Misuse of Drugs in Nursing Homes and Assisted Living Facilities
By the Law Office of Jeffrey J. Downey, attorney representing victims of elder neglect and abuse.
A recent report by Human Rights Watch estimates that every week in US nursing facilities more than 179,000 people, mostly older and living with dementia, are given antipsychotic drugs without a proper diagnosis. Facilities provide these drugs in many cases without obtaining the proper informed consent from residents are their families.
“The tri-state region of Washington DC, Maryland, and Virginia like elsewhere across the country is facing a problem, especially among our seniors,” explains Jeffrey J. Downey, a lawyer who has prosecuted civil claims against nursing homes for over 25 years.
Sometimes nursing homes that do not have proper staffing levels over-medicate their residents to keep them calm and sedated. Under OBRA, 1987, Facilities are charged with avoiding or minimizing any medications that could be used a chemical restraint.
In 2017, 1 million people aged 65 and over lived in over fifteen thousand nursing facilities across the United States. Many of those residents are on medications that could be over-used or abused.
Elderly patients that undergo surgery or who have chronic pain conditions are also at risk of becoming addicted to opioids. Opioids can also depress the patient’s respiratory systems and cause deconditioning or inactivity.
According to the Wall Street Journal, in April 2018 the Justice Department requested to join in settlement talks in a sprawling government litigation against the makers and distributors of prescription painkillers. More than 25 states as well as municipalities and Native American tribes have filed more than 1,000 lawsuits, claiming that aggressive marketing of prescription painkillers contributed to the opioid addiction epidemic.
Among the companies targeted are Purdue Pharma LP, Johnson and Johnson, Endo International PLC and Teva Pharmaceuticals Industries Ltd. The suits claim the companies misrepresented the risk of their medicines in marketing materials and seek to recoup the cost of opioid addiction borne by the government entities. Many suits also target pharmaceutical distributors, including Amerisource Bergen Corp., Cardinal Health Inc, and McKesson Corp., contending they failed to properly control shipments of opioids to pharmacies.
In Virginia, Attorney General Mark Herring filed a lawsuit in late June 2018 in Tazewell County Circuit Court accusing Purdue Pharma of contributing to the opioid crisis, claiming that it violated the Virginia Consumer Protection Act, particularly with the drug OxyContin. In Virginia alone nearly 8,000 Virginias have died from opioid overdose, and 5,000 from prescription use. Last year, prescription opioid death numbered over 500.
The use of these type of drugs without consent from the resident or their family or proxy is common. While federal regulations require nursing facilities to inform residents of treatment option and to give them the right to refuse treatment, among many of those interviewed by Human Right Watch say they just avoid following the rules.
The Nursing Home Reform Act of 1987 established protections of the rights of people in nursing homes, but with regard to antipsychotic drugs, those protections are weak. Between 2014-2017, there were over 7,000 citations, and nearly 100 percent of those citations did not carry mandatory financial penalties.
Families with loved ones in a nursing home or an assisted living facility should periodically review medications with the treating doctor and ask whether any medications that have sedating effects could be discontinued. These medications should also be cross-checked for contraindications, which are conditions or factors that serve as reasons to withhold a certain medical treatment due to the harm that it would cause the patient.
If you or a loved one have suffered from misuse of medication or neglect by health care staff, contact the Law Office of Jeffrey J. Downey, 8270 Greensboro Drive, Suite 810, McLean, VA, 22101, Phone 703-564-7318. On the web at www.jeffdowney.com.
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