Nursing Homes Rarely Penalized For Oversedating Patients

Antipsychotic drugs have helped many people with serious mental illnesses like schizophrenia or bipolar disorder. But for older people with Alzheimer's or other forms of dementia, they can be deadly. The Food and Drug Administration has given these drugs a black box warning, saying they can increase the risk of heart failure, infections and death. Yet almost 300,000 nursing home residents still get them.

So in 2012, the federal government started a campaign to get nursing homes to reduce their use of these drugs. But an NPR analysis of government data shows that the government rarely penalizes nursing homes when they don't get with the program.

Take Texas for example. More than a quarter of nursing home residents there still get antipsychotic drugs. Since the beginning of the federal initiative, the nationwide average has dropped below 20 percent. That puts Texas in last place compared with other states and the District of Columbia.

So Texas is playing catch-up. The state recently conducted a series of trainings to teach nursing home employees that there are alternatives to giving residents powerful drugs. Nursing home activities director Roxanne Stengel attended a session in Houston. She's been in the business for a long time. So it was not a surprise to her that Texas was in last place.

Check NPR's interactive database below to see the history of antipsychotic drug usage at nursing homes in your area and how they compare to national and state averages.

"I saw my fair share," Stengel says, of seeing the drugs used as a "form of control [and] restraint" in some of her previous workplaces.

"That's pitiful," she says. "There's got to be a better way."

In fact, the point of the Houston training event was to show that there is a better way to manage the anxiety or aggression that sometimes goes with dementia. It's one element of the national campaign started by the federal Centers for Medicare and Medicaid Services to reduce the use of antipsychotics in nursing homes.

The approach being taught is sometimes called individualized care. The idea is that if nursing home employees know enough about a resident, they can figure out the reason behind challenging behavior and deal with it without resorting to antipsychotic drugs.

For example, what should you do if you're caring for a resident who won't go to sleep and wanders the halls all night? Well, if you know he used to be a night watchman, you can just continue to treat him like one. The world won't come to an end if you deviate from the schedule and let him sleep during the day.   (Read More)

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Nursing Homes Rarely Penalized For Oversedating Patients