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Anti-psychotic drugs to nursing home patients protested

Original source:
Colleen Quinn
July 17, 2013

Nancy Sylvester, a first-grade teacher from Taunton, watched friend Bob Hinton’s health quickly deteriorate after he moved into a nursing home, a decline she attributes to doctors prescribing anti-psychotic drugs.

At 89, Hinton was placed in a nursing home because of medical problems, and he required dialysis, she said. He had no cognitive difficulties.

He quickly became too lethargic to eat and was given a feeding tube, Sylvester said. He told her he had trouble thinking and forming sentences.

“My questions were constantly, ‘Why is this happening to him,’” Sylvester said. “Not once did (caregivers) mention they put him on anti-psychotic drugs.”

He was prescribed Ambien, trazodone, memantine and Seroquel. Seroquel is prescribed for the treatment of depression, bipolar disorder and schizophrenia, according to an advertisement from the manufacturer, AstraZeneca.

One day he was restrained because he was trying to pull out his breathing tube. Later, Sylvester discovered that he had a sore in his nose when he grabbed her finger and put it up his nostril as a way to get someone to take care of it, she said.

“Why couldn’t he tell them? Because he was overmedicated; he was drugged,” Sylvester said.

On Tuesday, Sylvester and others with similar experiences with family members urged members of the state Legislature’s Elder Affairs Committee to strengthen laws concerning the giving of anti-psychotic drugs to patients in nursing homes and long-term care facilities.

The drugs are over-prescribed, often without a family’s consent, as a way for nursing care personnel to quell unwanted patient behavior, several people advocating for changes testified. The drugs cause severe side effects in dementia patients, they said.

Psychiatrists and nursing home operators said singling out anti-psychotic drugs for increased regulation would tie their hands in caring for patients. Doctors and caregivers said some patients need the drugs, and they are addressing the overuse of the drugs by creating new care programs.

Dr. James Ellison, a geriatric psychiatrist at McLean Hospital in Belmont, said many of the people in nursing homes have mental illnesses that need treatment.

“Dementia is very important, but it is not the only story,” Ellison said.

With the population aging, a growing number of seniors in nursing homes will need care for depression, anxiety and other mental health issues, he said.

Alison Weingarten said she never gave her consent for her mother, who had never suffered hallucinations and was not schizophrenic, to be put on the powerful anti-psychotic drugs and was unaware of the detrimental side effects. In 2008, her mother suffered a seizure, which Weingarten assumed was caused by Alzheimer’s.

“I was unaware it was much more likely the seizure was caused by Seroquel,” she said.

State Rep. Shaunna O’Connell, R-Taunton, said too often seniors in care facilities around the state are overmedicated and “shoved in a corner” until they die.

O’Connell is advocating for legislation she filed that would establish standardized protocols for getting a patient’s family or other representative to give written permission for the giving of psychotropic drugs.