University

05/12/2011

An epidemic of elder abuse -- through prescription drugs

The misuse of antipsychotic drugs on the elderly has been under scrutiny for some time now. Research reports, warnings by federal and state governments and physicians have apparently fallen on deaf ears.

According to recent research, millions of nursing home residents are being prescribed antipsychotic medications they don’t need – just to keep them docile.

Propublica, an independent nonprofit newsroom specializing investigative reporting for the public interest, published a blog May 10th, highlighting the troubles of nursing home care.

The New York Times also discussed a recent report issued by the Health and Human Services Department. The report reviewed the details from the largest medical care program for persons over 65 to determine just how many were receiving prescriptions for atypical antipsychotic drugs while they were living in nursing homes.  These are drugs that have not been approved for use on patients with dementia … and in fact the FDA specifically issued a warning in 2005 that they should not be used this way. 

A majority of nursing homes don’t appear to be listening. 

Research reported on in a 2010 issue of the Archives of Internal Medicine assessed a cross-sectional population of 16,586 newly admitted nursing home residents in the United States. The data was pulled from a 2007 report by the National Health and Human Services Department that was referred to in the recent NYTimes and ProPublic pieces. The numbers showed that 29% of the nursing home residents were prescribed an atypical anti-psychotic and that of those, 1/3 did not have any clinical (no psychoses or dementia) need for them.

Antipsychotics are basically being used as drug induced restraints rather than the physical leather bindings. The research is showing that this use and abuse is just as harmful to elders. Antipsychotics have been related to an increase of falls, pneumonia, heart failure and even death.

So, why is it happening? Why are the numbers of prescriptions in nursing homes increasing? In part, the drugs are used as a way to control the nursing home residents. Another and obviously more disheartening reason could be related to money.

We can do better.  Some of us are trying. Agencies have begun to launch their own anti-anti-psychotic programs in nursing homes. One program called the Awakening program, developed by Ecumen, a Minnesota based nursing home agency, has begun its own journey to getting off the drugs. The program has added two nurses, trained its entire staff on using alternatives that will help calm their residents; exercise, aromatherapy, massage, music and other activities.

Agesong located in the Bay area provides an integrative approach to giving peace and peace of mind to its assisted living residents. The centers approach is humanistic. The residents are allowed to be who they are in a safe and supportive environment. Aging and the ailments that are sometimes present are not seen as pathological.

Providence Rest Nursing Home in the Bronx was reported in the Wall Street Journal as being another nursing home that is trying the alternatives, massage and aromatherapy, to help their residents manage the symptoms of dementia. Providence isn’t alone in New York, two other nursing homes were featured in the story as centers of change.

In all of these programs, drug treatments are still on the table but they are not the first line of treatment.

Even with these innovations, there are still hundreds of our elders being treated with medications that are only serving the needs of the nursing home staff rather than them. Hopefully with continued exposure we can eliminate what is basically physical and emotional abuse via drugs in our nations assisted living centers.

With encouragement, more centers like Agesong will become the model of loving care for those we love.

-- Makenna Berry

Posted at 11:45 AM in

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Comments

If you have teens, you might have actually set up a system to keep them away from your alcohol depository or wine refrigerator. However professionals are now pointing out you must lock up something else-- your medicine depository.

The painkillers you take when your back discomfort flares? It's no secret that adolescents are popping those for fun. The Xanax you take to go easy just before a long airplane ride? They're into that too. And let's not forget the Ritalin your more youthful young child which includes ADHD takes, since that's one more favored one amongst the adolescent and university set.

While prescribed substance abuse isn't really brand-new, it's on the surge. One in every 5 teenagers were applying them in 2009, then one in every 4 teenagers were in 2010, according Dr. Drew and Smart Moves, Smart Choices, an interest initiative.

The company has actually paired that includes the man on the frontlines of battling addiction, Dr. Drew Pinsky. Huff Post Parents consulted with him about a failed to see link between suicidal notions and Xanax, why moms and dads require a lockbox instead of a medicine depository and the first indication of substance abuse.

There's been such a massive surge in the abuse of prescribed drugs. Precisely how did we get right here?

Children aren't dumb: if they have a real perception that something to damaging to them, they're less very likely to make use of it. However, their pre-fontal cortex-- the part of the mind that perceives repercussions-- isn't really absolutely established. The casualness by having which pills are applied in our homes is delivering a message to them.

Exactly how so?

Our basic mindset to prescribed drugs is that they're going to make our lives healthier and far better. Pills are made to treat medical complications, not to make life simpler. [Grownups think] you can easily apply these things without effects, and youngsters do not see the lasting perspective.

[Amongst adolescents] there's a basic note of, Just what's the big deal? They're offered by specialists, mother and papa apply them, just how damaging could possibly they be? And oh by the way, they truly do get me high. They work, and I can easily take them right away from my very own medicine depository. I do not have to go get them from the man on the street corner!

Then precisely how are teenagers getting their hands on the pills?

Sixty-four percent of [drugs stem from] from a buddy or relative. There are a bunch of pills out there lying around. Often [children are] stealing from a good friend. It's so pervasive and dealt with so causally in the house that children can easily take an overall container of pills and no one notices.

Take us with the drugs of selection-- exactly what are the children into these days?

Different societies have different drugs of appeal. The basic classes are benzodiazepines (like Xanax and Valium), psychostimulants (Adrerall and Ritalin) and opiates (Oxycontin, Vicodin and codeine).

The psychostimulants-- meds applied to treat ADD and ADHD-- are big on college and university campuses. They're frequently accessible since lots of [pupils] are on them for useful reasons to study. They're dangerous due to the fact that they can easily induce manic episodes and depression.

The most bothersome class is the opiates. These are the painkillers, a gigantic class. You name the painkiller, it's abused by little ones.

Can easily you inform us even more about the kind of difficulty children enter by abusing these meds?

The wellness hazards are the effects we are attempting to attend to that includes teens currently. Remember, every undesirable result you can easily think about for a young adult-- undesirable pregnancy, STDs or violent acts-- you name the occasion, and you will definitely constantly discover drugs and alcohol entailed. Merely since it's physician suggested does not indicate it's safe.

Prescribed drugs can easily even induce depression and manic episodes, and suicidal reasoning. ... Folks commonly do not also link the fact that they were suicidal on Tuesday which includes the fact that they took a Xanax on a Sunday evening.

Additional effects are intoxication, fatality ... Several of these [drugs] are strongly sedative. You do not need to take much to cease breathing. They can quickly cross over to a catastrophic dosage without recognizing it. These days when drug addicts pass away in my world, they pass away on prescribed drugs.

So, if a parent is on medication, precisely how can easily they transmit precisely how harmful it is to take for fun?

Get a lock-down box: a plastic box which includes a lock on it. Deliver a message. Your alcohol must be behind a lock door, and your pills must be in a secured box. Nevermind they [might be able to break into it]; you're pointing out something about these substances when you do that. [You're pointing out] these need to be dealt with thoroughly. That's truly vital and no one does this.

Just how will definitely we recognize if our very own little ones are popping pills?

There are practically no indications. That's the actually challenging part about this. Mental wellness problems, which including narcotics abuse in youngsters, have the exact same constellation of signs.

The things to understand to watch for are changes in rest patterns, desire, their outfit, [that] they hang out with ... The leading sort of indication that something's going on is an abrupt drop in grades; there's something going on.

If you presume your little one has a routine, exactly what's the most effective method to deliver it up?

Do not go at it alone, since right here's exactly what you're going to get from your children: "I'm great." There's not a 15 - or 17-year-old out there that is going to totally uncover to their mom or dads. Rapidly get assist if you have any type of indications that something's truly incorrect. Begin at school. A lot of individuals think about the school as the complication, however the school is your buddy. They're experts which includes specialized Non 12 Step drug rehab training from places like <a href="http://www.non12step-drugrehabs.org">this site</a>.

[When you] deliver it up, state, "Possibly I have actually been remiss. I simply became aware this stuff is being applied by children. I have actually been providing you the incorrect message, this stuff is dangerous."

Just what's the one thing you would like mom or dads to recognize?

That prescribed substance abuse is a larger complication than they recognize and that we're adding to it by our causal mindsets.

Posted by Ray M.D. (not verified) | 05/25/2012 @ 09:45 AM