How should a nursing home care for a difficult patient or a patient suffering from dementia? Well, the answer for some nursing homes is apparently to sedate them. According to a report by Consumer Affairs, “Sales of atypical antipsychotics have been rising steadily from $8.4 billion in 2003 to $14.6 billion in 2009 – outperforming sales for drugs to treat such common conditions as depression, heartburn, high cholesterol and hypertension.”
Nursing homes are often choosing to take the easy road when it comes to patients suffering from Alzheimer’s Disease or Dementia. Instead of using techniques such as “redirecting” which entails diverting the patient’s attention from something causing him/her agitation or confusion to another topic or focal point in an attempt to calm the patient, antipsychotic drugs are being employed. Behavioral techniques such as redirecting, talking about ‘old times’, looking at family photos, dancing, singing, or playing cards are often more effective and safer alternatives that are not being utilized.
Although it is obviously easier and less time consuming for a nursing home to administer such drugs, the risk to the patient can be severe. Antipsychotic drugs have serious and potentially life threatening side effects especially in the elderly. According to USPharamacist.com, “Both traditional and atypical antipsychotic agents are NOT FDA approved for the treatment of dementia-related psychosis. Use of these agents in geriatric patients with dementia-related psychosis is associated with an increased risk of death.”
In 2005, the FDA required a Black Box warning on these antipsychotic drugs due to a finding that “the rate of death in elderly dementia patients who received antipsychotics was about 4.5 percent during the course of a 10 week controlled trial, compared to about 2.6 percent in the placebo group.” However, the use of these drugs is continuing to increase.
Families must be vigilant. When admitting a loved one into a nursing home, read the fine print in the admission paperwork. Language in this paperwork may allow the nursing home to administer antipsychotic medications without your prior approval. Nursing homes that accept patients suffering with Alzheimer’s and Dementia have a duty to provide them with appropriate care. In some instances, the use of antipsychotics may be proper and necessary. However, the benefits must outweigh the risk and that determination should be made by the patient’s doctor and the person responsible for making the patients health care decisions. These drugs should never be used out of convenience. The nursing home’s first priority should always be the patient. Unfortunately, sometimes facilities lose sight of that and the patients suffer because of it.