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Are senior citizens being overmedicated?
June 3rd, 2011
09:42 AM ET

Are senior citizens being overmedicated?

Strong, antipsychotic drugs are being prescribed more often to senior citizens in U.S. nursing homes, setting off a debate about whether it's the right treatment for the elderly suffering from dementia.

Daniel Levinson, inspector general for the Department of Health and Human Services, believes this increase - detailed in a recent study by his office - is a cause for alarm.  "The report found that too often, elderly residents are prescribed antipsychotic drugs in ways that violate government standards for unnecessary drug use," he wrote in a commentary for CNN.com.

Psychiatrist Daniel Carlat disagrees, saying the study Levinson cites is a "blizzard of statistics" that doesn't tell the entire story.  "When these drugs are successful, they soothe the inner turmoil that makes life intolerable for these patients, improving their quality of life dramatically," Carlat wrote in his commentary for CNN.com.

The conflicting guidance is making it even more difficult for those trying to make sure their aging loved ones are getting the best care during the final years of their lives.  Laura Steckler, a Florida resident, recently sought treatment for her elderly mother after she suffered an episode of paranoia and hallucinations.  She tells CNN how she found herself in the middle of the debate over how much is too much medication for the elderly:   

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Filed under: Medications • Mental Health

soundoff (393 Responses)
  1. Woody

    Could our ills be coming from the very food we eat ? How many drugs were usen on your chicken, beef , and pork you just ate ?

    June 4, 2011 at 15:56 | Report abuse | Reply
  2. Edsr

    HELP me.....please......fell off my chair and can't reach my beer...........trying to overmedicate myself..........

    June 4, 2011 at 16:11 | Report abuse | Reply
    • Tthree Rivers

      do you really think this Topic is something to joke about???
      You too will grow old some day...aging is not fun.

      June 4, 2011 at 18:37 | Report abuse |
  3. Olaf Big

    Sounds like even this doctor admits that seniors are overmedcated. He says "the report cites a blizzard of statistics", which he does not dispute. Then he says "when the drugs are successful, they improve quality of life..". So, how often are they successful and what is the definition of success? Converting an agitated Grandpa into a listless vegetable? Might as well just lobotomize him...

    June 4, 2011 at 16:15 | Report abuse | Reply
  4. palintwit

    FACT: Bashing Sarah Palin is almost as popular an American pastime as baseball.

    June 4, 2011 at 16:18 | Report abuse | Reply
  5. Rick

    My main comment for everyone bashing nursing homes and the staff there would be to actually go a work in one
    for a month and then see what we as nursing home staff are up against.

    I mean, if your that un-trusting of the staff at nursing homes don't put your parents there, take them home and provide
    the quality care you seem to know so much about.

    Speaking as a CNA, we are under staffed, under paid, we are riddled with broken backs and bad knees, we are treated
    like dirt, we get spit at, hit, grabbed, elbowed, kicked, punched, we get yelled at, swore at..... and still, most of us care
    about these residents like they were family, it is we who comfort your mother when she is crying in the night, it is we who
    pick your father up when he falls down, it is we who sit all night with your grandmother when she is distressed.

    We do it.

    Walk a mile in my ripped nursing shoes and then we can talk, until then I will be provided comfort to the people who
    took care of you when you were little.

    -Rick-

    June 4, 2011 at 16:19 | Report abuse | Reply
    • linnybear68

      well said Rick!

      June 4, 2011 at 16:21 | Report abuse |
    • Judy

      I agree that the job of direct care staff should be elevated to something way above management and paid at a much higher rate.. You guys are directly responsible for the quality of care, thus the quality of life of our loved ones. I sickens me to see how many of you are devalued.

      As a founder of a facility specializing in APPROPRIATE care for persons with dementia and dementia related behavior. I do know that most facilities are horrendously understaffed and have little training for the staff they do have in validation of each person as an individual and meeting emotional needs in addition to physical needs. Unmet emotional needs are the number 1 cause of challenging behavior as their behavior is an attempt to communicate an emotional need.

      This can NEVER be done with the staffing levels that most all places try to operate with to increase profit margins. We have a 1-3 staff ratio, monthly training and support meetings, and a RN for every 15 residents as additional support for staff. I have witnessed what can be done to really improve quality of care, reduction in stress for the staff (less burnout) and the positive outcomes that you can achieve when appropriate staffing, training and staff support are put in place.

      I feel for those of you who do your best but are not given the support from management to care for people appropriately. That is why you have all the behavior you describle having to be subjected to.
      Kudos to you for sticking it out but we ALL REALLY need to change this broken system!!

      June 4, 2011 at 16:47 | Report abuse |
    • Tthree Rivers

      Bless you Rick♥...I've walked in your shoes (sorta) I worked 20 years in a Nursing Home in Ohio, I had a beauty/barber salon and provided hair care for the patients, I loved every difficult day I was there...I had my own mom there, so I worked 6 days and long hours, I know first hand the tough job CNA and RN have and appreciated each and every one...well there were a few I wouldn't pat on the back but for the most part they are caring people who have difficult jobs...after my mom died I decided it was time for me to retire, that was 12 years ago and I still MISS those folks...Blessing to all who work in Nursing homes...hugs...three rivers in Pennsylvania♥

      June 4, 2011 at 18:46 | Report abuse |
    • justathought

      II've been a nurse in an Alzheimer's unit for over a decade. This person is right. While not all CNAs are the best, they are under-paid and under staffed for the work performed. Until the companies that own these facilities (and state regulators) realize the need for change, the status quo will be maintained and trust me, it isn't good. Assisted living facilities SHOULD NOT be providing care for Alzheimer's/dementia patients. They are NOT TRAINED to handle this population. Somehow this field discovered a cash cow and has been making big bucks ever since. As far as anti-psychotic drugs, some work and the resident has a better quality of life. I have never seen anyone in a vegetative state (called chemical restraints and not allowed via state regulations in assisted living). If these residents aren't subdued they can cause harm to themselves, staff and other residents. Residents have been killed in facilities like this due to combative residents. If you visit your loved one and witness someone out of control, get your loved one out of that facility...fast.

      June 4, 2011 at 18:56 | Report abuse |
    • pam

      Yes Rick. I know where you are coming from. Is it not us that hold a person's hand when they are dying? Is it not us that do all the work when the resident nurse sits in her office reading her e-mail and won't come and look at a resident that you are concerned about? I worked in an assisted living for 3 years, got excellent reviews and was fired for spreading rumors, which I never did. I didn't fit in because I didn't party with the group and drink. Oh well, life goes on!

      June 6, 2011 at 10:28 | Report abuse |
    • Rob Rowen

      I agree you are underpaid and lack sufficient staffing. That is why it is imparitive that you, your co-workers, and all the friends you can reach, vote to re-elect Obama as President. The entire healthcare system is in need of change, and under Obama that has begun. Obama will work to further improve our failing healthcare system, including better pay and regulations for staffing levels. Republicans will go back to the same old profit driven system, and things will stay the same or even get worse. The choice is simple, snd it is yours.

      September 9, 2012 at 19:54 | Report abuse |
  6. Tired

    Seniors are absolutely over-medicated by a system that profits on people who fear dying. Yes, some medications help and some people need medications, but the medical profession is as much an art as it is a science and physicians often prescribe drugs simply as a last resort or because of their own uncertainties.

    June 4, 2011 at 16:41 | Report abuse | Reply
    • Judy

      I agree that psychotropic medications are significantly overused in many long term care environments. The behavior they are trying to medicate away is only the persons attempt at communication of an unmet need, often emotional. Yes there are theraputic reasons for some of this medication, but the issue I believe is not about using the medications but the overuse mostly prescribed for staff convenience. Most all of our long term care is grossly understaffed and undertrained in how to meet the emotional and spiritual needs of our elderly population in addition to their physical needs. It takes appropriate staffing, communication training in how to discover and meet each persons needs to solve this problem, not more medication.

      June 4, 2011 at 16:56 | Report abuse |
  7. Woody

    If you get a blood test I bet you find traces of drugs in your system even if you do not take any !

    June 4, 2011 at 16:46 | Report abuse | Reply
  8. Adam

    Everyone in America is overmedicated. Doctors don't believe in actually helping people anymore. They are just fronts for the pharmaceutical industry.

    June 4, 2011 at 17:14 | Report abuse | Reply
  9. SurRy

    Americans represent five percent of the world's population, but consume fifty percent of prescription drugs! Are Americans THAT disease-ridden?

    June 4, 2011 at 17:24 | Report abuse | Reply
  10. Biff

    It's important we keep senior citizens well medicated to prevent them from taking over the world.

    June 4, 2011 at 17:43 | Report abuse | Reply
  11. gonzoaster11

    Better question: Is everyone overmedicated?

    June 4, 2011 at 18:39 | Report abuse | Reply
  12. Curlgurl6

    Unfortunately it is very true that we over medicate our seniors. However, If you could see the conditions that these seniors in nursing homes live in, then I too would want to be medicated. Nursing homes do the best they possible can on the limited funding they get. They do not operate like hospitals and have a very marginal budget for their patients....that's another story. If over medicating these patients keep them comfortable in their end of life care, then by all means do it. They deserve to have the best quality of life and if extra happy pills do it, then do it!

    June 4, 2011 at 18:54 | Report abuse | Reply
    • justathought

      A lot of residents in nursing homes are self pay and the costs are astronomical. And, if you think things are bad now, wait another 3-5 years.

      June 4, 2011 at 19:01 | Report abuse |
  13. JOHN

    Not all Americans are drugged. I have been on the planet for over 80 years and do NOT do drugs of any kind. I am a vegetarian. I shop at health food-type stores and have a number of alternative health care providers. I am grateful for my good health. The secret to living healthy and living long is to think right, feed your body with alive, healthy foods, love and be loved.

    June 4, 2011 at 19:06 | Report abuse | Reply
    • donna

      And good luck with your genetics and environment!

      June 4, 2011 at 19:13 | Report abuse |
  14. caregiver

    How about elderly patients who suffer because they are not medicated by their doctors for fear of the FDA going after them.That is the other side of the story and it is a reality. We are dealing with serious disease's within the elderly community and the answers to cures are not that easy to come by. We scream too little too much – medicine is a science there is no pat answer for everything. One more issue the cost of drugs is enormous some seniors do without their medication and that is awful to live in discomfort and pain.

    June 4, 2011 at 19:21 | Report abuse | Reply
  15. Vicki Wolf

    As a health care provider to the masses, I can tell you it is not the antipsychotics that are being over prescribed as it is the fistsfull other drugs that elderly are asked to swallow two, three ,and four times a day that are the problem. This happens not only in nursing homes, but veterans administration facilities, and home settings, because no one thinks to stop the meds that people "have been taking for years"just because "they have been taking them for years". its not till patients start to refuse to take the pills, or they are dying that a light bulb goes on and someone says, gee maybe she/he is nauseated because of all the pills they are taking....or boy their blood pressure is really low, maybe they dont need 3 antihypertensive pills anymore...or this giant calcium pill at the age of 80 or 90. Sometimes the ONLY thing they do need is an antianxiety agent to help them relax a bit, or sleep better, and they deserve to get it. Try living in a nursing home and not have something to ease the tension that causes! We are all to blame for this oversight, one by one we in the health care profession can correct this oversight. Thanks.

    June 4, 2011 at 19:29 | Report abuse | Reply
    • Sara

      thank you, everything you said is so true.

      June 4, 2011 at 19:39 | Report abuse |
  16. Kaelinda

    I envy people who love vegetables, love exercise, and have lots of hobbies to keep them busy and happy. I intensely dislike most veggies, avoid exercise as if it were the plague, and don't have any hobbies at all. I reached all of my life's goals by the time I was 45, and since then, haven't been able to conjure up another one. I have the world's most wonderful man for my husband, I have 5 fantastic kids, got my baccalaureate (bachelor's) degree, owned my own home, owned my own business, and went to Israel. What more could a woman want? I'm 68 now and content with my life. I don't particularly want to live a long life, because I've seen too many elderly people who either have little brain function and healthy bodies or little physical function and healthy minds. I've met exactly one person in my life who was over 80 and still fully functional mentally and physically. And given the number of people I know who are over 80, that's NOT a comforting statistic.

    June 4, 2011 at 19:41 | Report abuse | Reply
  17. cmcrawford

    My father was placed in a nursing home a month ago. His dementia was progressing but at home he could still get up by himself in the morning, go to the bathroom by himself and eat unassisted. When my mom took him to the nursing home, he knew my mom was leaving him in an unfamiliar place, and he was angry that my mother was leaving him there. So they gave him two doses of Haldol right then and eventually added Atavan and sleeping pills (Ambien and Benadryl). Within two weeks he was suffering from stiffening and he could no longer swallow. His could not hold his head up and he stopped eating and drinking. He started getting kidney failure, pneumonia and losing weight precipitously. The staff said he was dying and offered to make him as comfortable as possible. They gave my mother the papers to sign to let him die and my sister hit the roof. She had to insist that he be hydrated. She had to get a doctor from outside to take him off the tranquilizers. They said they could do nothing to help him regain what he had before he entered the home, and he is now recovering in the hospital. When he came here he was in a fetal position and his arms and legs could not be moved. After a week of treatment he has started eating again and today spent most of the day awake and alert, not always coherent but not dying by a long shot. We don't know if he will be able to walk again.

    I realize there is a place for the use of antipsychotics when a person with dementia becomes delirious. But my dad still has some cognition, still recognizes me even though I only see him 2x a year, and was able to walk and eat. He knew who his wife was and he knew the difference between home and not home. He was given these drugs irresponsibly by incompetent nurses and interns. I have been observing him in the hospital, and he is angry when he is treated like a piece of meat. When procedures are explained to him, he complies. He complied with the feeding tube run through his nose when he was told he was going to have a tube put in his nose and he needed to be calm and still. I have seen him treated brusquely by one therapist and respectfully by another. His response to harsh treatment is fear and resistance, and his response to respectful instructions is genuine compliance. Of course all cases are different but he at this time he does not need either relief from psychosis or chemical straightjacket, yet he was drugged to the point of death.

    The fact of the matter is that no matter how appropriate it may be to administer antipsychotic medication to an elderly person with dementia, there are situations where it is abused. Sure the people who work in the top hospitals that rigorously follow best practice can say that it's an important means of treating serious problems and not harm their patients. But in substandard environments it is abused. This was a government facility that he was in. It was worse than barbaric.

    June 5, 2011 at 00:17 | Report abuse | Reply
  18. SAM

    Yes and they are told a LITTLE ACLOHOL is good for them,YEA SURE IT IS..........ALCOHOL IS A POISON,ANd when mixed with Meds it could be a NUKE inside the HUMAN BODY MORE than just by itself.......

    June 5, 2011 at 09:51 | Report abuse | Reply
  19. SAM

    Its called IRADICATION,NOT MEDICATION

    June 5, 2011 at 09:51 | Report abuse | Reply
  20. Sandra Boletchek of The Washington DC Metro Area

    Thank you to Daniel Levinson our Inspector General of the Department of Health and Human Services for making this report to CNN and to the CNN staff for printing his findings in this article STUDIES FIND SENIORS OVERMEDICATED. This blog is a credit to all concerned. Thank you...

    June 5, 2011 at 19:35 | Report abuse | Reply
  21. Mary

    My experience with medication is that it has its place for seniors with dementia but it can never replace the attention of a compassionate caregiver. Unfortunately, the typical nursing home is not staffed to provide its residents with the focused one-on-one support that an individual with dementia requires. Given enough time and proper training, caregivers can often understand why a person with dementia is exhibiting agitation and take proper measures to address this without medication. Unfortunately the medication route is a “quick fix” and often chosen over the human connection which can take more time.

    Sincerely,
    Mary
    http://www.Care.com

    June 6, 2011 at 09:31 | Report abuse | Reply
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    June 16, 2011 at 06:41 | Report abuse | Reply
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