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Psychotropic Drugs Are Prescribed Inappropriately in the Nursing Home

Falling is a common occurrence and a serious problem among the elderly population.  A myriad of studies has found that the use of psychotropic drugs on older adult patients in nursing homes significantly increases the risk of falling.  A recent study published by the Journal of the American Medical Directors Association (JAMDA) examined the relationship between fall occurrence and the prescription of psychotropic drugs and various categories of psychotropic drugs, such as antidepressants, antipsychotics, and benzodiazepines, among a representative nursing home population.

An estimated one-third of community-dwelling older adults experience a fall at least once per year.  This number is even greater among nursing home patients, increasing to incidences as high as 2 falls per bed every year. Injuries from falls can have detrimental long-term consequences, such as bone fractures, soft tissue injuries, and head trauma.  Moreover, the consequences that result from falls can take a major toll on the quality of life of an older adult.  Fear of falling, diminished confidence, and functional disability could eventually result in the loss of independence.

It is well known that nursing homes often give their residents psychotropic drugs.  This JAMDA study sought to assess the association between psychotropic drug use and falls occurring in the nursing home setting.  The study also sought to quantify the degree to which each category of psychotropic drug (antipsychotics, antidepressants, and benzodiazepines) increased the risk of falls.

The study found that benzodiazepines were the most frequently prescribed psychotropic drug to nursing home patients.  Antidepressants were second most prescribed and antipsychotics were third.  A combination of 2 or 3 of the drug types were also commonly prescribed.

The study’s primary finding was consistent with previous studies among nursing home patients.  Researchers found that benzodiazepines, antidepressants and antipsychotics were related to an increased risk of falling, and that the risk was higher for both scheduled prescriptions and prescriptions as-needed.  The study also found that male residents had an 87% higher risk of falling than female residents.  Researchers presume this is due to the fact that male residents are given psychotropic drugs more often.

A recent study that tested the balance of both young and older adult individuals after taking a hypnotic drug found that body sway (meaning, having less balance) was much more pronounced in the elderly subjects than in their younger counterparts. The results gave strong supporting evidence that psychotropic drugs can significantly impair balance and promote postural instability in older adults. Thus, the use of these drugs can greatly increase elderly patients’ risk of falls, hip fractures, and mortality.

One can argue that since these psychotropic drugs are commonly taken by elderly patients at night just before bed, its negative effects are relatively irrelevant.  However, the reality is that most patients wake up at least once during the night to, for example, go to the bathroom. During instances like these, elderly patients may be especially vulnerable to falls due to the psychotropic drug’s disturbing effects on balance.  An older adult could also happen to take the drug past normal bedtime hours, causing impairment to last until the next morning.

Nursing home and assisted living facility staff should take extreme precaution and administer psychotropic drugs to frail and vulnerable senior residents only when necessary.  Older adult patients who are given these types of drugs can be placed at unnecessary risk of falls, hip fractures, and even death. If you or a loved one has experienced a fall or injury due to the inappropriate treatment by a long-term facility staff, contact us immediately for a free consultation. Prescribing psychotropic drugs to a senior who does not necessarily need them heightens the chance of an adverse event that results in an increased risk of mortality. This form of elder abuse is reprehensible and ultimately puts an older adult’s quality of life in jeopardy.

If you or someone you love has been a victim of abuse or neglect by nursing home or assisted living facility staff, such as those in Los Angeles or Manhattan Beach, California, contact the Law Offices of Ben Yeroushalmi today for a free consultation.