Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Phony diagnoses hide high rates of drugging at nursing homes

nytimes.com

Post reply on HN
Print view View original

131–140 of 339 posts

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

#131

Post by grapist420 »

throw18376 wrote: post #76

unfortunately, there are some people who cannot function in the world without antipsychotics. a large number of people suffer from psychosis which in severe cases makes controlling their behavior, or even basic cause-and-effect thinking, impossible. the side effects of these drugs are terrible, but the alternative is worse. abusing these drugs as tools of control when they aren't needed is evil in itself. on top of t…

I still argue that antipsychotics are generally overused and that many cases that require them are either currently perpetuated or were in the past caused by technological or societal conditions, regardless 20% in these nursing homes is dramatic vs the overall 1.6%, down to .5% among older people. https://sci-hub.se/downloads/2020-10-18/9d/dennis2020.pdf

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

#133

Post by atdrummond »

simfree wrote: post #126
msrenee wrote: post #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…

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.

I assume the “one other drug” you are referencing is Ativan (lorazepam)?

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

#134

Post by spaetzleesser »

roenxi wrote: post #88
R0b0t1 wrote: post #47

Earlier quoted context omitted.

This is far beyond that. The doctors are brazenly prioritizing "not being bothered" over the health of their patients. Over prescription of antipsychotics is still common in US psychiatric facilities, and even if not there are alternatives, like very high dosages of SSRIs or other specific medications with complacency as a side effect.

If the alternatives are a doctor who cares and a doctor who doesn't then the choice is clear. But it is really difficult staying enthusiastic about treating someone, long term, who is never going to repay any extra efforts. Caring for the elderly/infirm is a really gruelling experience. It seems quite likely that there physically are not enough doctors who have the mental stamina to do that. The options the average p…

"Caring for the elderly/infirm is a really gruelling experience."

I can see that in the facility where my parents live. Overall the place is fine but it's constantly understaffed and people aren't paid well. This is a way harder job than my much better paid tech job. I can slack off for days when I feel like it whereas the care personnel never can escape the grind.

It's sad that these people get paid so little considering how psychologically strenuous their work is and how much human benefit comes out of it.

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

#135

Post by grapist420 »

simfree wrote: post #126
msrenee wrote: post #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…

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.

Benadryl and Haldol arguably don’t belong in the same sentence at all, considering their ridiculously different effects and profile. You’re right that they’re used though. Is there any reason Haldol should be used like that at all, beyond it already being available as a psych drug? And even if Benadryl isn’t as effective (I dunno) surely something that isn’t as bad in side effects could be found? Many instances of said sedation are totally unnecessary, but many are eminently necessary to restrain someone actively violent.

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

#136

Post by [deleted] »

vgel wrote: post #85
calvinmorrison wrote: post #65

Earlier quoted context omitted.

Step 1) fabricate an SMS Step 2) call police Step 3) enjoy Wow so easy to take down your political enemies huh

This happened to a friend of mine. "Friend" of theirs who was angry they didn't have a romantic interest in him called the police claiming they were suicidal. Police came, handcuffed them, verbally abused them, and dragged them to a hospital against their will even though they were clearly fine. They were forced to stay there for ~a day and then had no means to get home, thankfully a friend was able to pick them up a…

[deleted]

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

#137

Post by [deleted] »

nohuck13 wrote: post #129
easton wrote: post #117

Earlier quoted context omitted.

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) vo…

[deleted]

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

#138

Post by grapist420 »

QuarterReptile wrote: post #26
heavyset_go wrote: post #2

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…

The truth we fail to face is that, in the grueling task of caring for the elderly and all the perverse incentives to cut corners, providing holistic care is an enormous labor of love that will tend to not work well outside of family, despite all the money we throw at it.

yeah but antipsychotics severely retard every mental process and have a high risk of permanent motor and intellectual disability (it really sucks to have tardive dyskinesia). There’s absolutely no reason that should be prescribed. https://freddiedeboer.substack.com/p/the-weight Freddie explains it in this article - he deems it worth it for him to be able to keep a job and friends, but it is in no way called for for random old folks to be disabled like that to make them easier to handle

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

#139

Post by grapist420 »

quetzlbazaar wrote: post #17
heavyset_go wrote: post #2

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…

The solution in my opinion to this problem is to permit euthanasia and for assisted suicide to become culturally accepted as an alternative to a drawn out death of dementia in a care home. The quality of life for many (not all) care home residents who are on these sorts of drug regimens is dire and in reality not entirely for their benefit, as is apparent to everyone including those responsible for oversight like Med…

“euthanasia” is already available. gun, knife, bridge, rope.

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

#140

Post by lotsofpulp »

WalterBright wrote: post #21
quetzlbazaar wrote: post #17

Earlier quoted context omitted.

The solution in my opinion to this problem is to permit euthanasia and for assisted suicide to become culturally accepted as an alternative to a drawn out death of dementia in a care home. The quality of life for many (not all) care home residents who are on these sorts of drug regimens is dire and in reality not entirely for their benefit, as is apparent to everyone including those responsible for oversight like Med…

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

That seems cheap if you break it down into per hour of labor needed. I can only imagine how understaffed they are. I would hope I can take myself out before I end up in one of those.
Post reply on HN