On May 31, the California Department of Public Health released a report summarizing the work of its Antipsychotic Collaborative and making recommendations for addressing the multiple “failures” it identified. The report recounts the myriad regulatory violations it uncovered by reviewing medical records for a few residents in 42 separate facility investigations. These findings were largely reported in CANHR’s publication “In a Stupor: What California’s Antipsychotic Drug Collaborative Reveals About Illegal Nursing Home Drugging.”
In a nutshell, the Collaborative found widespread illegal use of antipsychotic drugs to control residents. A high number of facilities were found to have used antipsychotics without appropriate indications for use or complete plans for monitoring their side effects, violated informed consent requirements, and received very poor consultant pharmacy services.
To address the significant drugging problem DPH has revealed, it proposes to expand its Collaborative investigations, educate providers, and convene a stakeholder workgroup. Those seem like worthwhile efforts but perhaps the most obvious enforcement remedy – punishing facilities that have illegally drugged their residents with actual monetary fines – is not addressed. We welcome any effort from DPH to address the problem of chemical restraints but until it treats drugging without consent as the criminal elder abuse that it is, change is likely to be slow and mostly unsatisfactory.