Across the U.S., skilled nursing facilities (SNFs) are slashing their use of antipsychotic medication on long-term patients, especially those with dementia.
This is a very good thing!
The Centers for Medicare & Medicaid Services (CMS) started this push for healthier treatment back in 2011, when nationwide antipsychotic use in nursing homes was measured at 24%. Now, CMS is pleased to announce that most nursing homes are in compliance, having reduced drug use across the board by a 34% increment! (For facilities that didn’t make the cut, CMS is setting a new goal: a 15% reduction by the end of 2019.)
What are these successful nursing homes using instead of antipsychotics? For the most part, behavioral therapy. One example is Music & Memory, a N.Y.-based organization that provides iPods with familiar tunes for patients struggling with memory loss and other problems.
Siegel Law applauds this approach, and hopes that more nursing homes will develop thoughtful and personalized treatment for these extremely vulnerable patients and their families, who often struggle to make it through day-to-day life.
The Epidemic of Polypharmacy
Overmedicating “difficult” patients is a nationwide epidemic. Last year, PBS NEWSHOUR reported that seniors are often given lists of medications for various ailments, sometimes from multiple doctors who aren’t even communicating about their overall health. “This is America’s other drug problem – polypharmacy,” said Dr. Maristela Garcia, director of the inpatient geriatric unit at UCLA Medical Center in Santa Monica. “And the problem is huge.” Research showed that the highest number of drugs taken by Americans were taken by residents of nursing homes. It also found that nearly 50% of older adults take one or more medications that are not medically necessary.
These drugs can cause huge problems for frail nursing home residents: confusion, falling, excessive bleeding, low blood pressure, respiratory failure, and more. Antipsychotics in particular have other adverse side effects, which can include:
Low blood pressure
Irregular heart rhythms
Blurred vision, dry mouth, and cognitive impairment
Elevated cholesterol levels
Muscle cramps or tremors, loss of motor control
Restlessness/inability to stay still
Neuroleptic malignant syndrome (a rare reaction signaled by high fever)
Not every antipsychotic drug has all of these side effects. However, when a person is given an unnecessary drug, or two drugs that don’t react well together, the chances of a negative side effect increase greatly.
When in Doubt, Check Your Prescriptions
Families don’t prescribe or give medications to their elderly loved ones. That’s the job of doctors and nursing home staff, and as the report above shows, sometimes they tend to “take the easy way out” and overprescribe. If you’re in doubt about a loved one’s medication, there are several “drug interactions checkers” online – of course, they are NOT a substitute for speaking to a pharmacist or medical provider to find out which medications should never go together. Still, these checkers are free and a good place to start:
If you have any questions about overmedication, a medication error, or improper care at an assisted living facility, speak to Travis Siegel. At Siegel Law, our entire practice revolves around elder care. Call (562) 645-4145 to schedule a free sit-down with a Long Beach elder attorney.