All too many Americans believe that the sedate, docile elderly people they’ve come to expect in nursing homes are a normal state of affairs. It’s not unreasonable to assume this behavior is a result of aging or chronic illnesses like dementia. However, for many nursing home residents, this sedation is not caused by old age but by the side effects of their medications – medications they should have never been prescribed in the first place.
The use of chemical restraints to subdue nursing home residents is dangerous, illegal, and yet also a widespread practice among nursing homes. Federal regulations define chemical restraints as any drug that is used for disciplinary purposes or the convenience of staff, rather than for treating medical symptoms. These drugs are administered to an individual for the purpose of controlling their behavior, especially if they have dementia, which may make care more difficult.
Chemical restraints usually come in the form of antipsychotic drugs. Antipsychotics alter consciousness and can adversely affect an individual’s ability to interact with others. While their use is valid when treating diagnosed bipolar disorder, schizophrenia, or other psychiatric disorders, nursing facilities commonly administer these drugs to residents who do not have these diagnoses.
Haldol, Zyprexa, Seroquel, and Risperdal are all antipsychotics commonly used in long-term care facilities as chemical restraints. These and other antipsychotics sedate residents so that not only their behaviors but also the underlying causes for those behaviors do not have to be addressed. Like other resident care problems in nursing homes, the use of chemical restraints is attributable to a lack of adequate staff.
Antipsychotics are powerful, and responsible doctors will only prescribe them with extreme caution even when treating diagnosed psychiatric disorders. Many risks come along with taking antipsychotics, and those risks become a magnitude greater when they’re used as restraints rather than for their intended medical purpose. Common side effects include agitation, sedation, disordered thinking, muscle disorders, low blood pressure, constipation, and loss of appetite. The lethargic behaviors exhibited among drugged-up residents also substantially increase the risk of falls which are injuring or fatal. This is why antipsychotics usually have “black box warnings” – FDA labels warning of an increased risk of death if administered to elderly people with dementia.
Through the National Partnership to Improve Dementia Care in Nursing Homes, the federal government has sought to reduce the illegal use of chemical restraints, but many nursing homes still rely on antipsychotics to subdue their residents. State officials do little to enforce the laws prohibiting chemical restraints, and doctors tend to rubber-stamp drug orders requested by nursing homes.
The culture of a nursing home, rather than a resident’s medical needs, decides if you or your loved one will be subjected to chemical restraints. Human Rights Watch’s report, “They Want Docile”: How Nursing Homes in the United States Overmedicate People with Dementia, notes that in an average week, nursing homes in the US administer antipsychotics to over 179,000 people who do not have the diagnoses for which the drugs are intended to treat.
Should a nursing home administer these drugs to your loved one without consent, you have the right to demand them to stop. Nonconsensual chemical restraints are illegal and constitute battery. You have no obligation to accept a doctor’s recommendation to use antipsychotics – strongly consider seeking a second opinion. Antipsychotics can be deadly, and harm from their wrongful use may be cause to seek legal action.
To find out more about chemical restraints and what can be done to prevent their use, please refer to CANHR’s guide Restraint-Free Care and the Long Term Care Community Coalition’s Protecting Nursing Home Residents From Chemical Restraints.
