The Never-Ending Misuse of Antipsychotics in Nursing Homes


From Health Affairs: Although the problem of antipsychotic misuse in nursing homes has been raised to policymakers numerous times over the past six decades, the issue still remains unaddressed.

“With decades of documented abuse and more than one million Americans older than age 65 currently residing in 15,000 nursing homes, two-thirds of whom are women, and with a rapidly aging population that is projected to triple the number of adults with dementia, it is not surprising that the Human Rights Watch (HRW) has now weighed in on the problem. In 2016 and 2017, the HRW, whose mission is to uphold human dignity and advance the cause of human rights, visited 109 nursing homes in six states with the highest number of nursing home residents and the highest proportion of residents on antipsychotic medications, that is, California, Florida, Illinois, Kansas, New York, and Texas. The organization also interviewed more than 320 nursing home residents, facility staff and administrators, and various experts in the field and made a detailed analysis of CMS’s regulatory enforcement efforts. Its overarching conclusion is made evident in its February report’s title, ‘They Want Docile: How Nursing Homes in the United States Overmedicate People with Dementia.’

‘Nursing facilities in the US,’ the HRW report found, ‘use antipsychotic medications on a massive scale.’ The HRW estimated on an average week nursing homes administer antipsychotic drugs to more than 179,000 residents who do not have a diagnosis for which antipsychotic medications are approved. The report cites CMS’s own data that estimates 16 percent of long-stay nursing home residents, or those residing in a nursing home for more than 100 days, received an antipsychotic medication without one of three exclusionary diagnoses: schizophrenia, Huntington’s disease, or Tourette’s syndrome.”

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  1. as much as I appreciate some groups and professionals doing what they can to shed light on this serious problem, I doubt things will get better, not in the US, at least. With social and economic conditions the way they are, I think life for the 99% in America (well…definitely 80-90%, anyway…) is on course to get worse, not better. That goes 2x, 3x for those in any sort of institution, from juvenile facilities to nursing homes. I’ve even heard horror stories about hospice care.

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  2. If they have been doing it for 60 years despite repeated “education,” it should be clear that “education” isn’t going to do the job. They will stop when it’s made illegal and that the doctors are fined and/or jailed and lose their medical licenses when they do it. Nothing else will work, as the facilities really don’t care about this issue – they are meeting their own needs, and their clients in many cases are an afterthought.

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    • Steve

      You are correct to say that until this form of deadly abuse is made illegal, and those who perpetuate such crimes are duly punished, this will NEVER stop.

      A key question to be asked: can those type of legal interventions occur under a profit based capitalist system?

      I would argue a definite, NO, to that question.


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  3. Drugging residents of nursing home/retirement centers is a normal procedure, especially if the resident in question is outspoken or feels that the care that they’re receiving is not what it should be. The job of the resident is to be quiet and not cause any problems and problems are defined as anything that staff doesn’t like or approve of. If you don’t cooperate with what the staff demands of you, you will find yourself reported to the medical director with a recommendation from the nursing director that you should be prescribed Haldol for your “problems”. Medical directors of nursing homes usually sign off on these kinds of things without much thought, at least that’s the way it worked at the retirement center/nursing home complex that I worked at and it is considered to be one of the best in the entire city. So, if this is what is happening in the best of places what’s going on in the really bad places where older people are held, usually against their will? I was the chaplain for this center and witnessed people who were vibrant one week turning up drooling on themselves and locked in a gerichair the next. The more vocal you are the more you lay yourself open for being drugged. The worst thing is if they determine that you need to be sent to a geripsych unit due to your “problems”. These units are just a way to make money off of people. They are truly madhouses, very much similar to what went on in the asylums of earlier decades. I know because as the chaplain I went to visit any of my residents from the nursing home that ended up in these places. Visiting was like sitting smack dab in the middle of a true mad house!

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    • I also find it interesting that an article like this generates so little interest here on MIA. I am assuming that there isn’t much interest due to the fact that there are so few responses here. Perhaps more people actually have read it; I certainly hope so. Everyone gets angry about how children are drugged and everyone is angry about people getting drugged in the “hospitals”(warehouses), but not a lot of people seem to get angry about old people being drugged.

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  4. Visible horrors of Willowbrook took 20 years to end . The invisible horror of psychiatric drugs will not stop until the planet kick humans ass. More Floods, Fires, Famines and Pestilence.

    The elderly in Nursing Homes have no voting power , no financial power etc etc.

    “Revisiting the atrocities that once consumed the halls of Willowbrook State School in Staten Island – WARNING GRAPHIC CONTENT”
    Sen. Robert Kennedy toured the grounds in 1965. Afterward, he described the horror he’d witnessed.Kennedy referred to Willowbrook as a “snake pit”

    By 1986, only 250 residents still lived there; by September 1987, the last patients left the facility.

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  5. my take on it is that psychiatry tends to victimize those who are stigmatized, with less power, fewer resources, etc. thing is…in 21st century America, the middle class has been decimated, the working class is heavily controlled, and there’s lots of varying degrees of poverty. so…that alone provides fertile ground for Mental Health, Inc. to work their destructive magic on the populace.

    its worse in any kind of institution. thing there is….lots of people are in jail, prison, juvenile facilities, nursing homes, etc. The more toxic psychiatric drugs are especially popular in those settings, and…with economic and social factors taken into account, plus the aging of the overall population, I think things are going to get a lot worse, at least in the US….not better.

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    • I agree. It’s only going to get worse. Former drug reps have given interviews in which they tell how they were sent by their supervisors into nursing homes to find new victims to drug so that they could make more money. Not only their paychecks but their bonuses depended on how many new victims they could get prescriptions written for. I’m frustrated because I have no idea what one solitary person can do about this. How do we go about combating the spread of power by the drug companies and the mental health system? It’s not enough to come here to MIA and post things to one another. We’ve got to develop greater impact on a larger audience but I have no idea how to accomplish this.

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      • Now, with the “stigma reduction” campaigns, people are encouraged to identify -with- the labels applied to them, and that is somehow “liberating” or “progressive” or…I don’t know. Its never ending, and I get the sense its bad enough in many other developed, affluent, 21st century nations, but the US is really an outlier in a lot of respects. We have 0 tolerance schools, high rates of incarceration, lots of people “in treatment,” on and on it goes…and I think things are only going to get worse, not better. In “The New Economy,” scraping to get by is often as good as it gets. Even the well-educated have lowered expectations. Inequality has been growing by leaps and bounds since the 80s, and now the 1% is all hopped up on Ayn Rand and they want the rest of us hopped up on Abili-Quel or whatever.

        I guess try to warn those who you can. Thing is…a lot of people will not listen, or they will say “well, you just had a “bad experience,” or…whatever.

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