Inspector General and Others Condemn Antipsychotic Drugs in Nursing Homes

The Federal Office of the Inspector General (OIG) released a report in May exposing the widespread misuse of antipsychotic drugs in nursing homes.  The OIG l found that “nearly one in seven elderly nursing home residents, nearly all of them with dementia, are given powerful atypical antipsychotic drugs even though the medicines increase the risk of death and are not approved for such treatments...”  Even worse, the auditors found that 83 percent of antipsychotic prescriptions for elderly nursing home residents were for uses not approved by federal drug regulators, and 88 percent were to treat patients with dementia - for whom the drugs can be lethal.”

Senator Grassley, who requested the report to evaluate the quality and cost of these drugs in nursing homes focused on the financial impact when he said the report reveals an "astounding waste of taxpayer dollars."

In California, 19% of the deficiencies issued for violations of regulations which harm residents in 2007 were for "Unnecessary  Drugs". To put this in perspective, as of 2008 it is estimated that about 1.5 million Americans lived in nursing homes, and about 22% of the 5.3 million people who are 85 or older had a nursing home stay in 2006. There are an estimated 16,000 nursing homes in the United States.

Too often, the families are not told of the risks, benefits and alternatives to these dangerous drugs.  They may be embarassed that their loved one is exhibiting strange behavior, and just assume that the doctor would not recommend a drug merely for the convenience of the nursing home staff.  Unfortunately, this happens every single day.

As a firm dedicated to improving the lives of California's elderly through advocacy, it is distressing to say how frequently we come across instances of antipsychotic drugs being used on dementia patients. Often times it is a result of an under-staffed skilled nursing facility attempting to subdue or sedate a difficult patient rather than using scarce personnel to provide the necessary supervision and care. Typically, a facility employee will chart their their need to, “calm down”, “relax” or “stabilize” a “stressed out”, “depressed”, “anxious” or “combative” dementia patient - as a justification for use of a psychotropic medication.

And the Doctor?  Well he/she is a willing partner in this conspiracy if he/she allows the use of these drugs just to "treat behavior."  RED FLAG:  Generally, doctors don't "treat" behavior unless the patient has Obsessive Compulsive Disorder, Schizophrenia, or another psychiatric condition where behavior is used to diagnose the condition.

The California Advocates for Nursing Home Reform (CANHR) is one of many stakeholders trying to bring this important issue into the public discussion through education and advocacy.  Their fantastic report and information about their Campaign to Stop Chemical Restraints can be found here.

If you have any questions, please contact our office for a free consultation.

The real victims of "tort reform"

If I had to do one thing to protect seniors and disabled adults living in long term care in California, I would wind back the clock and stop "tort reform" from passing in California.  As you may know, since 1975 cases against "Health Care Providers" in California have been severely limited by MICRA. (The Medical Injury Compensation Reform Act.)  This law unfairly capped the recovery of victims, changed the rules of evidence to favor defendants, limited the amount of fees victims lawyers can charge but placed no similar limits on defense lawyers, and gives the defense the option to pay their verdict over decades assuming you survive.  While the $250,000 limit on non-economic damages may have seemed like a lot of money in 1975, it works out to about $83,000 in today's dollars.  The legislature was supposed to periodically increase the cap, but they never have.  Because victims of Elder Abuse and Neglect are not working, they generally have no economic damages.  This means, essentially, every patient in every nursing home has a price on their head of $250,000 at most.  

Today I read a great piece in the Atlantic Monthly that discusses the horrible result caused by the fact that "tort reform" placed a cap on the victims of the Metrolink train crash that devastated so many families, most of them with some connection to Ventura County.  The foreign corporation at fault for this accident has plenty of insurance to cover this claim, but under our "tort reform" they don't need to use it.  

Well worth a read, http://www.theatlantic.com/national/archive/2011/07/the-real-victims-of-tort-reform/242030/

One last thought:  Take David's slingshot and give it to Goliath.  Now you understand "tort reform".

Mr. Johnson Receives William F. Taylor Award.

Recently, I was honored to be awarded the William F. Taylor Memorial Award presented by the California Advocates for Nursing Home Reform (CANHR). I received this award for my work in creating the Elder Justice Advocate ™ program, where attorneys and their clients pledge a portion of every single case to prevent further abuse and neglect of California seniors in long term care. While I strongly believe that Elder Abuse and Neglect litigation makes a profound difference by improving the care in the community where the cases are brought, through this program we are making sure all seniors in California stand to benefit from these important cases.

CANHR is a nonprofit group dedicated to improving care, quality and choices for California’s elders. CANHR works closely with attorneys and Ombudsman programs throughout California to advocate and inform. They publish www.nursinghomeguide.org, www.residentialcareguide.org, and offer a wide range or counseling services to consumers, family counsels and attorneys with questions about long term care. CANHR also advocates for better staffing in our nursing homes and against the abuse of anti-psychotics.

A Memorial to Mr. Taylor can be found at http://www.canhr.org/memorials/In_Memory.htm

I am proud to call myself a supporter or CANHR, a CANHR Elder Justice Advocate ™ attorney and a partner with them to improve care for the elderly in California.