Using Antipsychotics To Pacify Nursing Home Residents: How Much Is Too Much?

Nursing Home Negligence

Antipsychotics are commonly prescribed to nursing home residents in order to control agitation and aggressive behavior, even if the residents do not have a diagnosis warranting use of an antipsychotic.  Typically, antipsychotics are prescribed to treat schizophrenia and bipolar disorder, but they are increasingly being used in the management of non-psychotic disorders in order to placate residents in nursing homes.  However, many of us have been unaware of how frequently these antipsychotics were actually being used in this troubling manner.

Recently The Boston Globe requested data from the Centers for Medicare and Medicaid Services (CMS) regarding the rate of antipsychotics in nursing home residents.  The Globe found that the national average for medicating residents with antipsychotics—who do not have a related diagnosis—is 16.7 percent.  Shockingly, the report also revealed that two local nursing homes in the Capital Region are medicating nearly 40 percent of their residents with antipsychotics; virtually triple the national average.

  • Our Lady of Mercy Life Center’s rate of antipsychotic use in residents was 39.6 percent
  • Guilderland Center Nursing Home rate of use was at 37.8 percent

Information regarding the medications being prescribed to residents is normally collected by nursing home regulators who regularly survey the nursing homes and the information is then provided to CMS.  The Globe obtained this data from CMS after making a Freedom of Information Act request which requires the government to provide full or partial disclosure of previously unreleased information and documents controlled by the federal government.  The Globe’s analysis on use of antipsychotics in nursing homes was based on data from 2005 to 2010.

Do you have a loved one or family member in a nursing home who may be on an antipsychotic?  Some of the most commonly prescribed antipsychotic medications are Abilify, Seroquel, Risperdal, and Zyprexa.  Many of these medications include dangerous warnings such as an increased risk of heart attack and stroke, while also warning of side effects such as increased confusion, trembling, muscle weakness, weight gain and mobility issues.  The medications also have shown to lower life expectancy.  The use of antipsychotics in elderly residents who are already vulnerable to many of these symptoms that are associated with these drugs is troubling.

In an interview with the Times Union, Dr. Michael Wolff, medical director of The Eddy which is a major operator of residential facilities in the capital region, suggested that antipsychotic medications should be used as a last resort and that anti-depressants which have less side effects should be tried on the residents firsts.   Interestingly, the report also showed that nursing homes with lower staffing levels and more Medicaid residents had a higher use of antipsychotics.

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