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Use of antipsychotics in nursing homes down but still a problem

Many nursing homes across the country have been accused of using antipsychotic medications to sedate patients. This makes the patients passive and easier to handle, but it has serious medical implications. These drugs carry federal warnings stating they increase the risk of death for people with dementia.

There has been some progress in recent years. The use of antipsychotics being given to nursing home residents dropped from around 24 percent in 2011 to less than 16 percent last year. There were decreases reported across the nation, but Tennessee, California and Arkansas led with the largest reductions.

Unfortunately, new data from Centers For Medicaid Services (CMS) indicates the problem of overuse of antipsychotics remains widespread. Ten years ago, around 270,000 nursing home patients with dementia were being given antipsychotics, according to the Department of Health and Human Services -- even though these medications are not approved for use in dementia.

Based on government data, about 179,000 such patients are receiving them now, without any diagnosis supporting the use of the medications. The report indicates that the drugs are often given without the consent of the patient or family, which violates government regulations and may well constitute negligence or medical malpractice.

"Given the dire consequences, it [that is, the number of patients receiving the medications without any diagnosis supporting the use of the medications] should be zero," said an attorney for the AARP Foundation, which is involved in several court cases challenging medication practices at nursing homes.

An industry group called the American Health Care Association has been working with CMS to reduce the unnecessary use of these medications. The group, which represents over 13,000 nursing homes in the U.S., has been involved in the project since 2012 and says a majority of its members have succeeded in reducing the use of antipsychotics by about 30 percent.

While recognizing there is room for greater improvement, a spokesperson for the association points to these substantial gains as indicating their approach is effective.

The lead author of the Human Rights Watch report says it is not effective enough. "Would you want to go into nursing home if there's a one in six chance you'd be given a drug that robs you of your ability to communicate?" she asked.

It's upsetting to imagine a loved one being sedated and left neglected in a nursing home, especially if the reason is not medical or even against medical protocols. Dementia is not to be treated with antipsychotics, even if their sedating effect is convenient for staff.

If you have a loved one in a nursing home and suspect they may be being medically sedated, we recommend having your case evaluated by an attorney right away. Regardless of their cognitive ability or impairment, your loved one deserves to be given appropriate medical treatment and to live out their final years in the least restrictive setting possible under the circumstances.

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