Antipsychotics report will have severe side effects

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John O'Connor, editorial director, McKnight's Long-Term Care News
John O'Connor, editorial director, McKnight's Long-Term Care News
Antipsychotic drugs are often used to calm residents with dementia.

This reality is common knowledge among most people who have spent more than a few minutes in a nursing facility. But it is apparently a great revelation to the folks at the Inspector General's office. They just released a report that slams the widespread practice. For good measure, they also threw in some milquetoast recommendations for the Centers for Medicare & Medicaid Services to implement.

I'm sure there are worse examples of goofy work done at taxpayer expense. But this little exercise deserves a spot in the team photo.

After spending countless hours and tossing away untold dollars reviewing records, the federal watchdog found almost all of the 375 facilities examined were painting outside the numbers. My, what a shocking surprise.

Antipsychotics were created to help people with schizophrenia and certain other mental illnesses. As such, they have never been approved for treating dementia. It just happens to turn out that they offer a far-from-perfect way to relieve pain and suffering among such unfortunates.

The IG report comes in the wake of the federal effort aimed at reducing antipsychotic use among nursing home residents by 15% in the next six months. It's safe to say that program just got a nice kick-start. And there are likely to be a lot more kicks where that one came from.

As a practical matter, the IG report means many facilities are in for a double-whammy.

That's because one of the few proven approaches for helping agitated residents with dementia is being removed. Moreover, state inspectors are likely to write up med cart violations with a renewed sense of purpose.

I understand consumers and regulators who see this practice as a misuse of antipsychotics. Strictly speaking, the meds were not intended for this purpose. But this practice did not become widespread because facilities thought it would be fun to recklessly administer dangerous meds to the people they care for. This approach took root for a very simple reason: In situations where there was no good choice, it was the best one available.

Now what? Let dwindling residents scream and howl in confused misery? It sure looks like the IG prefers that prescription.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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