U.S. Sen. Richard Blumenthal was in Hartford on Tuesday to highlight efforts to crack down on a form of elderly abuse involving the over-prescribing of antipsychotic meds to dementia patients.
At a state Capitol press conference, Blumenthal outlined legislation he hopes will reduce the instances of “off-label” prescriptions for dementia patients in nursing homes. A drug is considered off-label when a doctor prescribes it for something other than what it’s approved by the Food and Drug Administration.
Although he noted off-label prescribing is not an illegal practice, Blumenthal said it’s often dangerous and even deadly when it’s used as a first response to agitated dementia patients.
“When they are agitated or confused many patients are administered drugs, antipsychotic drugs, extraordinarily powerful medicine that can have dangerous and sometimes lethal side effects for our frail elderly,” Blumenthal said.
He said the practice also cost taxpayers through excessive Medicare claims. Eighty-three percent of all antipsychotic medication claims to Medicare are for off-label prescriptions for elderly patients with forms of dementia, Blumenthal said. Fifty-one percent of the claims were denied by Medicare because the use was deemed medically unacceptable, he said.
“That is a tragic and outrageous misuse of taxpayer funds in the misuse of antipsychotic drugs. It’s a form of elder abuse, chemical restraint no less pernicious and insidious than physical restraint of patients and it should be stopped,” he said.
Blumenthal said drugs like Risperidone can even kill patients when they’re used improperly.
The legislation Blumenthal is proposing will require the informed consent of the family of the patient or some other guardian. The bill would also require caregivers to get more training to discourage the overuse of medications. Blumenthal said the bill has support from both Democrats and Republicans.
Connecticut Long-Term Care Ombudsman Nancy Shaffer said the bill’s informed consent policy would be helpful to the families of people in nursing homes. Often families are unaware their loved ones are being administered powerful medications when they display certain behavior.
Eleonora Tornatore-Mikesh, executive director of the Connecticut chapter of the Alzheimer’s Association, said other forms of treatment can be effective and less damaging than medications. Sometimes things like calming tea or music and touch therapy are effective, she said.
“Have we tried other approaches? Being creative. It doesn’t always work but it is a start,” Tornatore-Mikesh said.
Shaffer said that if a family suspects their relative is being over-medicated, they should talk to the caregiving staff or reach out to the state ombudsman program, which can help sort out the issue.