Phony diagnoses hide high rates of drugging at nursing homes

Oh, dang, I forgot how administering and prescribing medicine isn't part of the medical system. Thanks for correcting me.

What do other cultures do for people who can no longer take care of themselves?

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 depression (to boost efficacy of primary antidepressant treatments). The "antipsychotic" label is an unfortunate holdover from long ago, but the drugs are actually much more useful than they sound. Current generation antipsychotics also have significantly fewer risks than first-generation antipsychotics. The article's attempt to call them "chemical straightjackets" is a cheap shot at a class of medications that can be very beneficial for several conditions. Overprescription is a problem, but that doesn't mean all prescriptions are bad.

The truly alarming stat is buried deeper in the article: The fact that 1 in 9 nursing home residents is diagnosed with schizophrenia is way too high. Schizophrenic patients will be overrepresented in nursing homes because they are less able to care for themselves in old age, but that's still an unbelievably high number. These misdiagnoses are what we should be focused on.

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 Medicare. This system exists (primarily in the West) due to a combination of taboos surrounding death and profit/political incentives on the part of pharmaceutical and care home companies.

FYI: for people who don't know what's really going on.

The homes in the US are prescribing unnecessary medication for 3 reasons:

1) To bill for the medication and dose administration.

2) To bill for the skilled nursing staff.

3) To make the resients more docile, reducing caretaking costs.

These perverse economic incentives greatly impact the residents' health.

It's important, especially in the US, for all patients to have an advocate (asking questions and helping to make good decisions) mediating between the patient and provider. Ideally that's a family member.

Besides over-medication risks, there are also lawyers fleecing the elderly out of their assets. It's low-risk to the lawyers because elderly patients die, and what's the family going to do - sue a lawyer?

Source: San Jose Mercury News has had several articles on this over the years.