Questions raised over antipsychotic use in elderly in CA

[cougarnurse]

Here it goes again: http://www.10news.com/news/27059153/detail.html

The 10News I-Team has learned many local skilled nursing facilities are using powerful drugs to control elderly patients' behavior.

Keith Blair suffered from mild dementia, and it wasn't until after his death that his daughter, Marian Hollingsworth, realized he'd been given antipsychotic drugs.

"It's a way of controlling them. It keeps him in bed," said Hollingsworth.

Until that realization, Hollingsworth was puzzled by her father's rapid deterioration. He had been given the powerful antispychotics Risperdal and Haldol without her permission.

"Antipsychotic drugs are for the treatment of mental illness, not dementia," said Tony Chicotel of California Advocates for Nursing Home Reform (CANHR). "And now we've got studies that show just horrific outcomes for people with dementia who take these drugs and that they're prescribed just as much as they ever were, if not more."

CANHR is trying to end the misuse of psychoactive drugs to control seniors. The group created a website which allows anyone to see how many patients are receiving psychoactive drugs at any skilled nursing facility in California.

Experts say while using these drugs is sometimes justified, there are dangers in their misuse.

"When you see nursing homes that are above 90 percent of their residents are receiving a psychotropic drug, you're wondering what the hell is going on there," said Chicotel.

To find out what was going on, the I-Team went to the U.S. Department of Health & Human Services and obtained specific information that tracks the mental and physical conditions of nursing home residents.

While some would expect the number of people with mental illness to be roughly equal to the number of people receiving antipsychotic medicines in nursing homes, the data obtained by the I-Team revealed differences at some facilities.

According to the data, Collingwood Manor in Chula Vista had 57 percent of its residents on antipsychotics, but only 17 percent had mental illness.

The data also showed Granite Hills Convalescent Hospital in El Cajon had 51 percent of its residents on antipsychotics, but only 11 percent had mental illness.

Vista Healthcare Center in Vista had 43 percent of its residents on antipsychotics, yet only 16 percent had mental illness, according to the data.

"I think it's indicative of a culture, an internal policy of some facilities to use drugs as a last resort and other facilities to use drugs as a first resort," said Chicotel.

In a letter, Granite Hills Convalescent Hospital responded to the I-Team's findings, and a facility administrator wrote that all antipsychotics are prescribed by a doctor, given with consent by the appropriate party and overseen by medical professionals.

Click on this link for information on antipsychotic use compared to the number of residents with mental illness at every skilled nursing facility in San Diego County.

[hppygr8ful]

This has been going on for a long time. Seniors are be giving powerful anti-psychotic medications to control behaviors resulting from dementia. This is why Seniors need to have some kind of legal conservator or health care proxy to protect them when they cannot make decisions for themselves. Otherwise their families will have no power in the decision making process. Hospita's and healthcare providers actually use HIPPA regulations as a shield to keep families out of the process where families are concerned. It does not surprise me that this article says that a daughter was surprised to find out her father had been medicated with anti-psychotics without her permission. Unless she was his conservator or legal health care proxy the hospital and doctor didn't need her permission.
If he had a spouse that person could give the permission but it's often only explained as a way to "Help the patient relax". The implications of side effects and health risks are often only glossed over.

Most of the antipsychotics are specifically contraindicated for use in the Senior population. The fact is these medications often make AD and other non-specific dementias worse not better and can shorten the life span.

I even saw this in the psych hospital with Seniors admitted to for psychosis and medicated without a complete medical work-up to rule out a medical cause for their symptoms. In one case I suggest to the psychiatrist that something medical was going on. I based this on labs and a gut feeling I had. The Doctor scoffed at me. Refused to send him for a medical work up. Pumped the guy full of anti-psychotics. The poor man ended up with neuroleptic malignant syndrome and died three weeks later.

This one of the reasons I left acute psych.

Peace

hppy