National Writer were reported in all 50 even the lower rate of an- lar disorder. nursing homes, was active
NEW YORK (AP) — U.S. states, with the biggest in tipsychotic usage is exces- Analyzing the latest govern- in the national partnership
nursing homes have sig- Tennessee, California and sive, given federal warnings ment data, Human Rights formed by CMS in 2012 that
nificantly reduced the use Arkansas. that elderly people with Watch estimates there are worked to reduce unnec-
of powerful antipsychotic Dr. Jerry Gurwitz, chief of dementia face a higher risk now about 179,000 people essary use of antipsychot-
drugs among their elderly geriatric medicine at the of death when treated with in nursing homes who get ics. The association’s senior
residents, responding to University of Massachusetts such drugs. antipsychotics every week vice president for quality
pressure from many direc- Medical School, depicts "Given the dire conse- without having a diagnosis and regulatory affairs, Dr.
tions. Yet advocacy groups the overall decrease as quences, it should be zero," for which the drugs are ap- David Gifford, said a ma-
insist that overmedication "one of the most dramatic said attorney Kelly Bagby proved. jority of the organization’s
remains a major problem, changes I've seen in my of the AARP foundation, "Antipsychotic drugs alter members reduced usage
and want the pressure to career." He wonders, how- which has engaged in sev- consciousness and can by more than 30 percent,
intensify. ever, if some nursing homes eral court cases challeng- adversely affect an individ- while some others failed to
According to the latest might be finding other ing nursing home medi- ual's ability to interact with fully embrace the initiative.
data from the federal Cen- medications that sedate cation practices. Bagby others," the new report says. The biggest challenge,
ters for Medicare & Med- their patients into passivity contends that the drugs "They can also make it eas- Gifford said, is to change
icaid Services, known as without drawing the same are frequently used for their ier for understaffed facili- a mind-set among some
CMS, the percentage of level of scrutiny as antipsy- sedative effect, not be- ties, with direct care work- nursing home staff and
long-term nursing home chotics. cause they have any ben- ers inadequately trained in some residents’ families
residents being given anti- Advocacy groups — in- efit to the recipients. dementia care, to manage that behavior arising from
psychotic drugs dropped cluding the Washington- The advocacy groups' long- the people who live there." dementia is “abnormal”
from about 24 percent in based Center for Medi- running campaign was re- The report also says that and warrants the use of an-
late 2011 to under 16 per- care Advocacy and AARP inforced Monday with the nursing homes, in violation tipsychotics. q