Gov't warns on use of psych meds in nursing homes

Yahoo News ^ | 05/09/2011 | AP Staff

[TennesseeGirl]

WASHINGTON – A new government report says many elderly nursing home residents suffering from dementia may be victims of overmedication with strong anti-psychotic drugs that could harm them...

The Health and Human Services inspector general says that in 2007, more than 300,000 nursing home residents got powerful drugs meant for treating serious mental illnesses like schizophrenia and bipolar disorder.

But nearly 90 percent of the time, the prescriptions were for patients suffering from dementia, a condition for which the anti-psychotic drugs are not approved. (excerpted)

[newzjunkey]

He does not have dementia.

So what does he have?

[Think free or die]

"like all medicines, sometimes you have to use them. For example, a small dose of anti psychotics for delusions and paranoid symptoms from dementia"

We grappled with this a few years ago with a loved one. He developed delusions which frightened him and made his care very difficult. He thought that shadows were rats, nursing home employees in the halls were plotting an overthrow, he was scared of the toilet . . . When the mind becomes damaged by disease, it can cause a lot of distress and pain. We resorted to psych meds, which helped calm him considerably, but also sedated him more than we thought wise. We reduced his levels somewhat, but it was all in his final weeks, and ultimately, there was no good solution. It is a cruel condition.

[dagogo redux]

Anyone who has not been in the positiion of providing psychiatric consultation in nursing homes, as I used to do, has very shakey grounds on which to form an opinion in this matter.

Most shrinks skilled in psychpharmacology stay the hell away from these places now - those who don’t prescribe, or who have no responsiblity for trying to get these people to function better, have ended up dictating treatment options to those who do, aided by the media and the gullible public.

[Think free or die]

I’m not quite following what you’re saying. Who is it that you’re saying is dictating treatment?

[stansblugrassgrl]

Apparently, he was mildly depressed. From what we’ve ascertained through research, depression in older folks is often misdiagnosed as early stage dementia. Otherwise, he healthy. What I don’t understand is why he didn’t speak up for himself. When this all started, his wife was the one pushing for meds. He never tolerated them well and had lots of side effects. The guilt of that is what contributed to her nervous breakdown.

[sheana]

Exactly. We just asked my fil’s doctor to put him on Ativan to keep him calmer. He has vascular dementia and his short term memory is gone. When I leave after visiting he gets agitated because he wants to go with me. All he can think about is going home.
Those are his only real symptoms so anything stronger would just turn him into a slobbering vegetable.

[TennesseeGirl]

The key word in the article for me was "overmedicated" - not so much the off-label usage as what helps one may not help the other. Overmedicated, however, is a biggie.

[TennesseeGirl]

You missed my point. See post #27. However, I strongly disagree with your assertion that family members who know their mom/dad/etc better than anyone else (especially someone who has been called in on a brief consultation) "has very shakey grounds on which to form an opinion in this matter". Last time I checked, nobody appointed the Ph.Ds and/or medical doctors King. You do not and cannot rule by edict. Health professionals are employed by US, the patients. With your vast knowledge, we depend on you guys/gals to give us your educated opinions. Until the health system changes, health professionals have NOT been appointed dictators, contrary to some opinions. BTW, you're fired.