Government pushes nursing homes to give patients less anti-psychotics

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Federal officials seek to raise the bar for nursing home evaluations

Many nursing residents are being unnecessarily and even dangerously medicated with anti-psychotic drugs, federal audits over the last several years have proven.

Now nursing homes are being graded on how much they use such drugs.

Nearly 20 percent of all nursing homes got the lowest possible score on the new measure of anti-psychotic drug use, according to an analysis by USA Today. The national average percentage of patients receiving those drugs in nursing homes is 19.5 percent. The rate in Tennessee is 23.1 percent, and it's 20.5 percent in Georgia.

The federal government targeted anti-psychotic overuse in nursing homes in 2011, after an audit showed the industry used the drugs to sedate or suppress patients who displayed troubling behaviors from Alzheimer's and dementia.

Anti-psychotics are mainly approved for people with mental illnesses such as schizophrenia, and can be dangerous for those with conditions like dementia.

"Difficult behaviors from people who have Alzheimer's and dementia are common, and can be difficult to address," said Amy French, manager of programs for the Alzheimer's Association Mid-South Chapter. "It would never be recommended to use medications only to deal with difficult behaviors. You need to have staff who are trained to intervene properly."

Of 2.1 million elderly nursing home residents, about 14 percent had at least one Medicare claim for an atypical anti-psychotic drug, a 2011 federal analysis found.

But by the end of 2013, nursing homes use of such drugs had fallen by 15 percent. The agency is aiming for a 30 percent reduction by the end of 2016.

"We have made really good progress trying to bring that number down over the last several years. ... But the ratings show that we have not gotten them down enough," said Jesse Samples, executive director of the Tennessee Health Care Association, which represents nursing homes across the state.

Local advocates for those with dementia and Alzheimer's said they were glad to hear that more scrutiny is being placed on the issue of prescribing drugs appropriately.

"The fact that it has reached a point where policies are changing shows that this issue has been of great concern for families who have had a loved one in a nursing home," French said.

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