Steve Gold, The Disability Odyssey continues
Abusing Drugs In Nursing Facilities - Information Bulletin #222 (0807)
Thirty one years after the federal government reported to Congress about
the widespread abuse of medication to residents in nursing homes with
dangerous drugs, it is apparent that not much has changed.
Before we review the extent of this abuse, it is important to remember
that psychoactive and other drugs frequently have very serious and
irreversible side effects. They should not be prescribed or used in a
wholesale manner, unless one cares more about easing the job of the staff
than about the well-being of the residents.
While we have only anecdotal information and do not know how widespread
the practice is, we have heard reports that doctors write these
prescriptions on an "as needed" basis, so that nurses or untrained aides
decide when to administer them.
When do nursing facilities think these drugs are "needed?" Answer : when
the facilities are short-staffed, when a resident's behavior is somewhat
aggressive or when a resident is very upset, acting out, agitated -- then
sedate them with drugs.
These drugs in nursing facilities are used primarily to control behavior;
not to treat medical or psychiatric illnesses.
Prescribing doctors may not be psychiatrists and may not even see the
patient on any regular basis, which could explain why the nursing home
industry fights so hard to limit malpractice litigation that could hold
them accountable for abusing these drugs.
Anyone who regularly visits nursing facilities, or even visits them only
occasionally, sees the "zombie" look of many patients. Psychoactive and
antidepressant drugs can have that effect, sedating residents to such an
extent they just sit around and "space out." It makes running the
institution so much easier.
Here is the CMS national breakdown as of 3/07:
- Re antipsychotic medications, nearly 27% of nursing home residents
were receiving such drugs regularly.
- Re antidepressant medications, a whopping 52.2% are prescribed
these drugs regularly.
When will disability and older American advocates stop this abuse in your
State? When will State health departments stop it?
Is it hopeless? Will we just pretend it does not exist?
Maybe this abuse does not matter because the people in these institutions
are disabled and old?
Will this abuse never stop as long as low-income people with disabilities,
regardless of their age, are warehoused and segregated in institutions and
are invisible to the populace at large.
Here is a breakdown by State for the % of people in nursing facilities who
regularly receive Antidepressants and Antipsychotics:
|
Anti-
depressants |
Anti-
psychotics |
| Alabama |
55.30% |
28.10% |
| Alaska |
56.50% |
20.80% |
| Arizona |
51.40% |
26.50% |
| Arkansas |
52.40% |
29.40% |
| California |
40.90% |
26.80% |
| Colorado |
53.50% |
23.70% |
| Connecticut |
54.20% |
30.20% |
| Delaware |
49.70% |
26.10% |
| D.C. |
27.50% |
23.60% |
| Florida |
53.00% |
25.50% |
| Georgia |
51.60% |
31.20% |
| Hawaii |
34.10% |
14.00% |
| Idaho |
59.90% |
27.20% |
| Illinois |
44.60% |
33.20% |
| Indiana |
54.90% |
25.60% |
| Iowa |
52.40% |
22.10% |
| Kansas |
56.40% |
28.30% |
| Kentucky |
55.70% |
27.50% |
| Louisiana |
49.80% |
34.40% |
| Maine |
59.60% |
26.30% |
| Maryland |
47.90% |
22.50% |
| Massachusetts |
60.00% |
30.50% |
| Michigan |
52.40% |
18.70% |
| Minnesota |
55.20% |
23.80% |
| Mississippi |
51.70% |
30.70% |
| Missouri |
57.60% |
27.70% |
| Montana |
53.80% |
23.90% |
| Nebraska |
54.80% |
25.20% |
| Nevada |
43.10% |
23.70% |
| New Hampshire |
49.40% |
28.70% |
| New Jersey |
54.40% |
24.90% |
| New Mexico |
49.20% |
24.10% |
| New York |
42.10% |
26.30% |
| North Carolina |
54.10% |
24.10% |
| North Dakota |
57.60% |
22.90% |
| Ohio |
56.70% |
28.30% |
| Oklahoma |
54.60% |
30.80% |
| Oregon |
57.70% |
22.90% |
| Pennsylvania |
54.30% |
24.70% |
| Rhode Island |
61.20% |
24.70% |
| South Carolina |
48.50% |
24.90% |
| South Dakota |
53.40% |
23.50% |
| Tennessee |
58.90% |
31.60% |
| Texas |
50.20% |
29.00% |
| Utah |
57.90% |
29.60% |
| Vermont |
56.90% |
29.10% |
| Virginia |
50.40% |
25.80% |
| Washington |
54.50% |
22.60% |
| West Virginia |
53.90% |
24.30% |
| Wisconsin |
53.10% |
21.80% |
| Wyoming |
54.10% |
22.20% |
|
|
|
| National |
51.20% |
26.90% |
|