Tag Archives: medications

January 22, 2023 · 11:53 am

Feds finally investigating nursing homes’ abuse of antipsychotic drugs

In a move that family caregivers feel is long overdue, the federal government is launching an investigation into the inappropriate use of antipsychotic drugs in nursing homes. Specifically, the government will be looking at the suspicious rise in schizophrenia cases and determine if the spike is being used as a workaround to use antipsychotic drugs to sedate difficult patients and make them more manageable for staff.

This is not a new issue, especially for family caregivers of those with dementia. I’ve written about it multiple times on this blog in relation to my father’s experience. My father was given risperidone, a drug used to treat schizophrenia and bipolar disease, at the memory care facility he resided in during the last year of his life. The doctor didn’t deny when I confronted him about the drug and how it was used to make dementia patients zombies and more compliant for staff.

After my father’s death, I reported the issue to the appropriate state agency, but never received a response. The federal government claimed in 2013 that antipsychotic use in nursing homes was on the decline. That remains true but only for the population not diagnosed with schizophrenia. There is also a troubling racial disparity, with Black nursing home residents being diagnosed with schizophrenia at higher rates than their white counterparts.

CMS will conduct audits and nursing homes showing a pattern of diagnosing schizophrenia incorrectly may see their public ratings impacted. CMS will monitor the nursing homes not in compliance to make sure corrections are implemented. It’s not known at this time if fines will be implemented for those nursing homes who continue to be out of compliance. Also, patients’ families will not be informed if their loved one was incorrectly diagnosed. Make sure to request a list of the drugs your loved one has been prescribed and question any medications that don’t seem appropriate.

Photo by Bruno Guerrero on Unsplash.

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August 14, 2022 · 2:40 pm

Prescription drug costs can be unexpected burden for elders

The legislation passed by Congress on Friday includes at least one initiative that has significant bipartisan support, especially among older Americans: Medicare will now be able to negotiate the prices of certain high-price drugs with drug companies.

In other countries, this is a common practice, but the pharmaceutical industry has lobbied hard against the measure over the years. AARP lobbied hard for elders and their families, and finally secured a victory.

I received an eye-opening education about the high price of medications when my father entered a memory care center during the last year of his life. He was put on several medications and Medicare only covered a portion of the costs. We had no say so on what medications he was placed on, and whether there was a generic, more affordable alternative. One medication was being used off label in a way that was not recommended in patients with dementia. We were left owing hundreds per month out of pocket, on top of the room rate of over $4,000 per month. We did not have the money to pay it off each month and after my father’s death, had accrued a bill of over $5,000 which we were able to negotiate down a bit and pay off out of my father’s estate.

The new legislation is limited in scope, but will still have a noticeable impact. In addition to negotiating drug prices, the legislation will:

Cap at $2,000 the annual out of pocket amount Part D prescription drug plan members would have to pay for their medications.

Levy a tax penalty on drugmakers that increase prices of their medications more than the rate of inflation.

Cap the cost of Medicare-covered insulin at $35 a month. (The insulin cost cap for private insurance did not survive a vote, so for now the cap only applies to Medicare members.)

Eliminate out-of-pocket costs for most vaccines under Medicare.

Photo by National Cancer Institute on Unsplash

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May 10, 2015 · 10:47 pm

A medicated Mother’s Day

So far, the hospice-provided “comfort kit” has not brought my mother as much comfort as she had hoped.

pills

My mom had a false impression about morphine, after experiencing the temporary euphoria of the IV morphine given sometimes during emergency medical situations. I think Mom was hanging on to the idea that morphine was going to be this miracle drug that was going to magically remove her pain and let her get things done and bring back her appetite.

Well, we all know what morphine does, especially to an elderly, frail person like my mother. It knocked her on her butt, once we adjusted her dosage to effectively relieve the pain. Then she ended up getting a bit too much (even though she was still self-reporting pain as a 7) and ended up getting sick twice.

That was Saturday night. She did manage to sleep through the night, a rarity.

Today the hospice nurse visited and recommended we try Haldol. I had read some things about it (often used for mental health conditions like schizophrenia) but also read that it is a proven anti-nausea medication.

So I tried Mom on the lowest dose and that really knocked her for a loop! I am a naturally cautious person around medications, but it is still surprising to see the effects they can have on an individual. Mom was hardly able to walk and she was very groggy, but still in pain so she couldn’t really sleep.

Figuring out the correct dosage and cocktail of drugs is really trial and error, and when done in the home environment, is quite stressful.

I just put her to bed, giving her a small dose of morphine along with an Ativan, the latter which she has taken for years and tolerates well. This worked for her overnight, so I’m hoping we have found the right combination to relieve her pain and help her sleep without making her sick.

I hope for another quiet overnight period. Ironically, I still slept poorly last night, because I kept waking up to make sure Mom was okay.

If you have any medication tips or experiences to share, please do so below in the comments section.

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