Antipsychotic drugs are prescribed too frequently in Connecticut nursing homes to keep patients who have dementia or mental illness under control.
Lisa Chedekel of the nonprofit Connecticut Health Investigative Team has reported that some nursing homes in this state significantly exceed the national rate of administering such drugs to long-stay residents. At some facilities, the rate is more than double the already high state average. At one nursing home, 68 percent of long-stay residents were getting antipsychotics.
Antipsychotic drugs are supposed to be given only to patients diagnosed as having a psychosis or related condition. But in many nursing homes, they are prescribed for those who are difficult to manage, regardless of whether there's a diagnosis of a mental illness.
That's not good for patients, and ought to be curbed. The U.S. Health and Human Services Department has urged taking action against inappropriate prescription. The state Department of Public Health is trying to develop ways to reduce the use of antipsychotic medications.
Critics say that nursing homes are tempted to overmedicate because agitated patients are easier to deal with when sedated. But there can be serious, perhaps fatal, side effects to giving these drugs to elderly people with dementia.
Many residents of long-term-care facilities are neither elderly nor frail, but mentally ill. In 1995, the state closed two of its three mental institutions — Fairfield Hills and Norwich State Hospital — and some residents ended up in nursing homes. They may need to be treated with antipsychotic drugs. Still, that doesn't excuse prescribing medication without a proper diagnosis, as some nursing homes do. That must stop.
Increasing staff and training has been suggested as a way to lower the need to use medication — but those are expensive, and for facilities that rely on Medicaid reimbursement, the funding may not be adequate. This problem, as so many in health care, is linked to money.
Long-term solutions to overmedication should involve alternative ways to care for those with mental illness, perhaps in supervised group homes.