California Nursing Home Abuse Lawyer Blog

In 2007, Dr. David Graham, a drug safety expert with the FDA, testified before Congress and stated that approximately 15,000 people die each year in U.S. nursing homes from the off-label use of anti-psychotic drugs. Off-label use is the use of the drug for a condition it was not intended. In California, it has been estimated that up to 60% of all nursing home residents are given psychoactive drugs, which is an increase of 30% in only 10 years. It's no wonder that when we think about nursing homes, we think of isolated elderly people sitting hunched over in wheelchairs, or in bed, segregated from the world. That life is a sad realty for many.

To combat the misuse of psychoactive drugs, the California Advocates for Nursing Home Reform have released a publication called Toxic Medicine - What You Should Know to Fight the Misuse of Psychoactive Drugs in California Nursing Homes. The 20-page booklet provides an overview of what psychoactive drugs are, their purposes, the risks associated with them, and an overview of the resident's rights.

Primary among those rights is the requirement of consent. Before a psychoactive drug can be used, a physician must inform the resident (or his/her decision-maker) about the drug, why it is being recommended, and the risks associated with it, and then must obtain consent before prescribing it. The guide also provides a list of questions that should be asked of a doctor who is recommending a psychoactive drug, and what to do if it is suspected that the drugs are being used without proper authority.

The California Advocates for Nursing Home Reform is a San Francisco based nonprofit dedicated to improving the lives of long-term care patients since 1983.

A .pdf of the Toxic Medicine booklet can be found by clicking here.

The nursing home abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults who have been abused or neglected in the nursing home and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

This story is flat-out disturbing, and started with a concern we have heard many times from the families of our nursing home abuse clients. It began with Phyllis Peters could not wake up her 97-year-old mother, who was residing in Kern Valley Nursing Home. When she complained to Gwen Hughes, the nursing home's director, Hughes would "chemically restrain" the patient by giving her powerful anti-psychotic drugs to shut her up. Hughes did this to other residents in the nursing home, and three of them died.

In a report from the California Attorney General, Hughes ordered one patient drugged because she "glared" at her. Another was given high doses of an anti-psychotic drug for throwing a carton of milk. Several residents became severely malnourished, and were left in bed drooling and emaciated.

"In a couple cases, elderly people were actually held down, restrained against their will, and given excessive amounts of medicine to keep them quiet," said AG Jerry Brown.

But here's the stunner. Hughes had been fired from a previous nursing home for over-drugging there. When the previous employer was called as a reference for the job at Kern Valley, they failed to explain why Hughes was terminated out of fear of lawsuits (ironically, since now they will become a part of a huge lawsuit). As a result of the deaths, Hughes, administrator Pamela Ott, and physician Hoshang Pormir have been charged with criminal elder abuse, all facing up to 11 years in jail. Lawsuits by the surviving family members, and probably others, are certain to follow. The FDA estimates that unnecessary anti-psychotics kill 15,000 nursing home patients each year.

Source: ABC News

The elder abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults throughout California who have been abused or neglected in the nursing home and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

The Chicago Tribune recently published a brief article called 5 Things to Know about Psychotropics, which I thought I would pass along to you. Here are the five things:

Your rights: A nursing facility cannot administer a psychotropic drug without a physician's order, which by law requires informed consent and a legitimate diagnosis. The standard of care requires that nursing staff must first try to calm patients, and other possible causes of agitation must be ruled out, such as infection.

The consent: Before psyschtropics can be used consent must be obtained by the "responsible party" of the resident, usually the person with power of attorney. The consent must be in writing.

The drugs: What are psychotropic drugs? Psychotropics generally include antipsychotics, antidepressants and anti-anxiety drugs. The antipsychotics generally pose the greatest risks to nursing home residents. Remember, antipsychotics are intended to treat serious mental illnesses, such as schizophrenia, but doctors may prescribe them for other uses. They cannot be used as a "chemical restraint."

The risks: As stated, psychotropic drugs are powerful, and can cause drowsiness, dizziness and confusion. This, in turn can lead to falls, dehydration, and extreme lethargy.

To complain: As a first step, contact the nursing home's administrator. If you are not getting the answers you need, contact the local ombudsman's office or the California Department of Public Health. Telephone numbers for the offices of the ombudsman and CDPH in all Southern California counties can be found by clicking here.

Source: Chicago Tribune

The Walton Law Firm represents seniors and dependent adults who have suffered neglect or abuse in the nursing home, residential care, or board-and-care setting. Cases are taken in all Southern California counties. For a free and confidential consultation call (866) 607-1325, or fill out an online form.

The administrator of Kern Valley Hospital was charged eight counts of felony elder abuse this week after permitting caregivers to forcibly administer psychotropic drugs to residents out of convenience and not medical necessity. One resident died because of the practice.

Since 2006 the director of nursing at Lake Isabella nursing home has allegedly ordered caregivers to administer high doses of psychotropic medications to Alzheimer's and dementia patients to control their behavior and make them easier to care for. This use of medications as a "chemical restraint" is illegal, and will likely expose the nursing home to civil lawsuits in addition to the criminal charges that have been filed.

According to news reports, three residents may have died as a result of the practice. The residents who died were Mae Brinkley, 91, Joseph Shepter, 76, and Alexander Zaiko, 85.

Last February three other employees were arrested and charged in the case, all of whom worked for the Kern Valley Healthcare District nursing home in Lake Isabella.

Source: Bakersfieldnow.com

The elder abuse lawyers at Walton Law Firm LLP provide free consultations to individuals and families who believe a loved one has been abuse or neglected in a Southern California nursing home or assisted living facility.

Three California nursing home employees were arrested yesterday for allegedly injecting 22 residents with mood-altering drugs to keep them quiet and restrained. According to the criminal complaint, a nursing director, a pharmacist, and a physician drugged the residents in order to keep them compliant and easier to care for. Three of the patients died.

“These are powerful medications that were given, in some cases against people’s will, primarily for management, not health reasons,” said California Attorney General Jerry Brown. “It's unconscionable behavior and it’s certainly not what people expect when they entrust their parents or grandparents to a skilled nursing home.”

The allegations in the criminal complaint are appalling, including residents becoming "zombie-like" and unable to eat or drink for days, causing severe malnutrition and dehydration. The three residents who died were Fannie May Brinkley, Eddie Dolenc, and Joseph Shepter. At least one civil lawsuit has been filed as a result of the deaths, and more are expected.

The use of powerful narcotics as chemical restraints is an ongoing problem in nursing homes. Under California law, a resident, or his/her responsible party must be thoroughly informed about the risks associated with anti-psychotic medications, and must approve any request for us. These medications must also be administered only with a doctor's order.

New research shows that elderly people suffering from dementia who are given antipsychotic drugs are more likely to end up in a hospital or die, even if the drugs are administered for a very short period of time.

Antipsychotic drugs are frequently used in nursing homes to address the behavioral issues caused by dementia, including aggression, agitation, and delirium. Physicians concede that alternatives to antipsychotics to address this type of behavior are limited.

Many experts feel behavioral interventions should be tried first and antipsychotics used as a last resort, "when the behavior or the psychiatric symptoms are really out of control and causing complete distress not only for the person suffering from Alzheimer's, but for caregivers all around them," said Maria Carrillo, director of medical and scientific affairs at the Alzheimer's Association in Chicago. "It's important to work these things out with the physician and, of course, do follow-up very closely together, so you can make sure these antipsychotics are having the effect you want and, if not, discontinue them immediately."

The study's findings were presented in the most recent edition of the Archives of Internal Medicine.

Medicaid spends more money on antipsychotic drugs than any other prescription drug. Physicians are prescribing these powerful drugs in record numbers to nursing home residents in order to control their behavior, not for the treatment of psychotic illness.

It is reported that nearly 30% of the total nursing home population is receiving medication in a practice that is known as "off label use" of prescription drugs. It's no surprise to lawyers who practice this area that studies also reveal that nearly 21% of nursing facility residents being given these drugs do not have a psychosis diagnosis.

"You walk into facilities where you see residents slumped over in their wheelchairs, their heads are hanging, and they're out of it, and that is unacceptable," says Christie Teigland, director of informatics research for the New York Association of Homes and Services for the Aging, a not-for-profit industry group. Her research, which she believes reflects national trends, shows that about one-third of dementia patients in New York's nursing homes are on antipsychotics; some facilities have rates as high as 60% to 70%. "These drugs are being given way too much to this frail elderly population," Dr. Teigland says.

Here at Walton Law Firm we frequently get calls from families angry at nursing providers for over-medicating loved ones. It's usually a similar story. The family stops by the facility for a visit, only to find their loved one non-communicative and listless, and sometimes incontinent.

The Centers for Medicare & Medicaid -- the federal agency that oversees the two huge tax-funded insurance programs that cover the elderly and the poor -- has "initiated a more rigorous process to oversee appropriate use of medicine," says Chief Medical Officer Barry Straube. He says the number of nursing home inspections that result in citations for violating drug-misuse rules has jumped by nearly 50% between 2004 and this year. Action is being taken and the increased vigilance is working, CMS says.

Dr. Straube says CMS -- which both funds and oversees nursing homes -- "is very concerned about the quality of care in nursing homes and has taken steps within its authority to discourage inappropriate use of all drugs, including psychotropic medications."

High use of antipsychotics in a nursing home can be an indicator of inadequate staffing or other negligent care, says Bruce Pollock, president-elect of the American Association of Geriatric Psychiatry. "We know the more staffing there is and the higher quality of care, the less the antipsychotic usage," he says.

If you have concerns that someone you know is being over-medicated contact the resident's primary physician immediately.