Boston Personal Injury Lawyers Blog

The number is staggering and suggests a resounding "yes" to the question, are nursing homes over medicating its residents? A reported 71% of nursing home residents are being treated for mental health issues. While I have no doubt that a certain portion of this percentage is necessary and legitimate treatment, I have to wonder what percentage of that number is for unnecessary and illegitimate reasons; namely, to make difficult residents calm and "cooperative." This is form of deliberate over-medicating is a form of nursing home abuse.

What is even more alarming is that of the 71% of residents receiving mental health treatment, most of them received no such treatment in the months leading up to their admission. Now, of course, there can be several factors for this large increase in mental health treatment and I would suspect that nursing home directors would argue that these residents should have been receiving mental health treatment and only received the proper treatment upon admission. The other more cynical view is that once admitted, nursing home staff finds that residents are much easier to deal with when medicated.

Unfortunately, many nursing homes opt for medication as the mental health treatment of choice over therapy or utilizing behavior changes, sometimes upsetting patients. While there are patients - ie. those with advanced dementia or Alzheimer's disease - that are not candidates for therapy sessions due to their illness, there are many residents that may benefit from this modality.

Residents and family of nursing home residents, if they are unable to make decisions for themselves, have the right to opt out of anti-psychotic medications. While I am not advocating and all out ban on these medications, I do urge that residents and families seriously consider the risks and benefits of taking same, discuss other treatment options with their family physician, and make an informed decision about whether these medications are the right choice of treatment and which nursing home is best for their loved ones.

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As The New York Times title declares, Study Finds No Progress in Safety at Hospitals. Since 1999 when the Institute of Medicine conducted a report that discovered 98,000 deaths were the result of medical mistakes in U.S. hospitals, efforts and overhauls were made to improve patient safety. The New England Journal of Medicine (NEJM) evaluated 10 hospitals in North Carolina between 2002 and 2007, which represented a variable cross-section of hospitals throughout the country. The studies found that "harm to patients was common and that the number of incidents did not decrease over time." The number of procedural complications, drugs incorrectly prescribed, hospital-acquired infections, and wrongful deaths did not decrease with the hospitals attempts to do so.

Other studies, however, show that progress in hospital safety would most likely result from the implementation of computerized systems to order drugs for patients, and to report medical errors. 162 of the 2,341 cases recorded during the NEJM study were caused because patients were prescribed the wrong medication. These medical errors were reported voluntarily by patients. Leapfrog Group, a patient safety organization, whose mission it is to "trigger giant leaps forward in the safety, quality and affordability of health care," believes a mandatory monitoring system would great improve the frequency of reports, and hopefully the frequency of errors.

According to The Times Article, Leah Binder, the chief executive officer of the Leapfrog Group, said it was essential that hospitals be more open about reporting problems.

"Right now you ought to be able to know the infection rate of every hospital in your community."

For hospitals with poor scores, there should be consequences, Ms. Binder said: "And the consequences need to be the feet of the American public."

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