FROM THE FOUNDATION

Big Business, Little Data

A growing number of Californians are being sent to ambulatory surgery centers for a wide variety of procedures, yet little is known about the care they deliver because reporting is not required.

And the Winner Is...

See how human-centered designers answered our challenge to encourage more people to complete advance directives and document their end-of-life wishes.

Ready or Not

Even with new federal resources to help, a study finds that communities with weaker safety-net systems are lagging in preparations for health reform.

Patient Safety

Friday, October 21, 2011

Use of Antipsychotic Drugs in Nursing Homes Spurs Debate

Ventura County stakeholders are debating the safety and efficacy of the use of antipsychotic medications in nursing homes. Many patient advocates oppose the practice, citing an FDA black-box warning that antipsychotic drugs can cause severe side effects and nearly double the risk of death in patients with dementia. Meanwhile, county physicians and nursing home officials say that they dispense the drugs sparingly based on careful consideration of the risks and benefits to patients but note that sometimes the medications are necessary.

Reader Comments:
  • 2
  • 11/18/2011
  • Robert Forster

Laura your heart is in the right place, but being a geriatrician during my clinical years I spent considerable time in SNFs or LTFs. I saw considerable functional elders made unfunctional for the convenience of the staff with drugs. Atypical anti-psychotics are widely recognized as abused or over used drugs to modify behavior in all age groups. Often 2-3 are given at the same time empirically and in reality the doc has very little time to assess this treatment. Bringing some science to this area will help on cost (some cost $3000 per month) and at least not harm those who are most vulnerable. It is something we need to look at closely and unemotionally. I agree with the comfort statement, but let's make our therapeutic decisions on the best science we have and not on drug promotions by Pharma.

  • 1
  • 10/21/2011
  • Laura Hart

Make it personal, think about it, if this was your family or you fifty years from now: would you want to be comfortable or tied to a gurney? There has to be more research to decide what is necessary and what is not. Safety is first and foremost, and comfort and care just as important. What to do? Medications can ease an elderly person's pain, both mental and physical. It should not be completely known as "chemical restraint." The majority of us would prefer proper medicating, but now, we have a potential for less care that I think is far more distancing between patient and caretaker, and that is telemedicine. If that is a potential for nursing home care, then we are going in the wrong direction. Most of us would prefer to be comfortable first, and if that requires more research and training into geriatric care, then so be it. But don't vilify and eliminate potential treatments for age disorders, dementia, alzheimers, PAIN, bed sores and so forth. I want to be comfortable.



Readers are invited to send feedback to: chl@chcf.org

Click to register for California Healthline