COMMENTARY | The U.S. Centers for Medicare and Medicaid Services (CMS) announced a multi-year plan this week to reduce the use of antipsychotic drugs in nursing homes, reporting that nearly 40 percent of nursing home patients with signs of dementia were receiving these drugs even though there was no diagnosis of psychosis.
CMS’ goal is to reduce the use of antipsychotic drugs on nursing home patients by 15 percent by the end of this year. Alice Bonner, director of CMS’ nursing home division, said in a recent Boston Globe article that the 15 percent cut was a first step.
“In 2013 we will set another goal,” said Bonner. “At this point, we will be looking at even more significant reductions.”
Antipsychotic drugs have sometimes-lethal side effects. The U.S. Food and Drug Administration (FDA) has issued two warnings since 2005 against using them in elderly patients with dementia. Unfortunately, the warnings have gone unheeded, and in many cases, the drugs, which have a sedating effect, are administered to quiet “difficult” patients.
“The drugging of nursing home residents has long been a national disgrace,” said Claire Curry, legal director of the Civil Advocacy Program at the Virginia-based Legal Aid Justice Center, in a news conference covered by HealthDay.
Curry went on to add that hundreds of thousands of long-term care residents are drugged inappropriately, despite the FDA’s warning that they can cause death in patients with dementia.
“Advocates welcome every step taken to raise awareness about the dangers, to end unnecessary drugging and the harm it brings residents, and to strictly enforce rules already in place to protect residents from unnecessary drugs, especially antipsychotics being used as chemical restraints,” said Curry.
But is it enough?
Participation in the CMS program, dubbed the Partnership to Improve Dementia Care, is voluntary and therefore lacking regulatory teeth.
And without the strength of legislation that can be enforced, understaffed and overworked nursing home personnel will continue to turn to antipsychotics to deal with dementia patients who cannot speak up for themselves. I know, because my father was one of the 185,000 nursing home residents nationwide who received the medications — medication that was administered without our knowledge and left him a shell of the person he was. He died three days after we moved him from the nursing home.
Last week, proposed legislation to curb the high levels of “off-label” use of antipsychotic medications failed to pass the Senate. It would seem that this country’s dementia patients have been deprived of their voice yet again.