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Elder Law and Estate Planning Blog - Lancaster, PA

Monday, August 13, 2012

Drugs, Dementia and Nursing Homes

Did you know that one of the most common and longstanding, but preventable practices causing harm to residents in nursing homes is the overuse of antipsychotic drugs?  Last year, the Department of Health and Human Services found that 14 percent of nursing home residents were prescribed anti-psychotics.  Of these people, 8 out of 10 were prescribed off-label (that is: for purposes other than the ones for which they are FDA approved).  This overuse costs Medicare hundreds of millions of dollars and harms patients.

Still, this issue is not as simple as it seems.  Usually the meds are used because aides cannot provide basic hygiene for dementia patients without them.  Patients might be too agitated or violent for the aide to change their diaper or give them a shower.  Alternatives to these antipsychotic drugs can be time consuming and may require special skills, but are less harmful to the patients.

Alternatives, like giving a bed bath rather than a shower or changing the aide who is working with the patient, are focused on first learning why the patient acts a certain way and what triggers his or her agitation.  Once this is determined, a nursing home can make adjustments.  However, this takes both time and training, and for many facilities it is easier to give the patient a pill.  Alternative therapies, like music therapy and other non-pharmacologic solutions, may also work, but need further testing.

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