February 5, 20188:51 PM ET
A study published
Monday by Human Rights Watch finds
that about 179,000 nursing home residents are being given antipsychotic drugs,
even though they don't have schizophrenia or other serious mental illnesses
that those drugs are designed to treat.
Most of these residents
have Alzheimer's disease or another form of dementia and antipsychotics aren't
approved for that. What's more, antipsychotic drugs come with a "black box warning"
from the FDA, stating that they increase the risk of death in older people with
dementia.
The study concluded that antipsychotic drugs were often
administered without informed consent and for the purpose of making dementia
patients easier to handle in understaffed facilities.
Researchers focused on six states, including California and Texas,
which have the most skilled nursing facilities. They used publicly available
data, along with hundreds of interviews with residents, families and state
ombudsmen, the officials who deal with complaints about long term care
facilities.
In 2012, the federal
government began a program to
reduce the use of antipsychotic drugs in nursing homes, in partnership with the
nursing home industry, and advocacy organizations. Since then,
the use of the drugs has dropped by about a third nationwide, from 23.9 percent
of residents in 2012 to 15.7 percent at the beginning of 2017. The Centers for
Medicare and Medicaid Services have called for an additional 15 percent
reduction by 2019 for those nursing homes that have lagged in curtailing their
use of antipsychotics.
But the Human Rights
Watch study contends that the federal government hasn't done nearly enough. It
faults the government for failing to enforce laws that exist to
protect nursing home residents from what are sometimes called
"chemical restraints."
An NPR investigation into
the first few years of the government's program to reduce the use of
antipsychotic drugs found that only 2 percent of
cases were deemed serious enough to trigger a fine.
The study also calls for the government to strengthen informed
consent procedures and to establish minimum staffing levels, something that has
long been opposed by the nursing home industry.
The American Health Care Association,
which represents most nursing homes, said in a statement that
the report "does little to highlight the effort launched by our profession
in 2012 that has resulted in a dramatic decline in the use of these
medications."
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