A whistleblower lawsuit filed against Johnson & Johnson (JNJ) didn’t get much attention in the media because the unproven accusations within it — paying kickbacks to nursing home pharmacy Omnicare (OCR) — sounded familiar. But the details in the complaint are worth exploring because they go further than the usual allegations of paying for no-work contracts to boost pharmacy distribution of their drugs.
Pharmaceutical companies view the elderly as a lucrative market. However a panel of experts at the recent Senate Aging Committee forum decided to speak up. Over-medication occurs far too often in those diagnosed with dementia, the panel warned, and as baby boomers age the problem will only worsen. One reason overmedication occurs, per this panel, is family members, caregivers, and nursing home workers often misinterpret patients’ complaints about physical ailments as unruly or aggressive conduct. To manage their behavior, such patients are administered antipsychotics they don’t need.
About five million patients are currently diagnosed with Alzheimer’s and other forms of dementia. “Those in this field have a feeling we’re headed in a very fast train toward the end of a cliff,” stated Patricia Grady, PhD, director of the National Institute of Nursing Research. Director of California Advocates for Nursing Home Reform, Patricia McGinnis, demanded nursing homes be held “accountable” for the drugs they administer. “The way anti-psychotic drugs are used in nursing homes is a form of elder abuse,” she told the forum. “Instead of providing individualized care, many homes indiscriminately use these drugs to sedate and subdue residents.”
Dementia patients can get anxious to the point of violence while bathing, and this cheery beach mural is one of many small innovations that have lifted moods here in recent months. Under the direction of psychiatrist Dr. Miguel Rivera, caregivers at the Pines have deployed such simple spa comforts as music, massage and calming colors to help reduce agitation. As a result, dosages of antipsychotic medications have dropped to less than half the state average for this most challenging patient population. “I remember so many times walking through that old west hallway at the Pines” before the building was remodeled, he says. “After the first few years of me working there and seeing how people were overmedicated, and boredom was so prevailing, I remember — and I feel it right now — just walking down that hall, and praying, saying, ‘Please, God, show me a way.’ ” It was Rivera’s wife, Natasha, he says, who put him on a path to exploring alternatives to drugs. Both practitioners of TriYoga, they met in 2007 on a spiritual trip to India. By the end of the three-week stay, they were married. A year later, she joined him in Sarasota from her native Russia. And almost immediately, Rivera says, she changed the way he was doing his job.
Rivera soon found research on the use of music, massage and other therapies on dementia patients. His reading also led to the use of daily affirmations by Pines staffers, who tell the patients, “You are safe; you are loved; you are happy.” The result, says Westbrook of the Pines, was “this whole beautiful circle he has created here that has changed that unit.”
The dangers of [psychiatric ] drugs: The drugs are especially hazardous to older people, raising the risk of strokes, pneumonia, confusion, falls, diabetes and hospitalization. “There’s a bunch of problems, not least of which is those drugs can kill you,” said Dr. Mark Kunik at Baylor College of Medicine in Houston who spoke last month at the Gerontological Society of America’s annual meeting in New Orleans. Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms, he said, because “It’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.” Federal regulators are cracking down on homes that don’t routinely reassess residents on psychotropic drugs. But use remains widespread.
Tens of thousands of vulnerable dementia patients are being prescribed ‘chemical cosh’ drugs in hospital wards in a ‘scandalous abuse’ of the elderly, ten leading health organisations have said in a letter to The Daily Telegraph.