By Suzanne Potter, Producer, Public News Service
Groups that advocate for older Americans are speaking out about the overuse of psychotropic medications in nursing homes.
Last November, the federal government reported that 80% of nursing facility residents they studied received these medications, which are supposed to treat conditions like psychosis, convulsions, depression and anxiety.
But Eric Carlson, author of a new policy brief from the nonprofit Justice in Aging, said residents are sometimes being sedated as a form of chemical restraint.
“Evidence suggests that nursing facilities are using these antipsychotic medications to keep residents manageable,” said Carlson. “These are, by and large, residents who have not had a history of psychiatric conditions.”
This spring, the California Legislature will consider Assembly Bill 48, which would require facilities to get written consent from a patient or the patient’s representative before administering psychotherapeutic drugs.
The California Association of Health Facilities says it is reviewing the bill and hasn’t taken a position.
California has made significant progress on this issue. Federal data show antipsychotic use for long-stay residents dropped from more than 21% in 2011 to 10.5% in 2021.
Carlson – who is also the director of long-term services and supports advocacy for Justice in Aging – said informed consent must be a bedrock principle for all patient care.
“People should say, ‘Yes, I want this medication,’ or, ‘No, I don’t want this medication,'” said Carlson. “And that decision should be made after being given information on the benefits and potential risks of the medication.”
The feds use the prevalence of antipsychotic medicines to rate nursing home quality, but they don’t count patients with certain diagnoses, like schizophrenia.
The brief points out that the number of diagnoses for that condition shot up 35% after the rating system took effect in 2015.
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References:
Long-Term Trends of Psychotropic Drug Use in Nursing Homes US DHHS OIG 11/4/22
Why Too Many Psychotropic Medications? (policy brief) Justice in Aging 1/1/23
National Partnership to Improve Dementia Care in Nursing Homes: Antipsychotic Medication Use Data Report (includes historical data) U.S. CMS 4/1/22
Number of residents in certified nursing facilities in the United States as of 2022, by state statista.com 2022