For more than 179,000 nursing home residents, part of their day involves taking antipsychotic drugs aimed at treating schizophrenia or other mental illnesses. However, according to a recent study conducted by Human Rights Watch, many people taking these drugs do not in fact have the mental illnesses these medications are made to treat. Thus, questions are now being asked as to why these medications are being prescribed for these patients, and are they given to patients with informed consent. According to the study, many patients given these medications suffer from Alzheimer’s disease or dementia, neither of which are illnesses the medications are designed to treat. In fact, the drugs come with a “black box warning,” which is a statement from the FDA that the drug could increase the risk of death for patients with dementia.
Why are the Medications Given to Patients?
Because the majority of patients given the drugs don’t suffer from mental illness, it’s important to know why they are being given the medications. According to the study, which focused on states such as Texas and California that have the highest number of nursing homes, patients are generally given the drugs in order to make them easier to manage. This has been found to be quite extensive in nursing homes where staff shortages exist, and keeping patients medicated allows staff to complete their duties without incident.
Reducing the Use of Antipsychotic Drugs
Due to the increasing problem with these drugs, the federal government has stepped in the past several years in an attempt to solve the problem. Beginning in 2012, federal government agencies formed partnerships with nursing homes and advocacy groups to examine the issue. As a result of the partnership, the number of patients receiving these drugs has dropped from 24 percent in 2012 to 15 percent in 2017. While this is a significant drop, the federal government wants to see even more progress, especially from nursing homes that have been slow to implement changes. As a result, the Centers for Medicare and Medicaid Services is aiming for an additional reduction by the end of 2019.
Chemical Restraints
Based on the Human Rights Watch study, many industry experts feel the federal government has failed to do enough to enforce what are known as chemical restraint laws, which are designed to protect nursing home residents from receiving unnecessary medications. However, based on study results examining the first several years of the government’s program to reduce the use of these drugs, less than two percent of all cases were deemed serious enough to result in fines.
Minimum Staffing Levels
To solve the problem of antipsychotic drugs being over prescribed to nursing home residents, researchers have made several recommendations to the nursing home industry. One is to strengthen informed consent procedures, which would involve families more significantly in the decision-making process. Along with this, they have also recommended the nursing home industry establish minimum staffing levels for all homes, which many believe would essentially solve the problem. However, this proposal has regularly been opposed by the industry, citing costs and other factors.
Solving the Problem
While additional studies are expected to be done on this matter, many researchers are still wondering how much progress will be made on this problem in the years ahead. As many nursing homes work to increase staff levels and work more closely with families, it’s expected the federal government will also work to pressure the nursing home industry to enforce laws, hire additional staff, and put the care of patients ahead of costs.
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