As we have previously discussed, the use of antipsychotic drugs on resident patients of nursing homes and long-term care facilities has been a controversial issue for years and years. Antipsychotic medications historically have been used to sedate patients with violent behavior as a result of psychological problems. Patients with schizophrenia, Alzheimer’s or dementia are often the victims of chemical restraints, including those who sometimes exhibit violent behavior that can endanger themselves and others. Thus antipsychotic medications have been used to control them.
However, there have been far too many cases over the years of nurses or nursing aides at nursing homes overusing or misusing medications. In some cases they were overused for patients that may have been prescribed the medications, but did not need nearly the amount given to them. In other situations patients that were not even prescribed the medications were given them anyway in an effort to simply keep most or all patients sedated even if they were not violent. Furthermore, there have been cases of a constant back-and-forth of giving patients sedating medications and then subsequently balancing them out with medications that counteract the sedation to wake the patients up. This constant provision of drugs would cause damage to the minds and bodies of patients, sometimes causing or hastening their deaths. Such abuse has been the subject of state inquiries, criminal charges against nursing home staff, and civil litigation by victims or their loved ones for the damage caused.
Tackling the Drug Problem
In more recent decades, there has been an effort to decrease the use of such chemical restraints. This is reportedly not so much the case in Kansas, however. In a recent news article, antipsychotic drugs have been used too frequently and often misused at facilities in the state in spite of the general national trend toward decreasing such use.
According to the article, the state of Kansas ranked 47th of 50 states plus the District of Columbia in the use of antipsychotic medications. These rankings were created and published by the Centers for Medicare and Medicaid Services (CMS), which handles the federal Medicaid and Medicare programs within the United States Department of Health and Human Services (HHS), including making regulations, as well as surveying facilities and assessing performance and quality of care and reporting those findings publicly. CMS has itself made efforts in recent years to decrease the use of antipsychotic drugs for dementia patients in nursing homes, initiated in light of an HHS Office of Inspector General report about frequent use of “off-label” prescriptions that were dangerous to patients, and sometimes led to deaths. Such drugs can induce heart attacks, strokes, or other horrible events or illnesses that can immediately or eventually lead to someone’s death. Such effects are commonly seen in the elderly.
Frighteningly, the CMS report noted that across the hundreds of nursing homes in Kansas, some homes administered antipsychotic drugs to more than 90% of their patients, while over half the facilities across the state did so with at least 30% of their patients. These are incredibly high numbers. In addition to the government, advocacy groups have taken note, including the Kansas Advocates for Better Care, which seek to improve quality of care in nursing home facilities in Kansas. It will be interesting to observe future reports from state health agencies and HHS/CMS on this issue as efforts are made to curtail the use of antipsychotic medications.
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