In early 2012, the Center for Medicare and Medicaid Services (CMS) announced a campaign to reduce the misuse of antipsychotic drugs in nursing homes with great fanfare. The centerpiece of the campaign was a goal to reduce the overall use of antipsychotics in nursing homes by 15% by the end of 2012. The goal was not met, then re-set, and subsequently slightly expanded – and criticized by many (including CANHR) as far too little to remedy a true travesty of poor nursing home care.
Two recent citations issued against California nursing homes illustrate the terrible damage that results from the misuse of psychotropic drugs to control the minds and behavior or people with dementia. Frankly, these tragedies are somewhat expected when the country’s top nursing home enforcement agency implies that most drug misuse is acceptable. Here is a brief summary of the two citations:
- EmpRes Post Acute, Petaluma, CA. A resident with dementia was drugged with three antipsychotics at the same time. Despite a rapid decline (including totally losing the ability to walk or talk) and pleas from other physicians, a nurse practitioner, and a consultant pharmacist to reduce the drug dosages, the resident’s physician made no changes and the facility continued to drug the resident for several months.
- Eureka Wellness and Rehabilitation Center, Eureka, CA. A resident with dementia was given an antipsychotic and tranquilizer drug every day. Despite a subsequent rapid decline (including the loss of the ability to walk and a descent into catatonia), the resident continued to be drugged until she required hospitalization. When the antipsychotic drug was discontinued, the resident began to recover.
Since the CMS campaign began, a lot of discussion about antipsychotics in nursing homes has been focused on good care providers and success stories and rightly so. But these two citations are one of many reminders that there is still a lot of work to be done – and that real people are suffering in the meantime.