Almost all nursing homes in Texas are giving residents medications they do not need and could potentially kill them, according to an investigation by a Dallas, Texas, television station. This dangerous trend needs to stop.

According to WFAA, 96 percent of Texas nursing homes admit they are giving medications to residents who do not need them. This practice continues despite the Food and Drug Administration (FDA) issuing its strongest warning that antipsychotics can be lethal to elderly patients, and should never be used in patients with dementia as the risk is even greater for this population. Antipsychotics kill 15,000 nursing home patients each year, the agency said.

Most often, the drugs of choice among nursing home caregivers are antipsychotics – medications like Risperdal intended to treat schizophrenia. They are used to serve as “chemical restraints” to sedate patients and keep them under control.

New federal guidelines require nursing home residents to be diagnosed with at least one of three mental illnesses before they can be prescribed an antipsychotic. As a result, many patients are being diagnosed with these diseases and subsequently prescribed these medications despite the risk. Coincidentally, schizophrenia is a condition that most often develops in patients when they are in their early 20s, and rarely occurs in older people.

“Does that surprise me? No. Are those diagnoses legitimate? Probably not,” Dr. Daniel Pearson told WFAA. He is the head of Psychiatry at Methodist Hospital in Dallas. “If you are using (antipsychotics) just to keep people quiet, there are significant risks that are associated with that … increased risk of cardiac death, increase risk of falling, breaking a hip.”

In a letter dated Oct. 28, 2016, the Texas Long-Term Care Ombudsman alerted nursing home administrators to a “concerning trend in Texas nursing facilities” of a significant spike in first-time diagnoses of schizophrenia and similar psychiatric conditions in nursing home residents since the antipsychotic prescribing guidelines were put in place. “The Ombudsman Program considers intentional misdiagnoses fraudulent and dangerous to residents,” the letter stated.

The federal government has already cracked down on drug companies who have pushed medications for the off-label use in elderly patients. In 2012 and 2013, Abbott Labs and Johnson & Johnson were fined $1.5 billion and $2.2 billion respectively to resolve criminal and civil charges regarding dangerous off-label marketing of their antipsychotic drugs.

Intentionally drugging vulnerable patients to make them easier to manage is nursing home abuse. All residents of long-term care facilities deserve the right to live in a caring environment free from abuse, mistreatment and neglect, and to receive personal care that accommodates their physical, medical, emotional and social needs.

Psychiatric News
Department of Justice
Texas Long-Term Care Ombudsman

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