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Overmedication of the Elderly: Restraint without Straps

In nursing homes all over the country, the elderly are being restrained from moving freely. Often there are legitimate reasons to restrain someone, like if they pose a risk to the safety of themselves or others. However, physical restraints on residents of a nursing home are used only when necessary, and for good reason. For one thing, using physical restraint for discipline or convenience is a violation of federal and Illinois law. Another reason is the appearance physical restraint takes. Physical restraint is often accomplished using straps, confining the nursing home resident to a bed or chair. The behavior of a resident restrained against their will can be unsightly and disturbing.

Contrast this with chemical restraint. Chemical restraint is the use of drugs to restrict the movement of a nursing home resident. The desired result of chemical restraint is the same as that of physical restraint: prevent the resident from moving. However, chemical restraint is dangerous for reasons that physical restraint is not.

Invisible Straps
When physically restraining a resident, the restraint is apparent to anyone nearby. One can see the resident straining against the straps, or hear the resident complaining of the restraint. However, when a resident is chemically restrained, there is no movement or vocalization. There is often just sleep. If there is no sleep, the resident lives in a drug-induced stupor that, while convenient for the nursing home employees, is harmful and in violation of the resident’s human rights.

Drugs: Use and Abuse
Another reason chemical restraint has become the problem it has is the insidious way it can become a part of a nursing home’s modus operandi. Under Illinois law, chemical restraints are not to be used at all unless authorized by a doctor, nor can medication be administered to a resident unless agreed to by the resident or the resident’s legal representative. However, it is simple for a nursing home employee to increase the dosage to a patient who already takes the drug. It is even simpler to fail to reduce the dosage when the symptoms the drug treats have become less frequent. In 2013, four different Illinois nursing homes were cited by the Department of Health and Human Services for failing to maintain the drug regimens of residents for their maximum well-being. (See the reports here, here, here, and here.)

Why It Matters
Consumers need to be aware of the dangers inherent in improper administration of drugs to the elderly in nursing homes. Apart from the obvious human rights and legal violations, unauthorized chemical restraint can be hazardous to the health of the resident.

According to the National Consumer Voice for Quality Long-Term Care, drugs used for chemical restraint (specifically antipsychotics) can increase confusion, decrease cognitive function, and create a situation where injury is more likely to occur. They also create a stupor in the resident, perhaps preventing communication of a serious problem to the employee of the nursing facility.

Medications are also expensive. The cost of those medications is often passed on to the consumer and, through Medicare and Medicaid, to the taxpayer. By preventing the misuse of chemical restraint, billions of dollars can be saved.

What You Can Do
If you believe that you or someone you know has been the victim of improper use of chemical restraint, contact an attorney to discuss your legal options.

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