State regulators rarely take action against Massachusetts nursing homes that, contrary to federal guidelines, use powerful anti-psychotic sedatives to control unruly elderly residents, a Boston Globe investigation has found.
Just 27 homes were cited for unnecessary use of antipsychotics from 2009-11, and inspectors in each of those cases did not deem the incidents as serious. The homes were not fined.
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The Globe should stop relying on cliches, such as "rein in," especially in headlines.
This isn't just nursing homes that are at fault. My mom was almost immediately placed on anti-psychotics within the geri-psych ward at the hospital. She had a significant negative reaction with increased psychotic episodes and side effects, but they refused to terminate the drugs even though they had no baseline for her. It took my another six months before I was able to get the nursing home to stop them. My mom responded well when they were terminated. I do know others who these drugs work well for, but everyone is different and family, who know the patient best and intimately are too often ignored.
Seroquel and Risperdol have specifi "black box warnings" that specifically state that they are NOT to be used on elderly aptients with dementia as they can cause death.
But the practice is wide spread.
Why is seroquel so heavily prescribed? What kind of marketing is there that has caused this overuse? Has the pharma company influenced doctor training or education?
Actually, Seroquel gained a foothold in the geriatric market as a low dose alternative to benzo's and an alternative to Trazadone. At a low dose - 12.5mg to 25mg, it acts similar to diphenhydramine or benadryl.
Many people question the use of or need for sedatives in this population. But very few people witness the self-destructive behaviors and violence by the elderly suffering from dementia.
@gandalf: excellent point. We need to be careful lest the desire not to over-medicate result in insufficient use of anti-psychotics for those patients that truly are dangerous.
Shouldn't Massachusetts be the model for regulation of health care and the education of health care workers? Where is Governor Patrick? I for one am getting tired of learning about the big holes in state audits and inspections when it comes to health care. Thanks again to Globe staffers for some great reporting!
Governor Patrick is busy, very busy, planning his next political move onto the national stage.
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Both Seroquel and Risperdol are anti-psychotics that contain black box warnings. The warning reads that they are NOT to be given to elderly patients with dementia...ever...as they can cause death.
Nursing homes use these drugs and overuse them. My mom is in a nursing home and was given, not one, but BOTH of these drugs and almost died. She experienced an episode of bradycacria (abnormally slow heartbeat) and had to be rushed to the ER. At no time was I (her health care proxy) asked or told about the use of these drugs. After the fact, they wanted me to sign papers stating it was OK.
Nursing homes will continue to use these drugs not matter the consequence. After all, who really cares if an elderly patient with dementia dies? It frees up a bed! Sounds cynical, but they do things that are not procedure all the time, figuring family will never know. And who is going to ask for an autopsy on an elderly patient with dementia? No one.
The answer would be more staff and more programs. But they won't pay for it and no one wants more taxes (you all don't want higher taxes until something happens and then you scream about the government).
The answer would be single-payer health care. Standards could be set and met, with oversight.
The question is, how much do you really care about fixing the problem?
For God's sake, how do you expect DPH to care about issues they don't understand? The public has been exposed to contaminated drugs, and conspicuously bad systems errors at the Jamaica Plains Lab. CMS and DPH have known for many, many years that this state has an abnormally high use of antipsychotic drugs in nursing homes. But this article failed to address the unusually high number of preventable pressure sores and falls that also occur among the elderdly in this state's nursing homes. CMS has comparison statistics for all states, and Massachusetts ought to receive a failing grade.
According to Alice Bonner, Director of CMS Nursing Home Division, she,"can see forward momentum." What the h@^% does that mean? Apparently Ms. Bonner, is just as full of buzz words down there in Washington as she waswhen sitting at the helm of DPH regulatory agency for her short term of 12 months!
Either you fix the problem or you are part of the problem. Madeleine Biondolillo claims, that nothing is done because CMS regulations are "too vague." OMG_ this is not an adequate or even common sense answer to the problem. It is a foolish comment from a Leader (?) within DPH, Health Care Quality. There are too many senior DPH staff who are part of the problem, and sadly don't look inward at there own lack of knowledge and skills to address major problems that fester, & fester.
just another example of state regulators doing nothing and then blaming others-and the feds make an easy target. What do these people get paid for? Almost every department in MA Gov has been found to be doing nothing even when they have been made aware of a problem. Look at the pharmacy scandel 37 people died and the board new about the problem last summer. On and on it goes...