Worthington Law Group
Injury Law Report

As the population grows and ages, the number of residents in nursing homes is rising. Nursing homes are a growth industry, and more and more for profit nursing homes are opening. Although some of these facilities are very good, some of them put profits ahead of patient care. A recent study shows that the average for profit nursing home has 30% fewer nurses and 45% more problems than its nonprofit counterpart has.

One of the unfortunate side effects of this lower staffing level is an increase in the “chemical restraint” of elderly nursing home residents. Increasingly, nursing homes are using drugs on their residents. This is usually some kind of antipsychotic medication. These drugs are intended to be prescribed to people suffering from psychoses or other mental illnesses. They have multiple side effects for patients including; drowsy or docile behavior, inactivity or confusion. The net result is a larger number of residents can be watched by a smaller number of staff members.

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The degree to which chemical restraints are being used is staggering. Research done in one state shows that more than 70% of new nursing home residents were put on some kind of psychoactive drug within three months of moving in. The research also demonstrated that many residents were placed on a cocktail of different drugs.

The overwhelming majority of these patients had not been diagnosed with a mental illness that required treatment before they moved into a nursing home. The suspicion is that the only reason they were given these drugs was to make them more manageable.

In many cases, these drugs are being given to nursing home residents without a doctor’s prescription. Those who refuse to take the drugs were forced to take them. Beyond the fact that it is unethical to sedate the elderly with drugs that used to keep them quiet, the practice can also have serious effects on the physical health of the resident.

Patients who have been drugged are less active, can lose muscle mass and develop bedsores. The depressive effect these drugs have on patient behavior may cause other injuries, such as fainting or falls. They may also react with other drugs that the nursing home residents are legitimately taking, e.g. blood pressure medication. Finally, these drugs have been linked to an increased risk of death when administered to people suffering from dementia, a common problem among the elderly.

Reaction to the growth of this problem of chemical restraint has been slow in coming. Some laws have been passed that are intended to crack down on the improper use of antipsychotic drugs in nursing homes. Unfortunately, these laws are filled with gray areas and loopholes. The net result is the use of these medications has actually increased since the laws were passed.

Additionally, nursing homes found in violation of these laws (and others) are usually given a chance to come into compliance within a certain period of time. If that happens they are not fined for their violations. This leads to sketchy nursing home operators “yo yoing” in and out of compliance. They fix problems only when forced to by regulators, to the detriment of the residents.

The best defense against a loved one’s being mistreated in a nursing home is a family that is involved and not afraid to ask questions. Nursing homes are less likely to drug a resident if they know the family might drop in at any time. If you have any questions about whether a loved one in a nursing home is being chemically restrained, don’t be afraid to ask. Don’t be afraid to consult our firm if you don’t like the answers .

With the cost of medications sky high, many people engage in a practice known as “pill splitting.” Pill splitting is exactly what it sounds like—splitting a large pill into smaller pieces that contain a smaller dose of the drug. Patients split pills because one large pill often costs less than two or three smaller pills, even if the dosage is identical.

In order to save money, many patients buy the less expensive larger pills and split them in half instead of buying the smaller prescribed pill with the correct dosage. Doctors and pharmacists who are sensitive to the cost of drugs have even been known to recommend pill splitting. It is so common that it is even possible to buy a mechanical pill splitter, a small cutter that makes pill splitting easier.

Unfortunately, a recent study has shown that pill splitting can be dangerous. The most obvious reason is that pill splitting may lead to patients receiving uneven doses. If the patient splits the pill inaccurately, he or she may receive a larger or smaller dose of medicine than intended. This depends on which half of the pill is consumed. Even if the patient is able to split the pill accurately, the amount of the drug in each half may vary from pill to pill.

The study shows that these problems indicate that dosages in split pills can vary by as much as 25%. Obviously, this is a large amount if the drug requires very precise dosing to be effective.

Pill splitting also leads to other, less obvious problems. One is that people who buy a higher dosage pill with the intent of splitting it may forget to do so, ingesting far too much medicine. This is a particular problem for elderly patients, who may be forgetful. Another concern is that even carefully split pills could crumble. If some of the pill ends up as dust this reduces the amount of medicine consumed by the patient.

Finally, some pills are difficult to split, either because they are an unusual shape or because they are harder than average. All of these problems make pill splitting a risky endeavor.

The study suggests that drug companies should routinely make drugs available at all recommended prescription strengths, especially for those drugs where correct dosages are more critical. Another possibility is for drug companies to charge the same price per milligram of drug without concern about the size of the pill. This would reduce the economic incentive to split pills. Until then, caution suggests that a patient should not engage in pill splitting unless it is absolutely necessary. .