I want to write about something that upsets me to my core… Something that happens every day in America’s nursing homes. Something, that if truly exposed, would shock and horrify people.
Now what do I mean by “over medication?” I mean doctors and nurses giving elderly patients in nursing home, more medication than they really need, to essentially stop the patient from requiring too much attention.
Example.
86 year old woman with Alzheimer’s likes to walk the halls during the day. She walks up and down the halls, for hours. She is exercising her body despite the fact that she cannot exercise her mind. Family comes in one weekend and Mom is not in her usual spot in the hall – she is in bed. She is groggy, not yet dressed. They realize something is wrong and ask a nurse. They are told she tried to get into another resident’s room last night and so she had to be medicated. The nurses write in the nurses notes – “cannot watch her every minute, called doctor and asked for increase in Ativan.”
Did she hurt anyone? No.
Were the nurses bothered by the fact that they had to monitor a resident at night? Yes.
Would it be easier for them if all patients just stayed in their beds, quietly? Yes.
So they call the doctor, report the incident and ask for an increase in medication.
I have probably looked at over 100 sets of nursing home records in the last 3 years. I am sad to say, I have never once seen a physician decline to over medicate a patient for nurse convenience.
You read that correctly.
Nurse requests, doctor prescribes. No questions asked. No actual evaluation as to whether the behavior at issue warrants anti-psychotic medication. No Physician says “refused to increase medication because pt is easily redirected.”
AND IT HAPPENS ALL THE TIME
Residents who want to walk, ambulate, transport themselves in wheelchairs, get out of the building are not re-directed as you expect. They are over medicated to change the behavior. If you are drugged out of your mind, you won’t be able t walk the halls. So families watch their loved ones waste away in bed, because nursing homes don’t have enough staff, or rather, the staff do not have the time or desire, to do what is right.