Thursday, August 29, 2013

Antipsychotics in nursing homes

The U.S. government spent almost $8 billion on antipsychotic drugs in 2011 -- and that's just through Medicare. Don't forget about Medicaid and the DoD/VA.
One-in-five of elderly nursing home residents are on antipsychotics. This is usually done to quell the agitation associated with dementia. Unfortunately, antipsychotics are not only expensive, they increase the risk of death in the elderly. The WSJ article has a positive spin ("9% decrease in antipsychotic use"), but it is rather depressing if you read it carefully:
Nursing-home officials say inadequate staffing prompts some facilities to give sedating drugs. "Unfortunately a lot of nursing homes would rather give someone a pill to pacify them" instead of hiring more workers, said Morris Kaplan, owner of Gwynedd Square Nursing Center in Lansdale, Pa. His home, he said, went from a 13.8% rate in July 2012 to 10% in July 2013.
Officials at AG Rhodes Health & Rehab of Cobb, a 130-bed home in Marietta, Ga., said nurses were taught that with an agitated patient they should rule out the obvious, like whether they were in pain or hungry. The effort needed a "totally different mind set," said Jackie Summerlin, director of clinical services. The home has gone from 30 residents on antipsychotics to nine.

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