November 2011 Archives

Overuse of Psychoactive Drugs in California Nursing Homes Reaches an Alarming Rate

November 21, 2011


The Department of Health and Human Services recently released a report revealing the excessive amount of "potentially lethal" antipsychotic drugs that nursing homes are dispensing to their residents. Aside from being a huge waste of taxpayer money (Medicare paid and estimated $116 million in unnecessary drugs, during a six-month period in 2007), it presents a dangerous health risk to our elderly population - particularly those who suffer from dementia.

Psychoactive drugs, also referred to as antipsychotic or psychotropic drugs, contain powerful chemicals that affect the brain and have dangerous side effects. These drugs essentially sedate the individual, which directly affects the individual's personality, behavior and mood. Psychoactive drugs typically fall into four major classes, including: (1) antipsychotics such as Zyprexa and Haldol; (2) anti-anxiety drugs such as Ativan and Valium; (3) anti-depressants such as Prozac and Zoloft; and (4) sedative/hypnotics such as Halcion and Restoril. They are particularly appealing to the nursing home industry because they can serve as a substitute for the individualized care the person truly requires.

Elderly patients with dementia are particularly vulnerable to dangerous side effects, including death. Nevertheless, many nursing home residents with dementia continue to receive psychotropic drugs that are not designed or approved for their condition. According to California Advocates for Nursing Home Reform, it is presently estimated that nearly 60% of California nursing home residents are given psychoactive drugs. The problem has become so critical that the U.S. Food and Drug Administration (FDA) issued a "black box warning" that antipsychotic drugs can cause individuals with dementia to die.

As with any approved drug, its use is not always harmful and the benefits can outweigh the risk. That said, if your loved one is presently taking these drugs, or if their use is being proposed, you have the right to better understand the risks and to decline the drug if you choose. Psychoactive drugs cannot be prescribed without first obtaining informed consent. In California, the key informed consent regulations are found within Title 22 of the California Code of Regulations, sections 72528 and 72527(a)(4-5). Essentially, the health care provider must explain any proposed treatment. This discussion should include the benefits versus risks of the proposed treatment as well as the reason for its use and reasonable alternatives. Furthermore, the resident or legal representative must agree to the treatment. Giving these drugs without first obtaining informed consent is a form of elder abuse and neglect and a direct violation of patient's rights.

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The Top Ten Signs of Elder Abuse

November 7, 2011

945156_wheelchair.jpgAs we age and certain everyday tasks become more difficult, we become more dependent upon the care of other people. These may be members of the family, in-home caregivers, or caregivers at a nursing facility. While many caregivers are skilled and dedicated, too often there are those who mistreat the people in their care. The result is that elder abuse is one of the most widespread forms of abuse.

Elder abuse generally falls into three categories that frequently overlap: physical, emotional, and financial abuse. Physical abuse can range from active harm by the caregiver to physical neglect. Emotional abuse may include intimidation through threats or yelling, routine humiliation, blaming or scapegoating, ignoring the elderly person, or terrorizing that person. Financial abuse can range from stealing the person's money outright to misusing his or her credit cards and personal checks. Elderly people are especially vulnerable to telemarketing scams and identity theft. A lonely elderly person might crave attention, even from a stranger over the phone -- leading him or her to give out personal information that the thief uses to steal credit card numbers and wipe out savings accounts.

Why is elder abuse so widespread? In many cases, unscrupulous people look to take advantage of those who are vulnerable. In other cases, care facilities may lack staff that is properly trained. Many family members also lack proper training and are generally overwhelmed by having to care for someone with significant physical and mental needs. Nonetheless, elder abuse is a crime and should be reported as quickly as possible. If you suspect an elderly neighbor of being abused, you can also find a California elder law attorney to obtain relief in a physical or financial abuse situation.

Here are the top 10 signs of elder abuse:

1. The person shows signs of physical trauma, such as burn marks, unexplained bruises and welts, and injuries that often don't match the explanation.

2. The person acts withdrawn, depressed, and fearful to talk openly.

3. You cannot get in touch with the person because he or she is being isolated from the community, especially family or friends.

4. The person shows signs of poor personal hygiene, such as bad odor or dirty, matted hair.

5. The person shows signs of being malnourished, dehydrated, or of having an untreated medical condition.

6. The person's living conditions are unsanitary.

7. The person's bank account shows signs of withdrawals when the person cannot access the bank.

8. The person's signature on checks and other financial statements does not match the person's signature on other recent documents.

9. The person's spending patterns change, resulting in the purchase of items the person does not need or normally would not buy.

10. The person's will undergoes suspicious changes, such as changing the primary beneficiary to a caregiver who is not part of the family.

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