“Chemical Restraint” Use Reduced In Nursing Homes With Proper Staff Training: Study

The findings of new research highlight how properly trained nursing home employees are less likely to give residents with dementia controversial antipsychotics, which could place the lives of elderly and disabled patients at risk. 

In a study published this month in the medical journal JAMA Internal Medicine, researchers with the University of Massachusetts Medical School found that training nursing home staff members to train other employees on the proper care of residents with dementia led to a reduction of the use of antipsychotic medications, which are commonly given the residents as a form of “chemical restraint.” However, the medications do not actually treat dementia and have been found to increase the risk of death.

Researchers looked at the effects of an educational program known as OASIS, which taught nursing home employees to see challenging behaviors by residents as an attempt to communicate unmet needs, and to anticipate and address those needs.

The study involved 93 nursing homes enrolled in the OASIS program, 27 of which had a high prevalence of antipsychotic use. The results were compared to antipsychotic use in 831 nursing homes that did not involve the training.

According to the findings, atypical antipsychotic prescribing dropped 7.6% in facilities in the OASIS program, compared to 3.9% reduction in other nursing homes. However, the researchers noted that the reductions did not continue in the three-month maintenance period after the classes were completed.

“Antipsychotic use prevalence declined during OASIS implementation of the intervention, but the decreases did not continue in the maintenance phase,” the researchers determined. “This study adds evidence for nonpharmacological programs to treat behavioral and psychological symptoms of dementia.”

Antipsychotic medications like Risperdal, Zyprexa, Seroquel and others may pose serious risks when prescribed for “chemical restraint”. In many cases, patients receiving these medications in nursing homes suffer from dementia, and studies have shown that antipsychotics not only provide no benefits for dementia patients, but could increase their chance 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. Given what is known about the potential side effects of antipsychotics, use of the medications is often considered a form of elderly abuse when the purpose is to sedate the individual, rather than treat.

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.