Map of life expectancy at birth from Global Education Project.

Wednesday, April 15, 2015

This time, it's personal

The Government Accountability Office finds that 1/3 of people in nursing homes with dementia are prescribed anti-pscyhotic drugs -- and that is excluding people who actually have psychoses for which these drugs are indicated.

Why is this wrong? Because these drugs are prescribed essentially to put people into a stupor who would otherwise be a problem for the staff. The term for this is "chemical straitjacket." And, they present a high risk for premature death and other side effects.

Why is it personal? My father spent a long time in a nursing home, with dementia. Once my mother found him slumped over in a chair, nearly unconscious, and drooling. It turns out they'd given him seroquel (which is heavily advertised on TV by the way, as a treatment for depression, which also should be against the law, but that's for another day) because he had wandered into the kitchen. They couldn't be bothered just to have somebody watch him.

I drafted a letter for her to give the nursing director, stating that he was not under any circumstances to be prescribed antipsychotics. The ND said okay. A few months later, it happened again.

There is  a black box warning on the label for these drugs, saying that they are not approved for symptoms of dementia and are dangerous and harmful to elderly people with dementia. But the nursing homes continue to use them. This is the sequel of an illegal, off-label marketing campaign which apparently has burrowed so deeply into the culture of nursing homes that it has so far been impossible to eradicate. Lots of awful things happen in those places, but this must stop.

If you have a loved one with dementia, make sure the Nursing Director knows your wrath will descend should this crime occur.


kathy a. said...

Our experience is different from that of most other people whose family member has a dementia. The presenting set of symptoms with frontotemporal dementia is behavioral -- and my 56 year old relative is way on the acting-out end of the spectrum. She is on an anti-psychotic, because without it, she is manic and rages and obsesses endlessly and tries to hurt people. She has needed involuntary psych hospitalizations because she is dangerous to self and others.

My SIL's primary problem is neurological; but that not-well-known neurodegenerative disease makes her psychotic. Not in a friendly hallucinations kind of way.

Believe me, we are aware of the danger of over-medication; and the preferred course is to decrease this kind of med. We work hard to have the PCP work with the neurologist, to avoid zombification. It is a constant struggle to find the right balance of meds, though.

Care facilities and doctors should be consulting with family about changes in meds -- but a lot don't want to. It takes a lot of vigilence on the part of family members.

Cervantes said...

My father actually had some form of FTD (they have highly variable features). He was never dangerous, quite calm and sweet-natured, actually. Your situation is not the one I'm talking about, as you know.