Back in action
Apr 11 2007 | Comment 1
Sorry to have lost an entire day yesterday. By the time I felt better, the Hour of the Blog had concluded. Today we start with an article sent by Jayne from Canada, about the overuse of antipsychotics in nursing homes there. It’s so enraging that such facilities utilize these drugs for people who are not mentally ill but simply aggressive or wakeful. It’s like the overuse of meds in children. Both populations demonstrate unpredictable behavior, and we just want to shut them up.
Reduce overuse of antipsychotics in nursing homes: geriatrician
liz | 9:14 AM | Uncategorized
A VERY complicated subject which is not as simple as antipsychotics=bad. One reason that such a high percentage of patients on these meds have no previous diagnosis of dementia or psychosis is that were likely never psychiatrically assessed- homes often have inadequate mental health services. That being said, antipsychotic medications are still a standard of care for treating the delusional symptoms and agitation of dementia.
Nursing homes are extremely difficult environments- most patients would have met criteria for inpatient hospital admission in an earlier time. Aggressiveness (ranging from simple hostility to overt assaultiveness) is a real problem and patient safety is an over-riding clinical and legal issue. This is a BIG business(witness the average cost of $80,000 to $120,000 per patient per year) and there is minimal focused regulation of factors other than medication which may aid in patient behavioural control. Many facilities have the most cognitively limited patients in the most crowded area of the facility to aid staff access rather than allowing such patients room to wander (wandering is a symptom of dementia).
No answers here- just a clarification of the complexity of the issue.
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