Antipsychotic medications treat serious psychiatric conditions like schizophrenia and bipolar disorder. That was their original intention, anyway. In some nursing homes and hospitals, antipsychotics have found a new use in patients suffering from dementia. In an effort to keep difficult dementia patients calm, some nursing homes use these medications as a “chemical restraint.” For dementia patients who also suffer from schizophrenia or other psychiatric conditions, this can be an effective treatment. For other dementia patients, though, it can worsen the effects of dementia and cause severe side effects, including an increased risk of death. The Centers for Medicare and Medicaid Services (CMS), after months of preparation, last month announced a partnership with state health agencies, nursing homes, and health care advocacy groups to push for the reduction or elimination of antipsychotics as a treatment for dementia sufferers.
We have followed the effort to reduce use of antipsychotics for some time at the Maryland Nursing Home Lawyer Blog. The group of drugs known as “antipsychotics” includes “atypical antipsychotics” like Abilify, Seroquel, and Zyprexa; and older “typical antipsychotics” like Haldol and Thorazine. Concern over the issue goes back at least as far as 2005, when the U.S. Food and Drug Administration (FDA) issued a warning to doctors about risks from antipsychotic medications to dementia patients, including an elevated risk of dying from pneumonia or heart attacks. A report from the Department of Health and Human Services (HHS) released in 2011 found that up to one in seven nursing home residents received an “atypical” antipsychotic in 2007, and that almost ninety percent of the antipsychotic prescriptions issued to nursing homes that year were for dementia patients. CMS first announced its new initiative during a webcast on March 29, 2012, and it followed up with a formal launch on May 30.
CMS unveiled the “Partnership to Improve Dementia Care in Nursing Homes,” an initiative involving federal and state health agencies, private nursing homes, other caregivers, and advocacy groups. The group’s national goal, according to CMS, is to reduce the use of antipsychotic medications in nursing homes by fifteen percent by the end of this year. CMS says that it will begin providing statistics on participating nursing homes’ use of antipsychotics, beginning in July 2012, on its Nursing Home Compare website.
CMS will provide training for nursing homes to promote “person-centered,” “high-quality” care and prevention of resident abuse and neglect. It will also emphasize alternatives to antipsychotic drugs for dementia patients, many of which involve staffing and behavioral changes rather than drugs. Pain management, increased outdoor and exercise time, consistent contact with familiar staff members, and greater individual attention all have the potential to benefit dementia patients far more than antipsychotic drug treatments. An editorial in McKnight’s touts the effectiveness of treatments for dementia involving pets, therapy animals, and “horticulture therapy.”
The Maryland nursing home lawyers at Lebowitz and Mzhen defend the rights of people who have suffered injury because of abuse or neglect by staff members. To schedule a free and confidential consultation, contact us today online or at (800) 654-1949.
More Blog Posts:
Resident Death and Antipsychotic Drug Violations in Nursing Homes, Maryland Nursing Home Lawyer Blog, June 30, 2010
Nurse Indicted for Chemical Restraint Leading to Nursing Home Resident’s Death, Maryland Nursing Home Lawyer Blog, June 28, 2010
State Investigates Nursing Home for Possible Negligence and Chemical Restraint, Maryland Nursing Home Lawyer Blog, February 26, 2010
Photo credit: ‘Abilify® (aripiprazole) 10mg’ by Boboque (Own work) [Public domain], via Wikimedia Commons.