The population of the United States is rapidly aging, with older people now accounting for one in seven Americans, or nearly 50 million. Moreover, the number of older Americans is predicted to double by 2060. While this increased lifespan is undoubtedly a positive development, it does not come without its costs. Longer life can also bring chronic illnesses, including dementia. In fact, the number of Americans with the most common form of dementia, Alzheimer’s disease, is expected to increase from 5 million to 15 million by 2050. Faced with such daunting health challenges, many have turned to nursing homes to help care for their loved ones, with an estimated 1.4 million Americans residing in such facilities today. While the majority of the country’s more than 15,000 nursing homes take the care of our seniors very seriously, a recent report by Human Rights Watch uncovered a disturbingly common form of nursing home abuse, including at facilities in Illinois: improperly prescribing antipsychotic drugs to “restrain” patients with dementia.
What Are Antipsychotics?
Antipsychotic drugs were first developed in the 1950s to treat schizophrenia, which is a long-term mental disorder that severely affects a person’s ability to think, feel, and behave clearly. Antipsychotics are one of several classes of psychotropic drugs, which affect the central nervous system.
The United States Food and Drug Administration (FDA) has subsequently approved the use of some antipsychotics to treat other medical conditions, such as bipolar disorder and Tourette syndrome. However, the FDA has never approved using antipsychotic medications to treat dementia symptoms.
Administered Without Informed Consent
In conducting its study on antipsychotic use in nursing homes, Human Rights Watch interviewed 323 nursing home residents, family members, caregivers, staff members, ombudsmen, advocacy organizations, and disability experts between October 2016 and March 2017. During this period, the organization also visited 109 nursing homes in six states, including Illinois. (The remaining states surveyed were California, Florida, Kansas, New York, and Texas.)
The results from the study were alarming. Human Rights Watch found that over 179,000 nursing home residents are administered antipsychotic drugs in an average week – despite not having diagnoses for which these drugs are approved. In addition to being improperly administered, these drugs are often given to patients without their informed consent.
In the medical community, informed consent occurs when a decision is based on a discussion of the purpose, risks, and benefits of and the alternatives to a particular drug or medical intervention. Just as importantly, the decision must also take place in the absence of coercion or pressure.
In Illinois, informed consent is not only a recommended best practice – it’s the law. According to Illinois’ Nursing Home Reform Law, antipsychotic drugs and other forms of psychotropic medications “shall not be prescribed without the informed consent of the resident, the resident’s guardian, or other authorized representative.”
In practice, however, the report finds that nursing home staff often does not hew to either the letter or the spirit of the law. As one Illinois patient advocate told Human Rights Watch, “Informed consent is telling people risks and benefits and giving them a choice. In practice, the conversation is, ‘take it or we will discharge.’”
“I Need a Restraint”
Why are antipsychotic medications so often administered to dementia patients when they are not medically necessary? Human Rights Watch found that it is less a matter of patient need and more a matter of staff convenience.
Caring for those suffering from dementia and Alzheimer’s Disease can be challenging. They may be confused about and resistant to caregiver actions necessary for their well-being. While these difficulties are understandable, it is considered medically unacceptable to resort to the use of antipsychotics solely to make a caregiver’s job easier.
And how does administering antipsychotics to a resident with dementia make a caregiver’s job “easier”? Antipsychotic drugs have a sedative effect. They alter consciousness and affect a person’s ability to interact with other people – effectively leaving them in a stupor.
Such a patient may offer fewer challenges to a caregiver, particularly one working in an understaffed environment. But make no mistake: As an Illinois-based expert explained, “Antipsychotics are often about the nursing staff, not the residents.”
When requesting antipsychotics for a patient, the expert continued, the staff may frequently say, “’I need a restraint.’ It’s not just a figure of speech.”
Dangers of Antipsychotic Drugs
As Human Rights Watch argues, such “drugs’ use as a chemical restraint – for staff convenience or to discipline or punish a resident – could constitute abuse under domestic law and cruel, inhuman, and degrading treatment under international law.”
But aside from the psychological damage that may result, misuse of antipsychotic drugs on patients suffering from dementia could cause immediate, serious health risks. Taking antipsychotics can cause diabetes, blood clots, stroke, cardiac arrest, and even death. Elderly dementia patients who have been improperly administered antipsychotics may be even more vulnerable to these side effects. According to data cited in the Human Rights Watch report, antipsychotic drugs almost double the risk of death in older people with dementia.
Despite the obvious dangers, wrongfully administering antipsychotic drugs to dementia patients – whether as a matter of convenience or even punishment – remains a far too common form of nursing home abuse in the United States. Illinois rates especially poorly in this regard, with AARP ranking the state 48th (out of the 50 states and the District of Columbia) for the percentage of long-term nursing home residents receiving antipsychotics.
Chicago Nursing Home Abuse Attorneys
If you believe your loved one has been seriously hurt because of improperly administered antipsychotic medication, you may be able to pursue a claim against the nursing home for damages. In seeking financial compensation for nursing home abuse, many find that they could benefit from the help and guidance of an experienced attorney, like the Chicago nursing home abuse attorneys at GWC Injury Lawyers, Illinois’ largest Personal Injury and Workers’ Compensation law firm.