THE BURNED OVER DISTRICT

But that does not stop nursing homes specializing in dementia patients from shooting up said patients with powerful antipsychotic drugs, despite their being contraindicated on the label.

The FDA has approved antipsychotics for use in schizophrenia and bipolar disorder, but advocates for the elderly say antipsychotics are often used off label as “chemical restraints” to sedate residents who are agitated or aggressive.

A Government Accountability Office report this year found one-third of nursing home residents with dementia receive antipsychotics. The national average for all nursing home residents is 18 percent.

Tony Chicotel, staff attorney for California Advocates for Nursing Home Reform, said antipsychotic use comprises a very small part of the overall formula determining how many stars a nursing home receives.

“The five-star rating system is sort of ‘enforcement light,’” he said. “It’s not telling facilities if your rate is high, you’ve done something wrong. If you’re drugging people without the necessary clinical indications, you’ve done something wrong, and you’re going to have to pay for it.”

Chicotel said too many nursing homes continue to see antipsychotics as a quick solution for residents’ difficult behavior

“It’s easy to call the physician and get a prescription and give it to them and suddenly they’re quiet,” he said.

Guerrero said she didn’t realize at the time her mother was receiving the antipsychotic Risperdal, which is approved for use in adults with schizophrenia. She did notice her mother would often look like she was in “a trance” and sometimes fall asleep in the middle of visits.

“I would ask the nurses, ‘Why is she so sleepy? They said, ‘Oh, she probably was up pretty late last night.’”

Neither Idle Acre, nor the nursing home’s owners, Sabu Enterprises, returned repeated phone calls from America Tonight...

Dr. Helen Kales, founder and director of the University of Michigan’s Program for Positive Aging, examined data on more than 90,000 patients at Veterans Affairs hospitals. She found that antipsychotics are much more dangerous than previously believed in people with dementia.

Looking at the effect over a six-month period, Kales found the antipsychotic Haldol caused an additional death for every 26 patients with dementia receiving the drug. For Risperdal, the rate was one additional death for every 27 patients; Zyprexa, one additional death per 40 patients; and Seroquel, one in 50.

Kales and her collaborators also found that risk went up with higher doses. Patients receiving several antipsychotics at once face the highest risk.

“We see this antipsychotic use, not because doctors are bad or greedy or because they're trying to do the wrong thing, but because they're faced with such difficult problems clinically and that is the behavioral symptoms of dementia,” Kales said.

Classic treatment of the symptoms. But who is really trained to deal with a medical problem that the patient can't tell you about? Until someone knows what agitates these patients, doctors will continue to shoot them up to keep them quiet.