The chair of a powerful United States Congressional committee has issued a powerful call to end the inappropriate use of antipsychotic drugs to sedate older people in nursing homes, calling it a “crisis.”
In a sharply-worded letter to the US Centers for Medicare and Medicaid Services (CMS), which regulates nursing homes, Richard Neal, chairman of the U.S. House of Representatives’ Ways and Means Committee, criticized CMS, saying that “data suggest nursing facilities are getting away with this practice” of inappropriate use of medication, “neither being cited nor penalized” including due to CMS’s insufficient enforcement of US laws.
The letter goes on to level a concern that while CMS has pointed to fewer cases of older people receiving medication not approved for their condition as a sign of improvement, this decrease may be partly the result of “some nursing homes falsifying psychosis diagnoses,” so that they can now justify prescribing antipsychotic medications to those patients.
Neal also rightly recognizes inappropriate medication in nursing homes as a human rights issue. In a 2018 report, “’They Want Docile:’ How Nursing Homes in the US Overmedicate People with Dementia,” Human Rights Watch documented nursing facilities’ inappropriate use of antipsychotic drugs in older people as well as the administration of the drugs without informed consent, both of which occur mostly as the result of inadequate enforcement of existing laws and regulations.
CMS should strengthen its enforcement of federal regulations regarding antipsychotic drugs. Residents and their families should be told they have the right to be informed of treatment alternatives and their right to refuse. The government should ensure nursing homes employ enough staff to provide adequate care.
An industry paid billions of public and private dollars cannot justify these practices, nor can regulators justify failures to hold nursing homes accountable. Committee Chairman Neal and others should continue to press CMS for answers and for rights-respecting changes.