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Gov't finds nursing homes misuse antipsychotics

Original source:

CBS Evening News
By Armen Keteyian
May 9, 2011

Daughter blames father's death, in part, on antipsychotic drugs under FDA's most severe warning for dementia patients

NEW YORK - Anyone who's ever been through it will tell you that putting a loved one in a nursing home is one of the toughest decisions you'll ever have to make. You hope and pray your relative will be well-cared for.

But a troubling new report from the government finds that, all too often, nursing homes are giving antipsychotic drugs to patients who should not be getting them.

CBS News chief investigative correspondent Armen Keteyian reports Debra Burchard moved her ailing father William Killingsworth into a Northern California nursing home in September 2005. Within days - she says- he had completely changed.

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"Eyes glassed over with sweating, cracked mouth," Burchard said. "How did that happen in three days?"

Less than four weeks after entering the nursing home, Killingsworth was dead. Burchard blames, in part, an antipsychotic drug the nursing home inappropriately gave her father who suffered from dementia.

"He was laying in his bed, unresponsive," Burchard said. "I just looked at him and thought what's going on?"

Antipsychotic drugs like Seroquel, Risperdal and Zyprexa were never approved for elderly patients with dementia.

In fact, in 2005 the FDA gave them its most severe warning - noting an increased risk of sudden death in patients with dementia.

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Now, a new government study has found that 88 percent of the time Medicare paid for antipsychotic drugs in nursing homes - they went to patients with dementia.

The report by the Health and Human Services inspector general also found that antipsychotic drugs were given to nursing home residents "unnecessarily" over 300,000 times between January and June 2007, with more than half of those drugs (150,106) given "in excessive dose."

"The use of anti-psychotic drugs when they are not necessary is a form of restraint," said Dr. David Zimmerman, University of Wisconsin. "It's a form of chemical restraint."

The Department of Health and Human Services also says it's "very concerned" that there are "financial incentives for unnecessary drug use." In the past those incentives have led to charges of "kickbacks" between nursing homes, pharmacies and a drug company.

Dr. Kenneth Brubaker represents nursing home medical directors and agrees antipsychotics are being used too often. He says the problem is staff turnover and training.

"Oftentimes lack of training, lack of adequate workforce, whatever else it might be - we tend to shortcut it by going to drugs," Brubaker said.

"I wish I would have said, 'what are you giving him? How much are you giving him?'" Burchard said.

Instead Burchard sued and settled. She's using some of the money to create a nursing scholarship in memory of her father.