Drugging dementia: Are antipsychotics killing nursing home patients?

MISSION VIEJO, Calif. – When Gerry Gilgan left the hospital after brain surgery in February 2013, the 78-year-old went into hospice care at Irvine Cottages, south of Los Angeles. He had dementia, but was in good spirits and lucid when he arrived.

The next day, daughter Patrice Gilgan’s cellphone video shows a different man.

“Daddy, wake up! Daddy, wake up!” Patrice Gilgan says, unable to rouse her father, a retired New York City firefighter, who has since died.

Gerry Gilgan’s widow, Marie, was shocked by the sudden change.

“We took him into this home thinking this would be the best place for him,” she said. “[After] a day or two, he’s a different person. It was like he was a vegetable. There was nothing to him. Staring in space, drugged out.”

Within hours of his arrival, records show Gerry Gilgan began receiving the powerful antipsychotic medications Haldol and Seroquel.

Nursing homes justify the use of antipsychotics, saying they calm agitated, anxious or combative residents. According to the facility, Gerry Gilgan was “combative,” though closed-circuit cameras in the nursing home show no evidence of belligerent behavior.

Antipsychotic drugs are approved for patients with bipolar disorder or schizophrenia, not for dementia. In fact, the FDA has given its strongest warning – a so-called black box warning – telling physicians not to prescribe antipsychotics to people with dementia because they can cause heart failure, infection and death.

Despite the FDA warning, a Government Accountability Office report released this month found one-third of long-term nursing home residents with dementia have received antipsychotics.

‘Zonked out’

Antipsychotics are often given to patients for the benefit of the officials at the facility, in order to control them, said Carole Herman, founder of the Foundation Aiding the Elderly in Sacramento.

“The patient can’t walk anymore. The patient can’t talk anymore, and so there’s less care because basically the patient is incapacitated,” she said. “They’re zonked out all the time, so you don’t have to be bothered with them.”

Gerry Gilgan’s prescription for Haldol was "as needed," as frequently as every six hours.

St. Joseph Health managed Gerry Gilgan’s care, which was paid for by Medicare. St. Joseph declined to speak with “America Tonight” but released a statement:

“Each patient’s condition is unique and often has many factors to consider in determining the appropriate medications. We place high priority on a patient’s right to privacy, and out of respect for that privacy we are unable to discuss the specifics of this case.”
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Drugging dementia: Are antipsychotics killing nursing home patients?