The American Association of Retired Persons, better known as AARP, is asking all Texans to contact their representatives in support of a bill on the floor of the Texas State House of Representatives aimed at fighting nursing home abuse. As the best known advocacy group for seniors, it certainly makes sense that AARP would use their platform to speak up about this proposed legislation.
This bill in particular is fighting against nursing home abuse that occurs when facilities use antipsychotic medications as a form of chemical restraint. Many readers may be surprised that such a measure is even necessary given the circumstances.
Chemical Restraints and Nursing Home Abuse
Texas House Bill 2050 seeks to strictly regulate the use of antipsychotic medications in Texas nursing homes. H.B. 2050 would require caregivers and healthcare professionals to have explicit, preferably written, consent to administer antipsychotics to nursing home residents.
You may be shocked to discover that nursing homes across the country inappropriately dose residents with antipsychotic medications. All over the country, there are hundreds of nursing home residents under the influence of powerful antipsychotic medication for no other reason than that they suffer from dementia or Alzheimer’s. It is a hidden, though no less unsettling, form of nursing home abuse.
To combat this practice, Texas lawmakers have finally introduced a bill that requires permission before nursing home workers can use these powerful drugs on patients. As it stands, use of these drugs in this manner is more often called “off-label use” than “illegal use.” This bill seeks to change that.
Using a pharmaceutical drug to control or restrict a patient’s behavior is sometimes called chemical restraint. Hence, residents who are easily agitated, rowdy, aggressive, or have special needs are sometimes given these medications to calm them down or sedate them.
Though chemical restraint is widespread in assisted living facilities across the country, this commonplace abuse is not the standard of care or treatment for patients whose cognitive degeneration makes them a time-consuming charge.
Antipsychotics are not approved for use with dementia patients. In fact, the drugs bear a Food and Drug Administration (FDA) black box warning – the most serious warning the FDA issues. As a result, the warning is printed on the packaging explicitly warning against their use with dementia patients. Sadly, nursing homes continue to inappropriately use these medications because they make their lives easier.
Commonplace Nursing Home Abuse
Dosing erratic and rowdy patients with chemical restraints has been the focus of legislation in America for decades. The United States Congress has been hearing testimony on this type of nursing home abuse since the 1970’s. One piece of testimony given in 2007 by an FDA agent suggested chemical restraints increase a resident’s chances of death by 100 percent. Public opinion has never been enraged enough to affect widespread change.
In 2017, Human Rights Watch published a report about this style of nursing home abuse, and their observations were staggering. Consider the following:
- 179,000 nursing home residents per week suffer chemical restraint.
- Nursing home workers secretly dose residents with antipsychotics.
- Caregivers lie to residents about giving them antipsychotics.
- Staff members coerce and guilt residents’ family members into giving permission for the drugs.
- Caregivers do not inform either the patient or their family of the side effects or risks of unnecessary antipsychotics.
- They threaten to discharge patients if they don’t submit to chemical restraint.
- They make false claims about obtaining permission to dose a resident from a family member.
What Needs to Happen to Prevent Nursing Home Abuse
The new bill before the Texas state government would go a long way toward solving many of these instances of nursing home abuse. In addition to requiring resident (or their proxy’s) consent, nursing home workers will also have to create a record of each use of antipsychotic medications that discloses:
- The name of the drug
- The dosage
- The expected duration of treatment with antipsychotics
- Information relating to the potential side effects for each patient’s case
- Any warnings about the patient’s conditions without the use of these drugs
Where applicable, these records should be completed and attached to a nursing home resident’s written consent form.
Why Do Nursing Homes Use Chemical Restraint?
Reports from the Centers for Medicare and Medicaid Services (CMS) show that up to 40 percent of patients in nursing homes who receive antipsychotic medication have no clinical diagnosis of psychosis. Caregivers administer the drugs to counteract the effect of patients with cognitive difficulties.
Patients who may be rowdy, irritable, disruptive, disoriented, or otherwise in need of attentive care are receiving antipsychotics that numb their minds and blur their consciousness because caregivers want docile patients. Consequently, patient wishes, physical health, mental health, and dignity as human beings take a back seat to the culture of chemical restraint.
Plainly put, nursing home abuse is the daily reality of almost hundreds of thousands of elderly patients in nursing homes.
Why Do Caregivers Want Docile Patients?
In the first place, Medicare has been paying for the drugs. A report from CMS showed 83 percent of claims they received for antipsychotic medications were for off-label use on patients.
Furthermore, nursing homes also have a systemic understaffing problem. This results in:
- In some facilities, there may be only one Certified Nursing Assistant (CNA) for 9-15 patients.
- Licensed nurses may have between 17 and 33 residents to look after.
- Nursing home staffing numbers decrease by 11 percent on the weekends.
The bottom line is a ratio of one aide to 15 patients, or one nurse to 30 patients, is much more manageable if those patients are zoned out on antipsychotics. Small staff sizes would not be able to care for the needs of unmedicated dementia patients in the same numbers. At least not to the same degree of attention.
If the choice is to commit nursing home abuse or to schedule more staff, a shocking number of facilities choose nursing home abuse over paying for more workers.
Take Action if Your Loved One has Dementia
If your loved one has dementia and lives in a nursing home, they should not take antipsychotic drugs. They deserve to be treated in accordance with the standard of care for their condition. Sedating them with antipsychotics is nursing home abuse. It is certainly not responsible medical care.
When a nursing home gives a dementia patient antipsychotics, the patient is at increased risk of:
Your loved one has a right to refuse treatment with these drugs. Furthermore, he or she has a right to know about their risks and side effects.
Concerned? Nursing Home Abuse Center Can Help
Texas lawmakers have introduced H.B. 2050 because it addresses a public safety issue – an issue that affects some of the most vulnerable members of our society. It is an unbelievable shame that so many American seniors suffer under chemical restraints every day.
So, what can you do? If your loved one has been given antipsychotic medications without his or her knowledge or consent, take action immediately. There are many known risks to these medications. It is certainly never appropriate to coerce or force someone to take medication. At Nursing Home Abuse Center, we can help you protect your loved one’s legal rights. If he or she has suffered harm from chemical restraints, contact us as soon as possible.
To schedule a free consultation, call us at 1-800-516-4783, or you can fill out our confidential online form.