Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.Then there is this:
Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.Like I said, ghastly.
I don't know why adult children put their parents in nursing homes. Why not use that same money to buy or rent an apartment. That way the other tenants will involve him or her in their social life. I mean if the complex is 10% ethical. Most people are neutral. Hopefully, there will be a 10% ethical influence among the tenants, which is enough to move things in the right direction. Hopefully, people will do the neighborly thing. As to regular meds, why rely on sedatives for your mom, dad, husband, or wife? Don't you want your loved to thrive in all that he does? One neighbor I had was an older gentleman whose family lived back in Chicago. He had emphasema but he still got around, drove around town, in fact, quite a bit with this portable oxygen tank. Great guy. But he left a pan with boiling water on the stove too long. The water evaporated and the heat turned his pan into a conductor and smoke began filling his apartment house. I smelled the smoke as it billowed out his window, so I stepped over to his apartment and knocked but his door was locked. He was asleep and couldn't hear me knocking and pounding on his door or my screams of "Bob!" I phoned the fire department and they broke into his kitchen window, woke him up, and extinguished the smoke. I apologized for making a big to do about it, but he was grateful. Somebody was looking out for him.
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| Red and brown onions, garlic, shallots, and leeks contain Benfotiamine. |
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| Leeks |
In the interview seen here, Charlene Wagner explains that the St. John's nursing home was giving her husband, who was diagnosed with Lewy Body Dementia, sedatives Seroquel and Adol, saying that the nursing homes use these meds to sedate her husband, not cure, relieve, or heal her husband's condition. Or, she says, "I would rather say that they use the meds to control them." Yeah, that's about right. Read what Seroquel is typically used for:
Here is the article.Seroquel is the brand name of the generic drug quetiapine, used to treat schizophrenia and bipolar disorder (formerly known as manic-depression).Seroquel changes the levels of neurotransmitters (naturally occurring brain substances) including serotonin and dopamine.Seroquel belongs to a class of medications called atypical antipsychotics.
Kansas nursing homes have 'become far too dependent' on mind-altering meds.
Allen Wagner used to light
up when his granddaughter entered the room, but when she visits him at his
nursing home in Overland Park now, he hardly reacts. He’s sleepy and
uncommunicative.
He’s sedated.
Wagner, 78, has Lewy Body
Dementia and Parkinson’s disease. But his wife, Charlene, said it’s hard to
tell how much of his lethargy is due to that and how much is due to the
anti-psychotic medications he was first given during an extended hospital stay
and has continued taking in nursing homes.
“I’ve seen a change since
he went to the nursing homes,” Charlene Wagner said. “Not because of the care.
The care is good. I believe it’s the medicines.”
Anti-psychotics are
contraindicated for people with dementia and include a U.S. Food and Drug
Administration warning that
they increase the risk of falls, stroke and other potentially fatal side
effects.
The federal government
started tracking the off-label use of such medications in nursing homes in
2011. Since then, Kansas has always ranked at or near the top in percentage of
medicated residents, suggesting there are thousands of residents in the state’s
certified nursing facilities who have been given drugs that aren’t medically
indicated for them, and could actually harm them.
“There’s something about
that dementia coupled with the anti-psychotics,” said Margaret Farley, a board
member for Kansas Advocates for Better Care, a group that represents nursing
home residents. “This is not just us saying, ‘Gee, that’s not very good, you’re
robbing them of their personality, they won’t talk, they’re not active, etc,
etc.’ This is hardcore. This is a 1.6 to 1.7 times increase in deaths that most
of the time is related to cardiovascular changes or it’s related to the
development of pneumonia.”
Kansas also led the nation
last year in percentage of skilled nursing facilities cited by the federal
government for a broad slate of medication-related violations, some of which
relate to anti-psychotic use.
Kathy Greenlee, a former
Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of
Aging under President Barack Obama, said the overuse of anti-psychotics is an
unintended consequence of removing physical restraints from nursing homes in
the 1980s and 1990s.
Now when people visit
nursing homes they’ll no longer see residents strapped to beds and wheelchairs.
But they will likely see some under “chemical restraint,” through the use of
anti-psychotic medications like Haldol and Seroquel, which Charlene Wagner said
have caused her husband to deteriorate.
Greenlee said she knows
Kansas nursing homes are not the worst in the nation overall. But the rate at
which they use anti-psychotics should cause some soul-searching about how they
deal with difficult or disruptive behavior of residents with dementia.
“They can be overprescribed
to sedate people and then mask the need to deal with these underlying causes
(of disruptive behavior),” said Greenlee, who is now vice president of aging
and health policy for the Center for Practical Bioethics in Kansas City, Mo.
Groups that represent
Kansas nursing homes say the state’s anti-psychotic use ranking is unfairly
skewed by a handful of homes that specialize in mental illness and that they
face a number of challenges that are outside their control.
It’s hard to find enough
qualified staff in many parts of the state. Some facilities rely heavily on
Kansas Medicaid and payments under that program have been delayed for years due
to bureaucratic changes. There’s also a shortage of psychiatrists in Kansas,
especially those who specialize in treating older people.
“All of those I believe do
factor into our ability to continue to really tackle this issue,” said Debra
Zehr, the president and CEO of LeadingAge Kansas.
Cindy Luxem, the president
and CEO of the Kansas Health Care Association, said Kansas homes have brought
rates down, but they need help to reduce them further.
“We’re going to take a lot
of responsibility on this topic, but at the same time we look at it as
something where we really better start getting family members involved,” Luxem
said. “Physicians, pharmacists, you name it.”
Zehr said that when doctors
and nursing home workers use anti-psychotics on people who don’t have a mental
illness, it’s not ideal, but it’s done with good intentions.
“Anybody who’s spent time
with people in the throes of dementia and has seen the kind of internal anguish
and volatile behaviors of people with dementia at certain stages, they’re
trying to help,” Zehr said.
But some facilities have
found better ways to handle those behaviors. Farley said more should follow
their example.
“It’s not an easy thing to
be able to take care of bad behaviors without these medications, but we’ve
become far too dependent upon them,” Farley said.
The fight over the rankings
On average, 20 percent of
all Kansas long-term nursing home residents received an anti-psychotic
medication at some point in 2016, tying it for the highest rate in the country
with Oklahoma and Mississippi. The national average is 16 percent. Missouri
ranked near the top at about 19 percent.
Kansas has dropped from a
high of about 26 percent in 2011, but other states’ rates have fallen more since
then.
