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Phony diagnoses hide high rates of drugging at nursing homes

nytimes.com

121–130 of 339 posts

Re: Phony diagnoses hide high rates of drugging at nursing homes

#121
post #77

Earlier quoted context omitted.

I think you're joking, but this is actually so true that you might be committing a crime by suggesting it.

> this is actually so true that you might be committing a crime by suggesting it Perhaps where you live. The legal system I live under has strong protections for freedom of speech that ensure that such a statement cannot be criminalized.

This statement is legal in the USA.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#122
post #29

Earlier quoted context omitted.

> I'm terrified of growing old in this country. Have kids, raise them right, and you’ll be fine. It’s worked out pretty well for a couple thousand years.

People did not live as long and would die of some cause such as illness long before they got to the age where they would develop things like dementia. Our situation with many people living to an advanced old age, an exceeding number by historical standards, is more recent (past 100 years or so).

Is that actually true?

Life expectancy is a bit of a misleading metric in that regard, since life expectancies are just averages. If a population has a life expectancy of 50, that doesn’t necessarily mean that 50-year-olds are dying of old age and no one makes it to age 80. It could mean that there are a lot more children and young adults dying and bringing down the average. So if you’re living in a society with a life expectancy of 50 years and you turn 50, your personal life expectancy is probably going to be closer to 70-80 because you’ve already managed to survive the causes of death that affect younger people.

And you may very well develop things like dementia. The concept of people becoming elderly enough to lose their mental faculties isn’t some unprecedented 20th century discovery. It is becoming more common, but that’s just because deaths from childhood illness, infectious disease, violence, and occupational accidents are becoming less common.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#123
post #94

Earlier quoted context omitted.

A nursing home around here for dementia runs $10,000 per month.

Same time we hardly pay that per year for k-12. Shows how messed up our priorities are.

School aged kids and teenagers also require a lot less individual care and attention

Re: Phony diagnoses hide high rates of drugging at nursing homes

#124

Antipsychotics are not something to be handed out like candy. They have serious, sometimes permanent and sometimes fatal, side effects in anyone of any age. The article notes how that class of medication increases mortality in elderly people in particular. The fact that some people were prescribed haloperidol as the first line of treatment instead of a newer, safer antipsychotics also blows my mind. I'm terrified of…

Supposedly, a haloperidol and lorazepam mix is effective in sedating someone that's agitated just long enough that it becomes the next shift's problem. Pretty sure that's what's happening.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#125
I haven't finished the article yet. I got sidetracked by the claim that Haldol is "a powerful sedative." I understand that journalists are neither doctors nor pharmacists, but if you're reporting on a story about medical ethics, maybe know a little bit about drugs, how they work, and what the words you're using mean in a medical context.

Haldol is a typical antipsychotic. If the patient has no symptoms that indicate its use, they should absolutely not be taking it. There's a lot of side effects. Some may even persist after the medication is discontinued.

One of these side effects is that it can be sedating. I've been on the patient side of a misapplied antipsychotic myself. They can make you very tired and cause you to feel "drugged". This is not the same as a drug being a "powerful sedative". Words mean things. Words in a medical context have specific definitions and nuance. If you're reporting on medical malpractice, it's important to get the vocabulary correct so that the way you word something represents the truth rather than a sensationalized version of it.

I can definitely believe that these people were medicated in ways that were dangerous to their health for the convenience of the staff. However, when you call Haldol a powerful sedative, I have to assume you're either trying to make the situation sound as horrible as possible or you have no idea what you're talking about.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#126

I haven't finished the article yet. I got sidetracked by the claim that Haldol is "a powerful sedative." I understand that journalists are neither doctors nor pharmacists, but if you're reporting on a story about medical ethics, maybe know a little bit about drugs, how they work, and what the words you're using mean in a medical context. Haldol is a typical antipsychotic. If the patient has no symptoms that indicate…

Haldol, Benadryl and one other drug are part of the common rotation used by nurses to sedate troublesome patients so they can skate out of handling said patient during their shift.

When said patient regains control of their faculties they are often confused and angry as a day is missing from their memory.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#127

Antipsychotics have horrific side effects but are useful in institutional settings to make residents/patients/inmates easier to manage - psychiatry is the tool used to legitimize drugging people without need for their consent in such settings, for the benefit of others and the institution. It makes me despondent to read an article like this as I believe there are too many perverse incentives and cultural taboos for t…

Not all antipsychotics have horrible side effects. Let’s not lose nuance in response to the terrible unethical behavior depicted here. Modern antipsychotics often do good in helping people function when they wouldn’t otherwise be able to. The illnesses they treat are ones of terror and loneliness. I will note however that there’s no purpose in them here except to force submission, and that’s abuse and spits on the go…

what’s an antipsychotic without horrible side effects? As far as I know newer antipsychotics have less frequent side effects but they’re still extremely bad. Obviously that compares to the total dysfunction of severe mentally ill people who don’t take them. But to say there is an antipsychotic without horrible side effects isn’t correct.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#128

Non-paywall link: http://web.archive.org/web/20210911161128/https://www.nytime... One nit: The article switches back and forth between incorrect schizophrenia diagnosis (11% of residents) and prescription antipsychotics (21% of residents), but those should be treated as separate topics. Antipsychotics can be beneficial in many conditions beyond schizophrenia, such as insomnia (at low doses), bipolar disorder, or depr…

> Current generation antipsychotics also have significantly fewer risks than first-generation antipsychotics

This is true, technically. Newer generations still have severe and often debilitating side effects though. Which gives an arguably favorable risk benefit for severe conditions, but very questionable ones for one in five nursing home residents.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#129
post #117

Earlier quoted context omitted.

Are there any states where people can be involuntarily committed indefinitely without judicial involvement? [edit responding to your edit] you were responding to the tone of my original comment, which I softened while you were responding, so sorry for the original combativeness. For what it's worth, holy crap does what you described suck. i would have done exactly what you did. no amount of knowing that it's not "ind…

Florida. I knew people in high school that were in there for weeks. https://en.wikipedia.org/wiki/Baker_Act

"Examinations may last up to 72 hours after a person is deemed medically stable"

"There are many possible outcomes following examination of the patient. These include

(1) the release of the individual to the community (or other community placement),

(2) a petition for involuntary inpatient placement

...

(3) involuntary outpatient placement (what some call outpatient commitment or assisted treatment orders), or

(4) voluntary treatment (if the person is competent to consent to voluntary treatment and consents to voluntary treatment)."

[Numbers mine]

So assuming #2 and #3 are the "bad" outcomes: both seem to require a judge's order within 72 hours?

Unless the definition of "stable" has a wiggle room I am not appreciating? Or some other practical nuance?

Re: Phony diagnoses hide high rates of drugging at nursing homes

#130

Phony Diagnoses not just at nursing homes, also in mental facilities. Was really surprised (better word-traumatized) that one flippant casual mention of not valuing my life in a private text message was enough to to get me detained by police in a facility for a night. "Doctor" threatened me with drugging just because I refused to answer some of their questions and instead insisted on a lawyer. Funny how freedoms can…

Careful, criticism of the medical industry and concern for your rights is verboten. You will take the drugs the experts tell you to take, and you will like it.
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