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CANHR’s Stop-Drugging Campaign Gains Steam

As CANHR’s campaign to stop the drugging of nursing home residents nears its second anniversary, it is a good time to consider how well it is working. The campaign began in the fall of 2010 after CANHR decided that its longstanding efforts to fight use of chemical restraints were inadequate. For years the rampant misuse of antipsychotics and other psychoactive drugs has been fueled by illegal marketing schemes, poorly trained nursing staff, inadequate staffing, absentee doctors, indifferent regulators, uninformed consumers and massive government funding of the drugs. Like an out-of-control wildfire, the pervasive drugging of residents has been very hard to put out.

In many ways, the campaign has been a great success. It has been especially so in educating consumers, thousands of whom have turned to resources on CANHR’s Stop-Drugging website or contacted CANHR advocates for help. Our Toxic Medicine guide, now in its second edition, has been widely distributed by ombudsman programs and others. We hear every day from families of residents, and sometimes residents themselves, that the information is helping them challenge drugging practices and to demand better dementia care.

Training of providers is another highlight. About 1,400 people – most of them long-term care providers – have attended one of the five stop-drugging symposia CANHR has co-sponsored around the state. In June, Dr. Jonathan Evans, the president-elect of the American Medical Directors Association, joined our training team for two very-well received symposia in San Diego and Los Angeles. Just as important as the training itself, the events have stimulated local advocacy efforts throughout California. Each event has been carefully planned and coordinated by local ombudsman programs and other CANHR partners, and their work on this issue continues after the training is over.

We’ve also succeeded, literally, in making a federal case out of the illegal drugging. In May, the Centers for Medicare & Medicaid Services (CMS) held a national press conference to announce a new initiative to stop the misuse of antipsychotic drugs and to improve dementia care in nursing homes. As part of the initiative, CMS set goals for antipsychotic reduction, posted information on Nursing Home Compare on antipsychotic use, and is working to strengthen enforcement of drugging-related laws and to improve training of surveyors. These are baby steps, perhaps, but very welcome nonetheless. These actions came about after CANHR joined forces with other advocates to establish a national advocacy coalition.

Even provider associations that have long been apologists for over-drugging are starting to see that there is a better way. For example, the July 2012 issue of Provider, a magazine published by the American Health Care Association and the National Center for Assisted Living, has a cover story on finding alternatives to antipsychotics for long-term care facility residents with dementia. The article urges staff members to understand behaviors as communication and to “play detective” to resolve them rather than turning to dangerous antipsychotic drugs to sedate residents who have dementia.

In California, there are modest signs that regulators may finally be waking up on this issue. The California Department of Public Health (CDPH) and the regional office of CMS are currently co-sponsoring a series of meetings on antipsychotic reduction in California nursing homes. Long overdue, these meetings offer an opportunity to address and respond to a long list of recommendations CANHR has made for reform in this area. Several of the recommendations are found in our January 2012 report: In a Stupor: What California’s Antipsychotic Drug Collaborative Reveals About Illegal Nursing Home Drugging.

Notwithstanding the progress, there is a very long way to go. The actual number of California nursing home residents being given antipsychotics is barely diminished and we continue to hear many heartbreaking stories about persons’ whose spirits and health were crushed through misuse of these drugs. Until the numbers come way down, and drugging practices are replaced by excellent dementia care, the campaign has no room to rest.

If you haven’t already done so, please join CANHR’s campaign. You can sign up for the campaign on our Stop-Drugging website and you can also (but separately) subscribe to CANHR’s Stop Drugging Our Elders Blog.

Page Last Modified: August 28, 2012