By Brette Sember
Having a parent
move into a nursing home is a stressful time. Although it may be the best (and
sometimes only) option, it’s still a difficult decision to make. Furthermore,
even once your parent is moved, you’ll continue to worry about their health,
safety, and happiness.
Well, add this to
your list of concerns: one in five nursing home patients are given
antipsychotic drugs, often to keep them quiet or to control their behavior, not
because they have an actual diagnosis that requires such powerful
pharmaceuticals.
Why are these drugs so commonly used?
Elderly
nursing-home patients are often drugged simply because it is such a simple way
to make them manageable. Drugging patients lessens the demands on the staff and
may even allow the nursing home to reduce staffing headcount. The drugs thus
serve the same function as restraints once did – to keep patients tractable and
in one place. They also quell complaints from patients, who are so heavily
medicated they can no longer speak up.
While nursing home
operators may perpetrate the over-medicating, the lawsuit chain indicates the
problem starts with the drug makers. Johnson & Johnson, for example, was fined millions of dollars for
aggressively marketing antipsychotics to nursing homes when they knew the drugs
had not been proven safe for the elderly. Eli Lilly settled a similar suit.
Stay informed and be proactive
The use of these
drugs is particularly common with dementia patients, who have disturbed sleep
cycles and often do not respond well to rigid scheduling. If your parent has
dementia, ask if the facility accommodates his or her needs by using a flexible
schedule for sleeping, eating, and socializing. This approach is often referred
to as the Beatitudes method, after a nursing home that implemented it.
Go over every
single drug being administered to your parent. Write them down and ask what
they are, then Google them yourself to be sure. Take your parent to an outside
gerontologist if you aren’t sure that mom or dad is being appropriately
medicated. Require notification every time a new drug is added to your parent’s
regimen and follow the same procedure to double check the appropriateness of
the new prescription.
An antipsychotic is often first
prescribed in response to a so-called crisis, such as a patient being disruptive
in the middle of the night, but it then has a way of becoming regular,
continuing medication. If this happens to your parent, investigate the
“crisis.” Find out what happened and why. If you suspect you are not being told
the truth, ask to see the actual incident records, not an interpretation of
them by a staff member. Ensure that a one-time dose does not become an ongoing
prescription unless warranted.
The administration
of antipsychotic drugs requires informed consent, either from the patient or
from a legally designated person who acts in the patient’s best interest. So if
you are the one authorized to make medical decisions and you think an
unwarranted drug has been administered, tell the nursing home that you do not
consent to this. Put it in writing if necessary.
Attend all
planning meetings for your parent. Get involved with the nursing home’s parent
council, where you can interact with other family members and determine if
there are widespread problems.
Obtain medical authority
If you do not
already have the authority to make medical decisions for your parent, contact
an attorney to determine what you need to do to obtain it. You will also want
to review whatever
existing documents exist around health care directives or health care power of attorney; your
parent may have designating you to step in when he or she is unable to make
decisions, but your parent needs to be declared incompetent for it to take
effect. If your parent is considered able to make decisions, obtain his or her
written authorization allowing you to make decisions on their behalf.
Filing complaints
If you believe
your parent is being drugged without consent, first complain to the staff and
administration at the nursing home. Next contact your state long-term care ombudsman. These representatives ferret out nursing home
abuse and advocate for patients. An elder law attorney can also help you. If you cannot reach a
satisfactory solution, you may want to consider moving your parent to a
facility that does not use antipsychotics on a regular basis. Careful research
and visits will be needed to determine this.
Above all, stay
involved. Be an aggressive advocate on your loved one’s behalf.
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