Forbes: Drugs, Dementia, and Nursing Homes

One of the most common and longstanding—but also preventable—practices causing serious harm to nursing home residents is overusing antipsychotic drugs, according to testimony during a Senate Aging Committee hearing last week, reports Forbes.

It’s common for these drugs to be used “off-label”—meaning, not as they were intended to be used—and this can both harm patients and costs Medicare hundreds of millions of dollars.

Last year, an investigation by the federal Department of Health & Human Services inspector general found that 14 percent of nursing home residents were prescribed anti-psychotics but 8 in 10 were off-label, and, thus, not for treatment of mental illness.


Still, this is not a simple issue. Sometimes, aides cannot provide basic hygiene for dementia patients without the use of these meds. Patients can be too violent or agitated for an aide to change their diaper or bathe them.

Edelman said the Center is not opposed to all uses of these medications but rather wants nursing facilities to try other solutions first.

Alternatives to drugs can be time consuming and may require special skills. For example, a patient may react poorly to a specific aide—not because the aide is not competent but because there is something about her that triggers agitation. A nursing home can figure this out and make adjustments. But it takes time and training.


A recent study published in Psychiatry Research in 2011 suggested that dementia could be more effectively treated through behavioral therapy rather than by psychotropic drugs, since many delusions suffered by dementia patients actually have a rational basis. 

The researchers found that drugs used to mitigate dementia systems such as delusions can do more harm than good, and these findings could have a significant impact on the way senior living providers respond to dementia patients.

Read the full Forbes article here

Written by Alyssa Gerace