Phony Diagnoses Hide High Rates of Drugging at Nursing Homes
Schizophrenia diagnoses among nursing home residents have surged 70% since 2012, yet the incidence of delusions, hallucinations, and other hallmarks of the disease is down. The disconnect suggests there is no medical basis for many diagnoses, which according to a New York Times investigation, provide a back door for nursing homes to sedate dementia patients with aggressive tendencies or a habit of wandering off. The practice also shields true prescribing patterns from government authorities, who recognize the dangers of using "chemical straitjackets" instead of hiring additional staff. Because older adults are at risk for fatal falls, infections, cardiac complications, and other problems, nursing homes must report how many residents take antipsychotic drugs. Medicare data indicates fewer than 15% of residents take the drugs, but the figure omits patients diagnosed with schizophrenia — one of three conditions excluded from the reporting requirement. The true proportion, the Times estimated after examining unfiltered data, is at least 21%, or about 225,000 older adults. An unusually high rate can damage a site's reputation and hurt its government rating, which in turn can have financial implications. "People don't just wake up with schizophrenia when they are elderly," notes geriatrician Dr. Michael Wasserman, a former nursing home executive. "It's used to skirt the rules." Nursing homes often blame the doctors who diagnose patients and order antipsychotic treatment, but the industry's main lobbyist — the American Health Care Association — is also seeking to augment the list of conditions that do not trigger antipsychotic reporting disclosures.
Read more on the New York Times.