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Antipsychotic Misuse Rampant in Dementia Care Facilities

by Richard Bitner
Antipsychotic Misuse Rampant in Dementia Care Facilities

There are few conditions that make aging in place more difficult than dementia. As dementia progresses, living at home becomes increasingly dangerous. Without support from family, friends, and dementia care professionals, most seniors with dementia end up moving into nursing care facilities. But as reporting over the past several years has revealed, many nursing homes are also dangerous for seniors coping with dementia.. Antipsychotic Misuse Rampant in Dementia Care Facilities

A recent investigation by Human Rights Watch — which uncovered rampant misuse of antipsychotic medications in nursing homes— is just the latest cause for concern among dementia care professionals. According to the report, nursing homes misuse antipsychotics on tens of thousands of nursing home residents every week. The vast majority of residents are in nursing homes to receive some form of dementia care. The report found that nursing homes are using these medications to control symptoms of Alzheimer’s and other dementias — despite clear evidence that these medications are highly dangerous for individuals with dementia.

FDA & APA Guidelines Warn Against Misuse

Concerns about the misuse of antipsychotic medications in dementia care facilities have existed almost as long as these medications have been available.
Under some circumstances, antipsychotics can be used to curb violent behavior in those coping with Alzheimer’s and other dementia. It’s understandable, then, why nursing homes might feel inclined to use these medications — that is until you learn how dangerous these medications can be for individuals with dementia.

Multiple studies have linked these medications with severe negative health outcomes for persons living with Alzheimer’s and other dementias, including a higher risk of death. When individuals with dementia are prescribed these medications, their mortality rate nearly doubles.

Given these risks, the American Psychological Association explicitly warns against misuse of antipsychotics in people with dementia. The US Food and Drug Administration, meanwhile, has legislated the use of black box packaging for antipsychotics, with labels that warn healthcare workers about the dangers these medications pose to dementia sufferers.

But as dementia care advocates have repeatedly warned, individuals with dementia cannot give informed consent, making it all too easy for nursing homes to misuse these medications. Despite recent government efforts to combat misuse, many believe that these efforts haven’t had the necessary impact.

In reporting hard data on the use of these medications, Human Rights Watch has uncovered the widespread scope of this problem. According to their investigation, nearly 180,000 nursing home residents who shouldn’t receive antipsychotics are given these medications every week. In certain areas of the country, more than 40% of nursing home patients are being given antipsychotics.

In addition to data reporting, Human Rights Watch also conducted interviews with nursing home residents and staff further. Residents reported that they were often threatened by staff if they refused the medications. Meanwhile, one nursing home worker said that antipsychotics were often given to residents who were crying out for help.

Safety Concerns Beyond Medication Misuse

Misuse of medications is far from the only safety concern that experts have raised in recent years around nursing facilities. A growing body of research has highlighted the emotional distress seniors face when they are forced to leave home and move into a nursing facility. Nursing homes also contain a range of physical health risks for seniors, including widespread exposure to pathogenic bacteria and viruses. In fact, nursing home residents face significantly worse health outcomes than seniors who receive healthcare or elderly care at home, even when seniors are otherwise equally healthy.

These concerns are a big reason why many Americans are increasingly uncomfortable moving their loved ones into nursing facilities. To avoid nursing care, many families are making senior-friendly modifications to their loved ones’ homes, providing unpaid senior care as family caregivers, or hiring in-home care services.
Even seniors living with Alzheimer’s and dementia — who continue make up the majority of nursing home residents — now have options for aging in place. The emergence of specialized Alzheimer’s care and dementia care programs, in which services are provided in the comfort of care recipients’ homes, have helped these individuals extend their time spent at home, even as they reach the later stages of dementia.

Antipsychotic Misuse Rampant in Dementia Care Facilities

Antipsychotic Misuse Rampant in Dementia Care Facilities Antipsychotic Misuse Rampant in Dementia Care Facilities Antipsychotic Misuse Rampant in Dementia Care Facilities Antipsychotic Misuse Rampant in Dementia Care Facilities Antipsychotic Misuse Rampant in Dementia Care Facilities Antipsychotic Misuse Rampant in Dementia Care Facilities

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