I recommend reading the whole article at the following link. Note that there are several pages, navigated by clicking on the links at the bottom right of each page.http://www.aarp.org/health/drugs-supplements/info-2014/antipsychotics-overprescribed.html
by Jan Goodwin, AARP Bulletin, July/ August 2014
When Patricia Thomas, 79, went into a Ventura, Calif., nursing home with a broken pelvis, the only prescriptions she used were for blood pressure and cholesterol, and an inhaler for her pulmonary disease. By the time she was discharged 18 days later, she "wasn't my mother anymore," says Kathi Levine, 57, of Carpinteria, Calif. "She was withdrawn, slumped in a wheelchair with her head down, chewing on her hand, her speech garbled." Within weeks, she was dead.
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"Yes, my mom had Alzheimer's, but she wasn't out of it when she went into the nursing home. She could dress and feed herself, walk on her own. You could have a conversation with her," says Levine. "My mother went into Ventura for physical therapy. Instead, she was drugged up to make her submissive. I believe that my mother died because profit and greed were more important than people."
A Ventura County Superior Court judge agreed that Levine had a legitimate complaint against the nursing home. In May, attorneys from the law firm Johnson Moore in Thousand Oaks, Calif., joined by lawyers from AARP Foundation, agreed to a settlement in an unprecedented class-action suit against the facility for using powerful and dangerous drugs without the informed consent of residents or family members. "It is the first case of its kind in the country, and hopefully we can replicate this nationwide," says attorney Kelly Bagby, senior counsel for AARP Foundation Litigation.
Tragically, what happened to Patricia Thomas is not an isolated incident. According to Charlene Harrington, professor of nursing and sociology at the University of California, San Francisco, as many as 1 in 5 patients in the nation's 15,500 nursing homes are given antipsychotic drugs that are not only unnecessary, but also extremely dangerous for older patients. The problem, experts say, stems from inadequate training and chronic understaffing, as well as an aggressive push by pharmaceutical companies to market their products.
"The misuse of antipsychotic drugs as chemical restraints is one of the most common and long-standing, but preventable, practices causing serious harm to nursing home residents today," says Toby Edelman, an attorney at the Center for Medicare Advocacy in Washington, D.C. "When nursing facilities divert funds from the care of residents to corporate overhead and profits, the human toll is enormous."
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Last November, in what the U.S. Department of Justice called "one of the largest health care fraud settlements in U.S. history," Johnson & Johnson and its subsidiaries were fined more than $2.2 billion to resolve criminal and civil charges because of their aggressive marketing of drugs, including antipsychotics, to nursing homes, when they knew the drugs had not been approved by the U.S. Food and Drug Administration (FDA) as safe and effective for a general elderly population. The corporation also allegedly paid kickbacks to physicians, as well as to Omnicare, the nation's largest long-term-care pharmacy provider. Omnicare pharmacists were recommending Johnson & Johnson's drugs, including the antipsychotic Risperdal, for use by nursing home residents.
Back in 2009, Eli Lilly did the same thing with its antipsychotic Zyprexa, marketing to older people in nursing homes and assisted living facilities, federal prosecutors charged.
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A report released in March by the inspector general of Health and Human Services charged that one-third of Medicare patients in nursing homes suffered harm, much of which was preventable.
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There should be one CNA for every seven patients, but in some cases, the ratio is 1 to 15 — or even more, Harrington says. There also tend to be too few physicians actually present in nursing homes. "These facilities are highly medicalized, but doctors are rarely there," says Tony Chicotel, staff attorney for California Advocates for Nursing Home Reform. He says that because of their low rate of reimbursement from Medicare, nursing homes are too often seen as a place where few top doctors practice.
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