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