WFAA had an interesting article discussing the problem of short-staffing and chemical restraints at nursing homes.  This article was Part 4 of WFAA’s continuing investigation of nursing home abuse and neglect. (See Parts 1, 2 and 3 ).  The ongoing WFAA investigation into Texas nursing homes has already revealed questionable practices in the hiring of criminal caregivers – and now WFAA has uncovered inappropriate and unnecessary drugging of residents.

In effort to cut costs, troubled nursing homes may drug the elderly rather than hire needed staff. The practice has been dubbed “chemical restraints.” It’s a practice of using powerful drugs to sedate or quell agitated, disruptive or violent patients.  When a facility is chronically short-staffed, often the staff will administer medications that sedate the residents so the residents are easier to take care of for the overworked and burnt-out caregivers.  In the latest report, called “Drugged and Dying,” News 8 investigative reporter Charlotte Huffman found that 96 percent of Texas nursing homes admit they’re giving drugs to residents who don’t need them.

According to the FDA, unnecessary use of antipsychotic medication kills 15,000 nursing home patients every year. Of all the drugs used as chemical restraints, antipsychotics are the most widespread and may be the most dangerous.

The federal government has previously caught drug manufacturers improperly promoting their antipsychotic drugs for use in nursing homes. (See here and here.)

Before nursing homes can give residents antipsychotics, new federal guidelines require doctors to diagnose them with at least one of three mental illnesses, the most common being schizophrenia.  A WFAA analysis of nursing home data shows that, after this new rule, the number of residents diagnosed with schizophrenia has skyrocketed 26 percent.  Schizophrenia develops in a patient’s early 20s, not later in life, experts say.

Various healthcare officials and advocates, when reached for comment, have found WFAA’s findings troubling:

“There’s no doubt that it raises a big red flag,” said Amanda Fredriksen, AARP Texas director of advocacy and outreach. “It’s pretty disturbing when people are that motivated to drive their numbers down to falsify medical records or to make up diagnoses. But to the extent that that’s happening, that’s a real serious issue.”

Dr. Daniel Pearson, head of psychiatry at Methodist Hospital, questions a first-time schizophrenia diagnosis of an elderly nursing home resident. He said such a diagnosis, especially to sedate, may be inappropriate, and possibly dangerous.  “Does that surprise me? No. Are those diagnoses legitimate? Probably not,” Dr. Daniel Pearson told WFAA.  “If you are using it just to keep people quiet, there are significant risks that are associated with that…increased risk of cardiac death, increased risk of falling, breaking a hip,” added Dr. Pearson, who spent a decade as a psychiatrist in nursing homes.

About 70 percent of a nursing home’s expenses are staffing,” said attorney Ernest Tosh, who handles nursing home lawsuits. “So, if they can cut back on staffing, they can directly increase their profitability.”

Last year, the state of Texas warned nursing home administrators about inappropriately drugging residents.

That same watchdog created this brochure to inform nursing home residents about the dangers of them being inappropriately drugged.

Here is a link to federal government regulations dealing with medication administration and monitoring – see p. 505.

Watch a 2011 U.S. Senate hearing on antipsychotic drug use in nursing homes.

 

 

 

 

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