Nursing Homes Using Epilepsy Drugs to Chemically Restrain Residents with Dementia:
A new government study indicates that anti-seizure medications usually reserved for epilepsy patients are increasingly being used by nursing homes to sedate dementia patients, says a Washington Post article.
Recent concern over inappropriate use of antipsychotic medications in elderly nursing home residents with dementia has resulted in in the formulation of government policies against the practice; however, the study, conducted by the Office of Inspector General (OIG) for the Department of Health and Human Services to examine drug prescribing patterns in nursing homes from 2011-2019, shows a new trend of increased prescribing of epilepsy drugs.
Echoing this report is a second one recently published in the Journal of the American Geriatrics Society, which shows an increase in anti-seizure prescriptions in nursing homes.
The OIG study included another finding: that in nursing homes with low-income residents where registered nurses worked shorter shifts, a greater proportion of psychotropics such as antipsychotics and anticonvulsant medications were used. This trend, the study indicates, might suggest a cause for inappropriate use of these medications
At issue, the article says, is the matter that powerful drugs are being used to sedate dementia patients in order to make caring for them easier rather than to preserve their safety—a measure known as “chemical restraint” that amounts to the kind of poor care that is considered nursing home malpractice.
Federal law guarantees the rights of all nursing home residents, including the right for individual dignity and the right to receive the kind of care that promotes quality of life. Drugging residents with dementia to make their care more convenient for nursing homes upholds neither those residents’ dignity nor their quality of life, and instead amounts to nursing home malpractice.
The use of psychotropics has not been approved as a treatment for dementia that results from brain diseases or Alzheimer’s or other brain diseases. Even though it is permissible for physicians to prescribe drugs for conditions outside their approved use, antipsychotics and anticonvulsants put elderly dementia patients at risk for dangerous side effects. Antipsychotics can cause strokes, heart attacks, and diabetes in dementia patients; anti-seizure medications can cause pancreatic inflammation and liver toxicity. For this reason their inappropriate use can be seen as nursing home malpractice.
Psychotropic drugs cause sedation, which puts elderly residents at higher risk of the following:
- Bedsores –Heavy sedation can leave dementia patients practically immobilized. Prolonged periods without moving is a primary cause of bedsores which, if not tended to quickly, can escalate into serious infections or even wrongful death.
- Nursing Home Falls – The heavy drowsiness produced by antipsychotic drugs often results in increased rates of nursing home falls that result in serious injuries, and even death, which necessitates the involvement of a wrongful death attorney.
- Wrongful Death – Studies indicate that elderly dementia patients using antipsychotics are twice as likely to suffer wrongful death, requiring the intervention of an attorney.
David Gifford, chief medical officer of the American Health Care Association/National Center for Assisted Living, responded in an emailed statement to the Washington Post that the hope is to continue combating nursing homes using epilepsy drugs inappropriately, drug use that equals nursing home malpractice.
“We ardently support increasing education about the proper use of psychotropic drugs among nursing home residents with dementia and have asked CMS and others to expand its outreach to physicians, hospitals, community settings, and families,” Gifford said.
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