Many of America’s nursing homes are understaffed. Often these facilities are for profit institutions. In a drive to maximize profits, staffing levels are cut to the bone. Those that suffer, of course, are the patients. And dementia patients suffer most of all. These patients require more attention and higher levels of care. Because they can’t easily complain, however, many nursing homes overmedicate these patients with medically unnecessary antipsychotic drugs.
Why? Because these drugs when misused can become a form of chemical restraint.
One nurse turned whistleblower told us that patients that are intentionally overmedicated are said to be doing the “thorazine shuffle.” The term is used to describe the use of antipsychotic drugs to sedate patients into non-functioning people who are able to do little more than shuffle around the facility.
A patient medicated with four times a normal dose of Zyprexa said, “It was like wanting to scream and throw a fit, but not being able to do anything except twitch and grimace. Horrible.”
A 72-year veteran in a Santa Barbara facility said dementia patients in the facility where he was rehabbing after surgery were drugged until they were “zombies.”
Recently Human Rights Watch released the findings of a major investigation into the overmedication of dementia patients. The results of their study were horrifying.
An 81-year-old nursing home patient in Texas told Human Rights Watch, “Too many times I’m given too many pills…. [Until they wear off], I can’t even talk. I have a thick tongue when they do that. I ask them not to [give me the antipsychotic drugs]. When I say that, they threaten to remove me from the [nursing] home. They get me so I can’t think. I don’t want anything to make me change the person I am.”
We hear these stories all the time. But just how bad is the problem and what can be done?
Human Rights Watch says that in an average week, over 179,000 patients are given antipsychotic drugs that are medically unnecessary. Ten years ago. that number was even higher according the U.S. Department of Health and Human Services. That means the problem is getting better but no patient should ever be drugged unnecessarily.
An AARP spokesperson says of the misuse of antipsychotics, “given the dire consequences, it should be zero.” We agree.
Only in limited instances are antipsychotics indicated in elderly patients and never if dementia is the only diagnosis. (Our medical experts tell us that antipsychotics are sometimes indicated for elderly patients suffering schizophrenia, Huntington’s disease, or Tourette syndrome. In rare instances, dementia accompanied by psychosis may warrant antipsychotic medications as a last resort.)
Despite data that shows the problem seemingly getting better, many more Americans are now nearing the age where they may require skilled nursing care. Absent a cure, in the next couple decades the number of Americans suffering from dementia is expected to triple!
Why Use of Antipsychotic Drugs in Dementia Patients Is Illegal
Federal law requires patients be fully informed of their treatment. Patients also have the right to refuse treatment. We believe that some nursing facilities are not properly informing patients or their families about the need for powerful antipsychotic medications. They can’t, however, as there is there is no medical justification for these drugs.
Despite state and federal regulations, many facilities are still administering these drugs as a form of chemical restraint. To an overworked or undertrained staff, it is an easy but dangerous shortcut. Just drug needy patients into compliance. If they are overmedicated, they can’t complain or be disruptive.
Of course, the patients that are frequently overmedicated are often the most vulnerable. Often elderly and isolated, many nursing home patients are afraid to complain. Add dementia into the mix and they simply can’t complain.
Worse, some nursing homes use these drugs to punish patients who they believe are unruly or require too much attention.
Families tell us they are often coerced into agreeing to the use pf antipsychotic drugs for loved ones or risk having their loved one ejected from the facility.
How Widespread Is the Problem of Medically Unnecessary Antipsychotic Drugs?
The use of antipsychotic drugs to restrain dementia patients is dependent on the specific facility. In some states such as Hawaii, these drugs are rarely used. Unfortunately, there are pockets of high use including Washington state, Utah, Idaho, Montana, Texas, Oklahoma, Kansas, Nebraska, Georgia, West Virginia, Pennsylvania, New York and Illinois. In some counties of these states over 45% of nursing home patients are on antipsychotic drugs. Overall, Texas and the New York have the worst percentages of overmedication and antipsychotic drug use.
Dangers of Antipsychotic Drugs
Drugs like Thorazine, Seroquel, Haldol, Risperdal and others of their kind have not been shown to have any therapeutic effect for dementia patients. Rather, nursing homes use them solely for their sedative effects. But these drugs are dangerous. So dangerous that the FDA requires most to carry black box warning labels.
The FDA says that using antipsychotic drugs on elderly patients doubles their risk of death!
Other possible side effects include an onset of nervous system problems, low or high blood pressure, high blood sugar, and blood clots.
According to the Alzheimer’s Association, “the decision to use an antipsychotic drug needs to be considered with extreme caution. Research has shown that these drugs are associated with an increased risk of stroke and death in older adults with dementia. The FDA has ordered manufacturers to label such drugs with a “black box” warning about their risks and a reminder that they are not approved to treat dementia symptoms.” [The FDA has not approved antipsychotics for dementia patients.]
Obviously, these drugs also seriously diminish the quality of life for patients. Many medical experts believe that when patients lose their will to live, death comes quickly. And not being able to communicate with loved ones and feeling so drugged that all you do is sleep can certainly drain one’s will to live.
Using pharmaceuticals as a form of restrain is in most instances considered elder abuse. If you or your loved one has dies or suffered a serious injury because of the illegal use of antipsychotic medications (or any other form of nursing home abuse), call us. We have helped people and their families in over 40 states.
For more information, visit our nursing home abuse page. Ready to find out if you have a case? Contact us directly online or toll free at 833-201.1555. All inquiries are kept in strict confidence.
Chart depicting percentage of nursing home residents receiving antipsychotic drugs was originally posted by Human Rights Watch and is linked above. We urge readers to donate to their organization and support their fine work. Investigative journalism is virtually dead today in mainstream media but lives on through organizations such as The Human Rights Watch.