New York Times: Doctors Say Medication Overprescribed For Dementia

The New York Times recently reported that doctors have found the anti-psychotic medications are overprescribed for dementia and alzheimers patients, particularly those who are residents of nursing homes. http://www.nytimes.com/2008/06/24/health/24deme.html?_r=1&adxnnl=1&oref=slogin&adxnnlx=1214618341-mX42KSg/N0jjqNLeiWyVYw

 

The Times reported that about one-third of all nursing home residents have been prescribed anti-psychotic drugs.  The drugs are often prescribed “off label,” because they have not been FDA approved for use by elders.

 

 

Soft Diets

There have been a number of nursing home residents who have choked and been injured or died as a result of the failure of the nursing home and its staff to follow orders to provide the resident with a soft diet or mechanical soft diet.  These diets are intended for residents who are unable for various reasons to consume certain difficult to chew and swallow foods.  For a more detailed description of soft diets, please see http://www.gicare.com/pated/edtgs35.htm.  Often, the reason that the diet is not followed is that there are insufficient staff or staff who are not adequately trained to meet resident needs.

Antipsychotic Medications

A recent study found that “elderly dementia patients prescribed antipsychotic drugs are at three times the risk of a serious health problem or dying within a month of treatment, compared to those not given the drug.” 

Strangulation Death & Cover Up

Here is a story about a woman nursing home resident in Mt. Vernon, New York who was asphyxiated and died when her head was caught in the bars of her bed after nursing home staff failed to lower the bed as required. http://www.wnbc.com/news/16320692/detail.html Other nursing home staff re-arranged the resident’s body in an effort to cover up their negligence. However, one staff member made an anonymous call to the government regulators to report the incident, and the regulators later investigated and confirmed the report.

$6 Million Verdict in Morphine Overdose Death Case

A jury in Tuscan, Arizona has awarded $6 million to the family of a nursing home resident who died from an overdose of Morphine. 

 

http://www.tucsoncitizen.com/daily/local/85219.php

 

This is just another example of the danger faced by nursing home residents from mismanagement and errors in administering prescription medications.   

GAO Report

The Government Accountability Office (GAO) issued a report this week showing that a substantial portion of surveys of nursing homes by state regulators failed to identify significant deficiencies.  The report indicates that “during fiscal years 2002 through 2007, about 15 percent of federal comparative surveys nationwide identified state surveys that failed to cite at least one deficiency at the most serious levels of non-compliance—actual harm and immediate jeopardy.”

 

The New York Times described the findings of the GAO report: http://www.nytimes.com/2008/05/15/washington/15health.html?_r=1&sq=nursing%20home&st=nyt&oref=slogin&scp=2&pagewanted=print

 

For the full text of the GAO report see:

http://www.gao.gov/new.items/d08517.pdf

 

Despite the findings in the report, Maine’s State surveyors performed better than most.  In fact, from 2002 through 2007, in twelve surveys comparing the State and federal survey results, Maine surveyors did not miss a single deficiency on the most serious levels of “actual harm” or “immediate jeopardy.”  However, on those same 12 comparative surveys, Maine surveyors missed 6 deficiencies with the potential for more than “minimal harm” to the nursing home resident.  Thus, on 50 percent of the comparative surveys analyzed by the GAO, Maine surveyors had missed at least one potentially significant nursing home deficiency.  In short, while Maine surveyors are doing better than most of their counterparts in other states, there is room for improvement.  The demands upon surveyors will only increase as Maine’s nursing home population continues to grow with the rapidly increasing elder population of the State.