We hear it too often:
“When I got there, she didn’t even recognize us she was on so much medication.”
“She almost fell out of the wheelchair she was so overmedicated.”
“She hasn’t eaten in days because she is on so much medication she barely wakes up.”
Overmedicating Virginia nursing home patients is a serious problem with potentially fatal consequences for residents. Yet, according to recent data from the Centers for Medicare and Medicaid Services, it is happening in Roanoke, Virginia, and elsewhere at alarming rates.
Over the last seven years, I have seen a very sad trend where overworked nurses who do not have time to redirect walking dementia patients have asked Virginia doctors for medication such as Haldol that will help “calm” patients – what the nurse is asking for is to keep a resident confined to a bed where they are easier to manage.
The practice is called a “chemical restraint” in the Virginia nursing home industry.
The resident goes from a walking, active adult with mild memory loss to being bed ridden, fall prone, malnourished patient within weeks. The same would happen to you if you were given an antipsychotic medication every time you tried to get out of bed and go for a walk.
Increasing Use of Antipsychotic Medication
Virginia nursing home doctors increasingly prescribe antipsychotic medications such as Haldol to patients suffering from dementia and other mental impairments, even though these drugs were developed for severe mental illness such as bipolar disorder and schizophrenia.
In fact, over 25% of nursing home residents in Virginia and around the country are treated with antipsychotic medication, according to Dr. Charles Crecelius, MD, AMDA Consensus Forms to Reduce Antipsychotics Use.
Does that mean 25% of Virginia nursing home patients have severe mental illness? Of course not. It means that physicians are prescribing these very strong medications off label to “calm” certain elderly patients in Virginia assisted living facilities and nursing homes without any sign or symptom of bipolar disorder.
In response to the growing problem of overmedication in Virginia nursing homes, the federal government has decided enough is enough.
Our most vulnerable population should not be taking medications where there is no FDA research reflecting their safety for elderly populations.
The Centers for Medicare and Medicaid Services (the folks that typically pay for nursing home care) have this summer begun new quality measures where information on antipsychotic use will be available to the public.
- Go to Nursing Home Compare for background information on Virginia nursing homes.
This morning, for example, I decided to search for the prevalence of overmedication at nursing homes in Roanoke, Virginia.
According to the data, one Roanoke nursing home within a mile of my office has over 27% of patients on these antipsychotics – almost 1 out of every 3 patients!
Consequences of Overmedication at Virginia Nursing Homes
The trend of overmedication has serious consequences. In addition to destroying quality of life, it can result in falls, stroke, weight loss, and cardiac problems.
So why would doctors be tempted to prescribe medications that are not approved for the elderly, for illnesses unrelated to the medication?
Sadly, its easier for nurses to care for bedridden patients.
When we don’t hire enough nurses to do the work, we are tempted to take shortcuts in care. I believe quality of life matters, and so long as we are over-medicating our seniors for the convenience of the caregivers, we should be ashamed of ourselves.
Make sure you check into a facility’s use of these serious and dangerous medications before you send your loved one there to stay. Go to Nursing Home Compare and search by zip code. With more awareness, perhaps families will begin demanding an end to the problem of overmedication.