Under the federal Nursing Home Reform Act of 1987, residents of skilled nursing facilities have a right to be free from chemical restraints. A chemical restraint is defined as “a drug or medication that is used as a restraint to control behavior or restrict the resident’s freedom of movement that is not a standard treatment for the resident’s medical or psychiatric condition.”
However, although the prevalence has decreased significantly in recent years, chemical restraints are still being used in nursing homes.
A chemical restraint is any drug used for discipline or convenience that is not medically required for the patient. “Discipline” can be defined as any action taken by a nursing home facility or its staff to penalize or punish residents. “Convenience” refers to actions taken to reduce the burdens of the facility and its staff, rather than to promote the best interests or well-being of residents.
How Do Psychotropic Drugs Affect Elderly People?
Seniors with mental disabilities are sometimes given psychotropic drugs as chemical restraints in nursing homes. Aging affects the way the body processes drugs, as well as the effects of the drug itself on an older person’s body. Research has shown that nursing home residents given psychotropic drugs on a regular, long-term basis suffer harmful side effects, which may include:
- Agitation
- Memory impairment
- Withdrawal
- Functional decline
- Movement disorders
- Gait disturbance
- Increased fall risk
In addition, an overuse of drugs as chemical restraints will erode the nursing home residents’ autonomy. Residents who are over-drugged with antipsychotics are less able to think and speak clearly and may lose interest in self-care.
Antipsychotic Drugs Are Not FDA-Approved for Treating Dementia
Psychoactive drugs are given to nursing home residents to control restlessness, pacing, and uncooperative behavior. They are used as restraints in elderly patients with dementia who become combative, endangering themselves and others.
However, these drugs are not approved by the FDA for this use. In fact, according to an article in the British Journal of Medical Practitioners (BJMP), an increased risk of mortality in the elderly prompted the FDA to order a “black box” label on atypical antipsychotic drugs, stating that they are not approved for treating behavioral manifestations of dementia. The use of chemical restraints is associated with:
- Increased confusion
- Falls
- Pressure sores (decubitus ulcers)
- Increased assisted daily living (ADL) dependence
- Increased walking dependence
- Reduced cognitive function
Studies indicate that conventional antipsychotics used as chemical restraints on nursing home patients are as likely to cause death as physical restraints, if not more so. One reason for the increased risk of mortality is the risk of falls with the use of these drugs. As reported by the National Council on Aging (NCOA), falls are the leading cause of fatal and non-fatal injuries among older adults in the U.S.
Polypharmacy Among the Elderly
Too often, drugs are administered in nursing homes without adequate monitoring for harmful side effects. Many elderly residents take multiple prescription drugs, a practice known as polypharmacy, which increases the likelihood of drug interactions, toxicity, and side effects exponentially. Antipsychotic drugs used as chemical restraints – to punish an uncooperative resident or for the convenience of the staff – only increase the risk of harmful effects from too many medications.
What Can You Do If You Suspect Chemical Restraint Use?
Thanks to a push by the Centers for Medicare and Medicaid Services, the use of chemical restraints in nursing homes has decreased significantly in recent years. However, it is still occurring in some facilities. If you suspect your elderly loved one is being chemically restrained, your best course of action is to speak with an experienced New Mexico nursing home abuse lawyer.
Contact us at (903) 230-5600 for sound guidance and dedicated advocacy in nursing home abuse matters.
