Prescribing a drug to a person who does not need that drug is unconscionable – I mean that word in the old-fashioned sense of an act being done by a person with no conscience.
When I was a child, Jiminy Cricket was a regular visitor in cartoons on Saturday mornings. He’d perch on a character’s shoulder and whisper, “you know you should not do this.” Woe to those who ignored Jiminy Cricket’s warnings, as there were always bad consequences.
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A Sorry State of Our Union
This week, in his State of the Union address, President Biden told America that “We’re protecting seniors’ lives and life savings by cracking down on nursing homes that commit fraud, endanger patient safety, or prescribe drugs they don’t need.”
President Biden isn’t referring only to the substandard and deadly care that too many seniors received during the COVID-19 lockdown, but more specifically to the overprescribing of medicines to vulnerable seniors each and every day.
Diagnosis Statistics Show the Truth
Here are the chilling facts, each one demonstrating how overused antipsychotics are in seniors at care facilities:
“…80% of Medicare’s long-stay nursing home residents were prescribed a psychotropic drug.” Health and Human Services, November 2022
“Today, one in nine residents [in nursing homes] has received a schizophrenia diagnosis. In the general population, the disorder, which has strong genetic roots, afflicts roughly one in 150 people.” New York Times, September 2021
“…While CMS [The Center for Medicare and MedicAID] focused its efforts [in long-stay nursing homes] to reduce the use of one category of psychotropic drug—antipsychotics—the use of another category of psychotropic drug—anticonvulsants—increased.” Health and Human Services, November 2022
Why They Overprescribe
It seems inescapable to conclude that nursing homes are overmedicating our seniors, our own family members! There could be many reasons for staff to decide to over prescribe a patient. The drugs keep the resident docile and calm. The drugs make life easier for the aides. The staff doesn’t have enough people to properly care for all the residents. None of these are acceptable excuses.
Overprescription Leads to Unnecessary Side Effects
Prescribing a drug that isn’t indicated by the symptoms or a diagnosis opens the patient to the risk of side effects without any promise of a benefit. And, it turns the resident into a patient! Antipsychotic and anticonvulsant drugs both cause drowsiness and fatigue, stealing away the person’s ability to enjoy the time left in his or her life.
Other common side effects of antipsychotics are dry mouth, weight gain, and movement disorders. They also carry warnings of rare side effects like suicide ideation (thinking about suicide), impulsive behavior, or excessive gambling. Anticonvulsants are known to cause sleepiness, inability to concentrate, and memory challenges.
How To Find Quality Care for Seniors
If you or a loved one is in, or selecting, a long-term nursing home, please check this government site: https://www.medicare.gov/care-compare/. It helps find residential and other types of care. But most importantly, it gives ratings to long-term nursing homes. It gives ratings on health inspections, staffing, and quality.
The Center for Medicare and MedicAID (CMS) is now conducting off-site checks of prescribing patterns in nursing homes. If CMS finds that nursing homes are putting a code on a health form stating a resident has schizophrenia without a doctor diagnosis, it will affect the overall rating on the website listed above.
Prescribers Should Face Consequences
Getting the information to the public that a nursing home is making fake diagnoses is a good start, but fines won’t be given out for several years yet. WHY? There is no question of wrong-doing, they are harming the very people they are paid to care for each day. We need stronger consequences for knowingly doing harm, and we need them immediately.
Overprescribing Happens at All Ages
Please learn more about the dangers of being prescribed any drug that you don’t need, no matter your age. Always question why a doctor is prescribing a medicine. Ask your doctor at every visit if you still need to keep taking any medicine you are prescribed. And, remember to tell your doctor about supplements, vitamins, and herbs you routinely use, too.
