All Sections

Home | Health

Use of meds to sedate those with dementia not just a problem in nursing homes

By ANDY MARSO
The Kansas City Star

May 07. 2018 11:01PM




KANSAS CITY, Mo. — The use of dangerous medicines to sedate seniors with dementia has been a well-documented problem in nursing homes.

But according to a new study published by AARP, the problem is deeper.

AARP researcher Elizabeth Carter found that the improper use of anti-psychotic drugs is growing for seniors with dementia in assisted living or who live with family.

“I think there’s been a lot of interest (in the study) and a lot of surprise because the focus has traditionally been on the nursing home setting,” Carter said.

Using Medicare Advantage data, Carter found that 13.4 percent of seniors with dementia outside of nursing homes were prescribed an anti-psychotic in 2015, even though they didn’t have the mental health conditions those drugs are intended to treat.

That’s up from 12.6 percent in 2012, at a time when the use of the drugs in nursing homes was dropping.

“To see an increase, even if it was a slight increase — I think that surprised a lot of people,” Carter said.

Mitzi McFatrich, the executive director of Kansas Advocates for Better Care, said years of federal attention to over-medication in nursing homes has made medical directors and staff at those facilities more aware of the dangers of anti-psychotics, which carry risks of falls, stroke and other potentially fatal side effects.

Patients outside of nursing homes are seeing internists or family medicine doctors who might not be as aware of the issues.

“There might not have been the same kind of education among physicians in the community,” McFatrich said.

The federal government embarked on a campaign to curb anti-psychotic use in nursing homes in 2012, when nearly 25 percent of residents nationwide were being prescribed the drugs.

Since the campaign began, the national rate has dropped to about 15 percent.

It’s still about 20 percent in Kansas, which has ranked among the worst states since the federal campaign began. It was one of six states singled out in a Human Rights Watch report earlier this year.

But Kansas nursing home representatives have long argued that they’re not the sole source of the problem.

Cindy Luxem, the president and CEO of the Kansas Health Care Association, said the AARP study provides more evidence of that.

“We believe only about 2 percent of folks are prescribed (an anti-psychotic) after they enter a facility,” Luxem said via email. “They are coming in already prescribed, whether from the hospital or community setting.”

McFatrich’s group has been pushing for a bill to strengthen Kansas’ informed consent laws governing what nursing home residents and their families are told about medications before they’re given.

There was a hearing on the measure in March, but it hasn’t advanced.

McFatrich said the AARP study has raised more questions for her. For instance, why did Carter find that women were more likely than men to be put on an anti-psychotic?

McFatrich said she hopes Kansas officials will consider creating a statewide plan to address dementia care in every setting, including best practices, training standards and resources for caregivers, as well as non-pharmaceutical options for calming people with dementia when they are distressed.

“If we know there are things that can be done that don’t put a person’s life or quality of life at risk, why aren’t we promoting those things?” McFatrich said.


Health Mental Health

FOLLOW US
Follow us on Twitter Follow us on Facebook Follow our RSS feed
Union Leader app for Apple iPad or Android *
Click to download from Apple Apps StoreClick to download from Android Marketplace
* e-Edition subscription required