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.