There have been changes in geriatric health care- and the changes have not been for the better.
In the distant past, the news occasionally covered stories about elderly persons who were physically abused, verbally abused, illegally restrained, and neglected in long-term care facilities. Perhaps it did not happen often, but it did happen. But while these abuses against the elderly may still be occurring, there is a newer form of abuse that is becoming widespread. Quoting a staff attorney for a nursing home reform advocacy group: “They're being sedated into zombiehood.”
This is not o.k. Second only to children, the elderly population is a vulnerable segment of the population. When placed in long-term care facilities, their rights and best interests can be easily taken away. In one particular state, the advocacy group claims over 25,000 residents of nursing homes receive anti-psychotic drugs. This figure matches another source that states more than 25% of nursing home residents in this country are on anti-psychotic medications.
As for psychiatric-drug pushers, here is where statistics do not reflect reality: the claim that more than half of the residents in long-term care facilities suffer from 'some form of dementia.' An acceptable definition: 'a chronic or persistent disorder of the mental processes caused by brain disease or injury...'
Another sample review study: 16% of residents did not have a prescription in their medical records to support the use of medications; anti-psychotics are most commonly used to manage 'problem behaviors.' And this practice continues, even though the FDA has provided a warning that these medications are not safe for elderly persons, and can increase the risk of death.
Let's go back to the definition. 'Dementia' is not a synonym for 'aging,' 'elderly,' or 'old.' Elderly persons can be in their seventies, eighties, nineties, and retain their mental faculties. Forgetfulness, behavioral changes, and similar issues do not mean an elderly person has a 'disorder.' Yet elderly persons are given anti-psychotic medications- and antidepressants- often without their consent and without the consent of their family members.
While each person is unique, some points are common in 'average' elderly men and women:
For approximately twenty-five years, my parents owned and operated a home for the elderly. We did not drug our residents. In all those years, there were only two residents who were psychiatric patients- a long-term resident who was schizophrenic, and a short-term resident with 'homicidal tendencies.' As for all the other residents who came through the door, spending a few years or many years, the administrators, aides, and patients' physicians did not use the word 'drug' as a verb.
What changed? How did this new form of elder abuse become so common? Direct-to-consumer advertising has played a role; health care providers receiving 'nice benefits' from pharmaceutical companies to push and prescribe unnecessary drugs has also played a role. But I believe we also need to look at the diminished sense of responsibility caregivers today have toward the elderly. In other words, it does not matter what type of credentials caregivers have, but what they are doing with their roles. Whether someone is an RN, a CNA, a Home Health Aide, or any other 'title,' caregivers to the elderly need to be responsible, stable, mature, and have a solid understanding of the elderly population and their experiences. And from the outrageous rate of psychiatric drugging, it appears too many lack these qualifications, and do not even recognize the elderly population as human beings who are entitled to personal dignity and respect.
In the distant past, the news occasionally covered stories about elderly persons who were physically abused, verbally abused, illegally restrained, and neglected in long-term care facilities. Perhaps it did not happen often, but it did happen. But while these abuses against the elderly may still be occurring, there is a newer form of abuse that is becoming widespread. Quoting a staff attorney for a nursing home reform advocacy group: “They're being sedated into zombiehood.”
This is not o.k. Second only to children, the elderly population is a vulnerable segment of the population. When placed in long-term care facilities, their rights and best interests can be easily taken away. In one particular state, the advocacy group claims over 25,000 residents of nursing homes receive anti-psychotic drugs. This figure matches another source that states more than 25% of nursing home residents in this country are on anti-psychotic medications.
As for psychiatric-drug pushers, here is where statistics do not reflect reality: the claim that more than half of the residents in long-term care facilities suffer from 'some form of dementia.' An acceptable definition: 'a chronic or persistent disorder of the mental processes caused by brain disease or injury...'
Another sample review study: 16% of residents did not have a prescription in their medical records to support the use of medications; anti-psychotics are most commonly used to manage 'problem behaviors.' And this practice continues, even though the FDA has provided a warning that these medications are not safe for elderly persons, and can increase the risk of death.
Let's go back to the definition. 'Dementia' is not a synonym for 'aging,' 'elderly,' or 'old.' Elderly persons can be in their seventies, eighties, nineties, and retain their mental faculties. Forgetfulness, behavioral changes, and similar issues do not mean an elderly person has a 'disorder.' Yet elderly persons are given anti-psychotic medications- and antidepressants- often without their consent and without the consent of their family members.
While each person is unique, some points are common in 'average' elderly men and women:
- Whether a person is seventy or ninety, the largest part of his life is behind him, and there is not nearly as much to look forward to in the future; In fact, regardless of how long a person resides in a facility, most do realize they are in the last stage of their lives;
- An elderly person has likely lost many of his long-time friends, and may even have lost one or more of his own children;
- Even in the absence of medical conditions, natural aging eventually brings limitations- a person who was fully self-sufficient throughout his life will eventually come to need assistance with activities of daily living (ADLs): a formerly self-sufficient individual may not be able to use the bathroom, bathe, or dress without help;
- And while independence is reduced from natural aging, the freedoms the elderly enjoyed throughout life do not exist when one is placed in a 'facility': the person can no longer make basic decisions such as when and what to eat, and when to go to bed at night.
- Life in a facility also means the person must give up most of his personal possessions, or leave them behind in the care of a family member. A facility is not likely to have room to accommodate his mementos, cherished valuables, or his pets.
For approximately twenty-five years, my parents owned and operated a home for the elderly. We did not drug our residents. In all those years, there were only two residents who were psychiatric patients- a long-term resident who was schizophrenic, and a short-term resident with 'homicidal tendencies.' As for all the other residents who came through the door, spending a few years or many years, the administrators, aides, and patients' physicians did not use the word 'drug' as a verb.
What changed? How did this new form of elder abuse become so common? Direct-to-consumer advertising has played a role; health care providers receiving 'nice benefits' from pharmaceutical companies to push and prescribe unnecessary drugs has also played a role. But I believe we also need to look at the diminished sense of responsibility caregivers today have toward the elderly. In other words, it does not matter what type of credentials caregivers have, but what they are doing with their roles. Whether someone is an RN, a CNA, a Home Health Aide, or any other 'title,' caregivers to the elderly need to be responsible, stable, mature, and have a solid understanding of the elderly population and their experiences. And from the outrageous rate of psychiatric drugging, it appears too many lack these qualifications, and do not even recognize the elderly population as human beings who are entitled to personal dignity and respect.