A pill is just so much easier. Drug ’em up and shut ’em up. Rather than deal with all the individual needs of elderly persons with dementia in their care, some nursing homes are dosing them with powerful antipsychotics. Not only have the folk not received a diagnosis that the medicine was designed to treat, not only does the drug turn them into zombies their families don’t recognize, but the FDA has warned that using antipsychotics on older patients with dementia nearly doubles their risk of death.

Indeed, it’s not just for treating problem youth in juvenile jails. Nursing homes with poorly trained staff are also using medication intended to treat bipolar disorder and schizophrenia to subdue the people placed in their care.

The California Advocates For Nursing Home Reform have put together a free booklet, “What You Should Know to Fight the Misuse of Psychoactive Drugs in California Nursing Homes” (PDF). It can help families and caregivers, even if they’re not in California, make sure that their loved ones aren’t being “chemically restrained” by their nursing homes.

Informed consent is required by most states before a nursing home starts giving a patient psychoactive drugs. Not all of them do, which is why it’s important for the people who love the elderly person remain actively involved in their care. Here are some of the questions the guide recommends asking when psychoactives are proposed as treatment:

• What specific, documented behaviors or symptoms prompted the need for a psychoactive drug? (e.g., are there delusions or is the resident simply agitated?)
• Have all possible medical or environmental causes been ruled out? (e.g., pain, dehydration, infection, sleep disruptions)
• Has the doctor recently physically examined the resident to determine the need for the drug?
• What alternative treatments have been tried? Are other options still available?
• What are the risks and side effects of the drug?
• Has the FDA issued black box warnings for this drug?
• Has the FDA approved the use of this drug for this purpose?
• How will side effects be monitored? Who will do it?
• Will the proposed drug interact with any of the resident’s other medications?
• Is the proposed drug duplicating other current medications?
• Will the resident start on the lowest possible dose of medication?
• When and how often will the need for the drug be reassessed?

There is no approved drug for treating dementia. Antipsychotics can kill if they are used improperly. Off-label use of the drugs on nursing home patients could be the basis of a citation by the Department of Health, an investigation by your state’s Attorney General, or a lawsuit. Download the guide, get informed, and get involved.

Toxic Medicine: What You Should Know to Fight the Misuse of Psychoactive Drugs in Nursing Homes (PDF) [canhr.org]

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