Elder Abuse: Overuse of Antipsychotic Medication in Nursing Homes

Antipsychotic medication puts elderly dementia patients at higher risk of death.

Unfortunately, the upsetting stereotype of the overmedicated and dazed nursing home resident is too often true for institutionalized elders across the nation. This can be caused by prescriptions for antipsychotic medications like Seroquil, Haldol, Thorazine, Abilify, Risperdal, Zyprexa and others, which have been approved by the federal government to treat schizophrenia and bipolar disorder.

However, these drugs are being given to elderly nursing home residents with Alzheimer's disease and other kinds of dementia for related symptoms like behavior problems, poor memory or confusion, despite specific label warnings ordered by the Food and Drug Administration. Based on scientific studies and other evidence, the agency requires that the labels warn that these drugs can be particularly dangerous for those with "dementia-related psychosis" by putting them at higher risk of death.

According to the FDA website, these deaths usually seem to be related to heart problems or infections such as pneumonia. The FDA first put medical professionals on notice of this elevated risk in 2005, but it is still legal for a doctor to prescribe a drug for uses not officially approved.

Patient advocates assert that before an antipsychotic is used, less intrusive treatments for dementia symptoms should be tried like behavioral therapy, redirection and anti-stress techniques. People with dementia face frightening loss of memory and inability to communicate their needs and feelings, to say nothing of finding themselves institutionalized with unfamiliar people. Therapeutic, nonchemical ways to help them transition may lessen symptoms without powerful medications with dangerous side effects.

Nursing homes and similar institutions are heavily regulated by federal and state laws. Patients have the legal right to refuse treatment and physicians have the duty to tell patients of significant or dangerous side effects of prescribed medication so that the patients can make informed consent. If an elderly patient is not able to make medical decisions for him or herself because of cognitive impairment, his or her legal guardian or conservator, legal representative, health care agent or involved family members should be consulted for substitute informed consent to treatment on the patient's behalf.

Patients also have the right to be informed when significant treatment changes are needed. Stories in the media tell of patients receiving antipsychotic medications without the patients, legal representatives or family members even being told, much less being able to exercise informed consent after understanding the pros and cons of these drugs.

Patients also have the right to be free of chemical restraint, meaning that powerful drugs should not be prescribed to sedate patients for the convenience of staff or because understaffing makes less restrictive alternatives impossible.

Recently class action lawsuits have been filed in California against individual nursing homes and associated medical providers for their use of antipsychotic drugs to treat elderly patients with dementia without first obtaining fully informed consent. According to media reports, one such case settled and another is pending.

If you are disturbed by the drugs being prescribed to your loved one in a nursing home or if your family member has suffered serious injury or death as a result, speak with a personal injury attorney immediately to understand the legal remedies available. The elder abuse law firm of Brayton Purcell LLP with offices in the San Francisco Bay area, Los Angeles, Portland and Salt Lake City represents these clients across the country.

Keywords: antipsychotic medication, elderly, dementia, patient, risk, death, elder abuse, overuse, nursing home, overmedicate, drug, label warning, FDA, side effect, physician, duty, informed consent, treatment, chemical restraint, less restrictive alternative