Linda A Curtis, LMSW
Nursing Homes Use of Antipsychotic Drugs to Control Patients
Sadly people with advanced dementia at times may not be able to control their own behaviors. They may wander out of their homes in the middle of the night, they may fight caregivers who are attempting to help them shower or go to the bathroom...... Due to these unpredictable variables families may be forced to have their loved ones admitted
to skilled nursing homes.
Skilled nursing homes also have difficulty in managing their patients with dementia. By law they are not allowed to use physical or chemical restraint (drugs). In the past these types of facilities would resort to literally tying people to their beds or wheelchairs to prevent them from doing something that may lead to injuring themselves or someone else.
Today nursing homes have become much more creative in how to manage this. Chemical restraint also know as pharmaceutical restraint is not permitted but with a diagnoses of schizophrenia they are allowed to prescribe "anti-psychotic" medication. These anti-psychotic medications include risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa), ziprasidone (Zeldox), paliperidone (Invega), aripiprazole (Abilify) and clozapine (Clozaril).
The bottom line with schizophrenia is that people do not get schizophrenia in late life. This is a mental health condition that occurs in young adults from 18 to 29. So patients in nursing homes given these diagnoses are most likely being deliberately given the wrong diagnoses simply for the purpose of being able to then place the patient on antipsychotics.
When used appropriately these drugs can be a huge benefit to the patient, but more often than not they are used in high dosages and basically for sedating the person so they are not a problem for staff. There are many effective strategies that can be used instead of drugs.
After receiving thousands of complaints the Centers for Medicare & Medicaid Services will conduct targeted, off-site audits to see if nursing homes are properly assessing and coding residents diagnosed as schizophrenic. These facilities will be cited and held responsible. The Biden administration has ordered that CMS be more transparent in their findings. The public will be able to monitor these facilities on the CMS website.