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Phony diagnoses hide high rates of drugging at nursing homes

nytimes.com

171–180 of 339 posts

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

#171

Earlier quoted context omitted.

Yeah, I've read some incredible stories. Locking the doors behind the patient. Using some tiny remark as cause for involuntary institutionalization. It made me think american psychiatry was like american prisons where they get paid per person and are therefore incentivized to stuff as many people in the building as possible.

It's less about pay and more about liability. Mental health is terrified that someone will do something to harm themselves. The incentive systems have yet to realize that there needs to be some balance in bad outcomes to support the good ones. It results in a system where any mention of self-harm is taken extremely seriously, even at the cost of a larger treatment plan.

I think we are seeing literal survivorship bias here where the person whose texts were taken too seriously is alive to tell their tale and everyone whose weren't successfully committed suicide.

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

#172

One of the most disgusting parts of western culture is how they relegate their old to these nursing homes.

>One of the most disgusting parts of western culture is how they relegate their old to these nursing homes.

Most people can't afford it and last time I checked, Medicare doesn't cover it at all or not enough to make it affordable.

Of course in the 80s and 90s, long term care was much more affordable and wasn't as, uh, let's call it, profit seeking.

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

#173
post #167

Earlier quoted context omitted.

>Phony Diagnoses not just at nursing homes, also in mental facilities. Schools too. My mum spent two decades as a primary schol teacher, and it's an open secret in that industry that Ritalin and other behavioural drugs are, at least in some cases, administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.

Because that child with behavioral issues is sharing a classroom with 10 to 20 other children. It has never been fair to everyone else to put up with the issues on the one. In more brutal prior days, they'd be expelled and become the parent's problem. Now, they get medicated into compliance. It isn't fair to anyone, neither that child nor the others, that they get streamed in with everyone and everyone has to figure…

I'm not arguing the ethics of it, just stating that (at least to the best of my understanding) there is a culture of that thing happening.

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

#174

Earlier quoted context omitted.

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 r…

It’s actually tardive dyskinesia (I assume you may have thought that the tardative stems from retarded as in intellectual disability). As far as I am aware, this movement disorder does not have any causal relationship with intellectual disability.

I agree with the principle behind your other points though, in an ideal world we would not prescribe these medications to the elderly to ‘aid in management’

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

#175

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…

Haloperidol is absolutely a powerful sedative (amongst its other effects). This isn’t a misplaced claim or hyperbole, it is used (and I have used it) to sedate agitated patients in hospitals. I mean, it actually sounds like you don’t really know what you’re talking about. It’s not quite in our ‘take down’ class of drugs (think meth patient in the emergency room) but it sure as hell knocks patients out in IV/IM admini…

Having sedating properties is not the same as being a powerful sedative. If they had said it was used because it can be sedating, I wouldn't have said a word.

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

#176

There needs to be judicial punishment for the care workers and higher ups who administered the drugs. Merely sweeping it under the rug is not enough.

It's probably because of cost cutting. If you care for 10 patients in a shift, that's one thing, if you care for 50, that's when bad things happen. The buck stops at the top right?

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

#177

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.

So if you were writing an article about benedryl, you would feel comfortable describing it as a powerful sedative?

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

#178

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…

This is literal survivorship bias. I'm sure there are many people who are no longer alive because people did not take their texts seriously. I can easily imagine someone posting something just like this from the other side of the coin.

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

#179

Earlier quoted context omitted.

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 r…

It’s actually tardive dyskinesia (I assume you may have thought that the tardative stems from retarded as in intellectual disability). As far as I am aware, this movement disorder does not have any causal relationship with intellectual disability. I agree with the principle behind your other points though, in an ideal world we would not prescribe these medications to the elderly to ‘aid in management’

whoops. Looks like tardive actually refers to it developing late in the course of treatment, https://www.dictionary.com/browse/tardive and dyskinesia refers to the actual disorder of movement

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

#180

Earlier quoted context omitted.

>Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. That's definitely correct. It can be a great help for some children, and some teachers (maybe even the majority) do make carefully considered decisions where the primary concern is for the welfare of the child receiving the drugs. Other times, though, they just want some ratbag kid to STFU so they can get on with their job…

> some teachers (maybe even the majority) do make carefully considered decisions In the United States, teachers do not prescribe medications. They may make a recommendation that parents seek the guidance of a doctor, and a qualified medical professional (usually a psychiatrist) will diagnose the child, and the parent may choose to pursue medicating or not. In our case, we had regular checkup appointments with a psych…

>Unless the laws have changed since then in Australia, Ritalin is a controlled substance, according to this, and it's not even guaranteed a general practitioner can prescribe it, and a psychiatrist is preferred.[1] Maybe you misheard, or maybe the teacher misunderstood what their capabilities were?

Just like in the US, teachers here can make recommendations for parents to seek medical treatment. Said recommendations can include comments like "I suspect your child has ADHD". While nothing is guaranteed, if the parent follows up on it there's a good chance the child will be medicated.

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