Reducing Antipsychotic Use in Nursing Homes

Over half of nursing home patients suffer from Alzheimer’s disease or some form of dementia. To treat some of these patients, or to alleviate some of the symptoms of dementia, nursing home workers often use antipsychotic medication. Estimates vary about how widespread the use of antipsychotics is, but one estimate puts the rate at around one out of every five residents.

That means that nearly 20 percent of older nursing home patients are given antipsychotics to treat dementia. So, where is the problem, you might be asking. The problem is that antipsychotic drugs are not supposed to be used to treat patients with dementia. In fact, antipsychotic drugs are extremely dangerous for older adults, for a variety of reasons.

The Food and Drug Administration says that antipsychotics are not recommended for older patients or patients with dementia. These drugs can actually cause (or worsen) many of the symptoms associated with dementia, including confusion, agitation, anxiety and, in some cases, death. However, nursing home treatment for patients with dementia regularly includes antipsychotic drugs, often as a method of controlling or subduing patients.

Explaining the Erroneous Use of Antipsychotics in Nursing Homes

There are many reasons why this is happening. One reason is that nursing homes are understaffed and undertrained in these matters. If nursing home workers hear that these medications are effective in treating patients with dementia, they are likely to use them. They have many patients, and finding a quick solution is likely preferable to administering treatment that requires more time and resources.

Medical professionals have indeed been told that antipsychotics are effective and not harmful to older patients. Pharmaceutical companies market antipsychotics in ways that go well beyond their actual practical uses. In the case of Johnson & Johnson, claims of drug effectiveness among the elderly led to fines totaling over $2 billion after it was found that they knew the FDA did not agree with their claims but the manufacturer promoted their products as being effective anyway.

There are uses for antipsychotic drugs. For patients with schizophrenia, for example, they can be an effective form of treatment. However, they are too frequently used as powerful sedatives. This can worsen a patient’s mental state, zapping them of energy, personality and making them more susceptible to falls.

More Can Be Done to Treat Elderly Dementia Patients

The good news is that there has been a decrease in the prevalence of antipsychotic drug use among elderly dementia patients, though it is still far too common in nursing homes.

Elderly patients who have dementia require specialized care. Progress can be made if nursing home workers are properly trained in working with this specific subset of patients. For nursing home administrators and nursing home workers, this might seem like a large undertaking, especially when nursing homes are struggling to find enough employees to adequately staff their facilities. But continuing down the path of antipsychotic overuse will certainly not address the problem.

By ensuring that a nursing home staff is trained and prepared to properly treat elderly patients with dementia, costs can be reduced and, more importantly, patients will be better taken care of.