All over the United States, nursing homes are trying to control seniors by putting them on antipsychotic drugs without any authorization. This practice, unsurprisingly, makes the nurses’ job more convenient because the seniors’ become lethargic or suffer more severe physical reactions. In addition to the legal and moral issues that stem from this misuse of drugs, the practice also carries disastrous health repercussions for residents.
According to the Food and Drug Administration (FDA), antipsychotic drugs are meant to treat psychiatric conditions. Nurses, however, are administering antipsychotic drugs to seniors – not for its intended purpose – but as an unwarranted sedative for residents with dementia. The FDA requires manufacturers to label antipsychotic drugs with the strongest “black box” warning about the risks they pose to people with dementia because these drugs nearly double the risk of death for residents. One director of nursing stated that seeing a senior decline on an antipsychotic is “sadder than watching someone with dementia decline.”
This inhumane phenomenon is so widespread that, according to a report by the Human Rights Watch, every week over 179,000 residents who do not have diagnoses requiring antipsychotic drugs are still given them. This practice reaches beyond creating irreversible health repercussions for seniors. Unnecessarily putting peoples’ parents, grandparents, and other relatives on drugs without authorization from the senior or his or her family also violates human rights norms.
This widespread phenomenon blatantly violates the 1987 Nursing Home Reform Act, which provides a Bill of Rights to each resident to protect rights and ensure a level of care. The Act is supposed to ensure that nursing home residents a quality of care “that will result in their achieving or maintaining their ‘highest practicable’ physical, mental, and psychosocial well-being.” Administering antipsychotic drugs to residents with dementia yields the exact opposite effect. Instead of maintaining the “highest practicable” physical, mental, and psychosocial well-being, this practice increases the speed of these seniors’ health deterioration.
Under this act, the residents have a right to be “fully informed in advance about care and treatment.” The residents, however, are administered these drugs without adequate information for them or a family member to properly consent nor the opportunity to object. For example, a resident of a Texas nursing home explained that she had no idea she was being given antipsychotic drugs because “they crush it and put it in baby food, so you don’t know what you’re getting fed.”
The 1987 Nursing Home Reform Act also provides that the residents’ care is free from improper medical treatment. Abusing antipsychotic drugs, however, puts lives at danger, and is worse than improper medical treatment. This treatment is inhumane.
While there are federal regulations in place to bar the use of drugs without adequate indication for use, there should be stronger enforcement in connection to nursing homes. One example of an initiative that is already put in place is the National Partnership to Improve Dementia Care in Nursing Homes by the Centers for Medicare & Medicaid Services. The issue, however, remains prevalent.
One potential reason for the continuation of unauthorized administration of antipsychotic drugs in nursing homes is because initiatives focus too much on the drugs, and less on the root of the problem, the rights of the residents. The 1987 Nursing Home Reform Act focuses on the rights of the residents, but the value of this act depends on the effectiveness of its enforcement. Nursing home staff should be required to learn its principles. Additionally, the US government should work further to enforce residents’ rights as per the 1987 Nursing Home Reform Act and hold nursing facilities accountable for their misconduct.