Despite Dangers, One In Five Nursing Home Residents Are Given Antipsychotics

April 04, 2013 (Press-News.org) Despite Dangers, One In Five Nursing Home Residents Are Given Antipsychotics

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It would be shocking to walk into a nursing home and find dozens of patients restrained by straps and chains, unable to move simply because the restraints make it easier to control their behavior. Yet many residents of nursing homes across the United States face restraints, but not by straps.

Antipsychotic drugs -- which are approved for use in patients with schizophrenia and other mental disorders -- are commonly used in long-term care, especially in residents with dementia. Many patients in long-term care have dementia, and they may develop challenging behaviors. Antipsychotic medications are sometimes used in an attempt to modify behavior, but their use has the potential for serious health consequences.

Antipsychotic Drugs Increase The Risk Of Death

The drugs are given to dementia patients even though they have not been approved for dementia-related psychoses. In 2005, the Food and Drug Administration (FDA) warned about using newer types of antipsychotics, after finding that older patients who took them had a higher risk of death. In 2008, the agency extended the warning to older antipsychotic drugs.

Despite these warnings, more than one in five residents in U.S. nursing homes take at least one antipsychotic medication, according to a recent study. Often, these are prescribed for an off-label use such as dementia.

Researchers analyzed data on more than 1.3 million residents who received drugs from a long-term care pharmacy that serves about half of the U.S. nursing home population. About 22 percent of those residents were prescribed at least one antipsychotic drug in 2009 and 2010.

Of the residents who received these medications, 68 percent took a drug from the newer class of antipsychotics, called atypical. Usually these are used for treating bipolar disorder and schizophrenia.

Prison Sentence Results From Convenience Drugging

In one unusual case, a nursing director was convicted of elder abuse and sentenced to prison for convenience drugging. She was accused of giving 23 patients powerful drugs to make them easier to control. The patients were noisy, argumentative or prone to wandering, often because of Alzheimer's or dementia.

As a result of the drugging, all the patients suffered complications, and the complications contributed to the deaths of three patients, according to the attorney general's office in that state. In a news story about the conviction, an attorney for the Center for Medicare Advocacy said although this case was extreme, the overuse of antipsychotic drugs in nursing homes is a serious problem.

Last year, the American Health Care Association and the Centers for Medicaid and Medicare Services set a goal of reducing the off-label use of antipsychotic medications by 15 percent. According to the AHCA, 18,400 fewer residents would receive the drugs if the goal was achieved. It recommends that nursing homes focus on other ways to prevent challenging behavior, such as consistent staffing and environmental changes.