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“Chemical Restraint” Of Dementia Patients Goes Beyond Nursing Homes: AARP

The unnecessary prescription of antipsychotics to dementia patients has long been considered a type of nursing home abuse in facilities nationwide, but a new report warns that such “chemical restraints” have become an increasing problem in the community at large, and may not be limited to long-term care facilities.

The AARP Public Policy Institute published a report (PDF) on April 20, which indicates that the use of antipsychotics to sedate dementia patients has decreased in nursing homes over the past few years, but the practice has increased for older adults who live at home.

The unnecessary use of antipsychotics, such as Risperdal, Zyprexa, Seroquel and others, pose serious health risks when prescribed for “chemical restraint”.

Studies have shown that antipsychotics use among dementia patients not only provides no treatment benefits, but could increase their risk of dying. The FDA has previously warned against the use of antipsychotics with dementia patients, indicating that the medications provide no benefits and may increase the risk of death.

In this latest study, researchers used administrative claims data for individuals age 65 and older who had dementia and were enrolled in Medicare Advantage plans from 2012 through 2015. They looked at individuals who were living in any location other than a nursing home, and included individuals in assisted living facilities in the study.

According to the findings, antipsychotic use among dementia patients increased among community-living older adults by six percent from 2012 to 2015. The drugs were used more frequently among women than men and more frequently among those who live in the South. The study also found that the older the adult with dementia, the more likely they were to be prescribed antipsychotics.

The study found that 12.6% of community-dwelling older adults with dementia were prescribed antipsychotics in 2012. That increased to 13.4% in 2015.

“It’s concerning that the use of antipsychotic drugs is not decreasing among these dementia patients during a time when antipsychotic use has reportedly dropped substantially among nursing home residents with dementia,” Elizabeth Carter, AARP Public Policy Institute senior health services research advisor, said in a press release. “These drugs are known to be risky when prescribed to elderly patients with dementia.”

In September 2014, the National Partnership to Improve Dementia Care announced that it has set a goal of reducing the use of antipsychotics in long-term care facilities. However, currently about 25% of elderly dementia patients in nursing homes throughout the U.S. are still treated with antipsychotics, even though they may not need the drugs.

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