Wednesday, January 18, 2023

Increased Oversight of Antipsychotics: A Good First Step, Not a Substitute for Enforcement

 

wednesday, january 18, 2023



What I have with this entry is a copy of the letter sent out by an 

advocacy organization, Long Term Community Coalition.  It 

addresses the all-too-common use of  anti-psychotic

medications to "control behaviors" of residents living with 

dementia.  

Anti-psychotic (AP) drugs are designed to aid persons with 

psychosis. Dementia is not a psychosis. These AP drugs are used

as chemical restraints when prescribed for persons living with 

dementia.  Beyond the sedating impact of these drugs (They're 

sleeping, so they are not a problem – or so the thinking goes) there 

are other harmful side effects.

Why am I sharing this on this blog?  For anyone who loves someone living in a nursing home, if you have any responsibility -- moral or 

legal – this information is important.

For those Congregations of Sisters who depend on licensed 

nursing home care, whether that care is provided by the 

Congregation's own nursing home, or in another public licensed 

retirement center, this information is vital information. Quality of

life is of the essence in this issue as well as quality of care

considering serious negative side effects and the inappropriate use 

of these chemical restraints.


In desiring and in expecting the highest quality of life and the 

highest quality of care for our Sisters, as mandated by Federal 

and State Nursing Home Regulations, those Sisters who have the appointed responsibility for their Sisters receiving long-term care 

must know what those standards are in order to be effective advocates.

And here is the letter with links as provided in the original letter.

 

Good morning,

 

Today, CMS announced it is taking additional steps to strengthen 

nursing home safety and transparency by increasing oversight of inappropriate antipsychotics use. These steps include:

  • Targeted auditing of nursing homes to determine accuracy of 
  • schizophrenia diagnoses, and
  • Posting citations under dispute on Care Compare.

The inappropriate use of antipsychotic (AP) drugs and other 

psychotropic drugs to chemically restrain nursing home residents is a persistent and widespread problem. In particular, AP drugs are too often used on residents with dementia because a facility is unwilling to hire sufficient staff, with the appropriate competencies, to employ non-pharmacological approaches to dementia care (as professional standards of care require).

 

We and other advocates have been calling on CMS to improve 

oversight and accountability for many years. This has resulted in some improvement, but not nearly enough. As found in our recent report, "A Decade of Drugging," ( A Decade of Drugging - NursingHome411 approximately 20% of nursing home residents are currently receiving these dangerous drugs. That report cites an October 2022 federal report which found that a shocking 80% of nursing home residents are receiving some form of psychotropic drug.

 

In what other setting would we allow so many living things to be drugged into submission? If it was discovered in an animal shelter, it would be all over the news and heads would roll. But when it comes to nursing homes, we not only accept the unthinkable, we bankroll it: super-rich investors and operators are making millions, thanks to a steady stream of public dollars and minimal oversight. Meanwhile, residents suffer 

avoidable pain and degradation.

 

CMS's announcement  ( Biden-Harris Administration Takes Additional Steps to Strengthen Nursing Home Safety and Transparency | CMS )  is a good first step. 



By cracking down on false diagnoses of schizophrenia, it has the potential to help address one of the ways in which nursing homes hide the inappropriate use of antipsychotic drugs. However, it is not a substitute for vigorous monitoring and enforcement of longstanding minimum standards of care.

 

 

 

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