A study published Monday by Human Rights Watch revealed that around 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.
Antipsychotic drugs, such as haloperidol and risperidone, are FDA-approved for treating schizophrenia and bipolar disorder, but they can increase the risk of death in older people with dementia. Dubbed “chemical straitjackets,” antipsychotic drugs have faced criticism for decades because they nearly double the risk of death from heart problems, infections, falls, and other ailments. They even come with a “black box warning” from the FDA.
But understaffed nursing homes have often used the sedatives, so they don’t have to hire more staff to handle residents. What’s worse is that the drugs were often administered without informed consent.
According to an analysis of Medicare data, the number of residents with a schizophrenia diagnosis soared to almost 70% since 2012, when the federal government, concerned with the overuse of antipsychotic drugs, began publicly disclosing such prescriptions by individual nursing homes.
Schizophrenia, which has strong genetic roots, afflicts approximately one in 150 people in the general population. It often causes delusions, hallucinations, and dampened emotions and is almost always diagnosed before the age of 40.
Dr. Michael Wasserman, a geriatrician and former nursing home executive who has become a critic of the industry, concurs, cautioning that “People don’t just wake up with Schizophrenia when they are elderly. It’s used to skirt the rules.”
Unfounded diagnoses are the driving force in the upswing. In May, a report by a federal oversight agency noted nearly one-third of long-term nursing home residents with schizophrenia diagnoses in 2018 had no previous Medicare record of being treated for the condition.
Many facilities have found ways to hide serious problems like inadequate staffing and sloppy care from government audits and inspectors. Studies have found the worse a home’s staffing situation, the greater its use of antipsychotic drugs. That suggests that some homes are using powerful drugs like Depakote, a medication to treat epilepsy and bipolar disorder that makes patients drowsy in order to subdue patients and avoid hiring extra staff. Homes with staffing shortages are also the most likely to understate the number of residents on antipsychotics.
Interestingly enough, as of late, one in nine residents has received a schizophrenia diagnosis.
As a result, the government and the industry are obscuring the actual rate of antipsychotic drug use on vulnerable residents.
In short, the facilities want docile, easy to manage patients.
If you have a loved one in an elder care facility, it may be time to ask A LOT of questions and dig deeper into what their actual care plan is, ESPECIALLY if you’ve noticed a rapid decline in their mental and overall health. It may save their lives.
For a deep dive into this issue, The New York Times published an investigative article here.