COURANT: Killing old people with the psych drugs
Foley Hearts Chuck
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Subject: COURANT: Killing old people with the psych drugs
Date: Mar 2, 2008 6:06 AM
They know what they're doing. They're trying to kill these patients,
since
the heavy drugging causes heart damage and weakness. It happens to be
against the
American Psychiatric Association's guidelines to treat dementia with
CNS depressants:
http://www.actionlyme.org/PHILLIPS_AND_MARCUS_PERJURY.htm
This is exactly what Yale's James Phillips and DMHAS' Kenneth Marcus
perjured
themselves about during my bag job.
It's more than a bit off the charts cowardly for a Freudian to perjure
himself
to avoid a malpractice lawsuit:
http://www.actionlyme.org/KFORSCHNER_ON_FDA_EXHIBIT_A.htm
They're trying to kill these patients with these drugs, and certainly
Ely-Lilly
knows it, since that was what the big cover-up and lawsuits were
about, which were
reprinted in the New York Times, and which had to be retracted due to
a judge's
order.
http://psychrights.org/about/Gottstein.htm
Many people saved this Ely Lilly data before they were ordered removed
the web,
including myself.
It would have been better just to read the science I gave the State,
since now the
State is eligible for all sorts of wrongful death suits, including
that of the Burgos
boy who hanged hinself in the pediatric prison, after DCF bagged him
again and threw
him in jail because he refused the psych meds duh DCF was forcing on
him.
http://www.actionlyme.org/BURGOS_SUICIDE.htm
You can see how popular the examination of this psychiatric baloney
is:
http://www.actionlyme.org/08_Feb_top_AL_pages.htm
http://www.actionlyme.org/AL_2007.htm
Kathleen M. Dickson
http://www.actionlyme.org/JAMES_PHILLIPS_HOMEPAGE.htm
Former Pfizer Analytical Chemist
==================
courant.com/news/health/hc-
druggedresidents0302.artmar02,0,2380275.story
Courant.com
Low Risk, Heavy Drugs
State's Nursing Homes Might Be Overusing Antipsychotics
BY LISA CHEDEKEL
Courant Staff Writer
March 2, 2008
Connecticut's nursing homes dole out antipsychotic drugs to residents
who do
not have psychotic disorders at one of the highest rates in the
country, raising
questions about whether the medications are being used to subdue
agitated patients
because of a lack of staffing and attention to alternate treatments.
Federal data from the Centers for Medicare & Medicaid Services show
that since
2005, Connecticut has consistently ranked in the top four states in
the prevalence
of antipsychotic drugs dispensed to nursing home residents who have no
psychotic
or related conditions. In the most recent quarterly report, through
September 2007,
only Louisiana had a higher prevalence rate than Connecticut, where
more than 26
percent of residents who lacked an appropriate psychiatric diagnosis
were prescribed
antipsychotics.
Nationally, the prevalence rate is 19.8 percent, with several states,
such as Florida,
Pennsylvania and New Jersey, well below that average.
"This is not a good indicator" for Connecticut, said Charlene
Harrington,
an expert on nursing home quality and professor of sociology and
nursing at the
University of California-San Francisco. "One of the main factors [for
a high
medication rate] is not having enough staff. If patients are having
behavioral problems,
it's easier to give them a pill to keep them quiet" than to hire more
staff.
"It's cheaper. They'll sleep a lot."
Nursing-home staffing is now a focus of state lawmakers, who are
weighing proposals
that would update the state's minimum staffing standards to nationally
recommended
levels. The existing standards are more than 25 years old and rank
among the least
stringent in the country. The staffing proposals were prompted by a
series in The
Courant that detailed the troubled patient-care and financial history
of one of
the state's largest chains, Haven Healthcare, which filed for
bankruptcy after
the stories appeared.
Federal data from the past three years show that Connecticut has
ranked highest
or second-highest among states in the prevalence of antipsychotic use
among "low-risk"
nursing home residents, defined as those who do not exhibit cognitive
impairment
and behavioral problems. In the most recent reporting period, 23.3
percent of low-risk
residents were receiving antipsychotics, compared with the national
average of 16.5
percent.
Among "high-risk" residents who do exhibit those problems, Connecticut
prescribes antipsychotics at the highest rate in the country -- 55.2
percent, compared
with the national average of 42.5 percent, according to data from the
most recent
reporting period.
The Nursing Home Reform Act of 1987 mandates that residents be free
from "chemical
restraints" imposed for the purposes of discipline or convenience.
Federal
guidelines allow nursing homes to administer antipsychotic drugs to
residents with
dementia-related behavioral symptoms, but they require that residents
meet specific
clinical criteria and receive gradual dose reductions and behavioral
interventions
in an attempt to wean them off the medications.
Although the newer antipsychotics, called atypicals, are approved only
for bipolar
disorder and schizophrenia, doctors routinely prescribe them "off-
label"
to quiet behavioral problems associated with dementia or Alzheimer's
disease.
The use of such drugs in nursing homes has grown in recent years,
despite studies
questioning their benefits and highlighting their risks.
The most commonly prescribed antipsychotics carry Food and Drug
Administration "black
box" warnings that elderly dementia patients using them face an
increased risk
of death. In addition, studies have shown that the drugs most commonly
prescribed
off-label for Alzheimer's patients are no more effective than placebos
for most
people, and carry side effects that include confusion, sleepiness and
rigidity,
which can increase the risk of falls.
State public health officials say they are not sure why Connecticut
nursing homes
have a high rate of dispensing antipsychotics to residents who lack an
appropriate
diagnosis. They say that their prevalence data might be better
reported than other
states, and they note that the health department has been aggressive
about citing
homes for medicating residents unnecessarily.
Some health officials suggest that the prevalence rate is high because
Connecticut
has a relatively large proportion of residents who are over age 80 and
who have
dementia-related problems.
"One of the reasons could be we have a large number of seniors in our
[nursing
home] population. Our population is getting older. Our dementia
numbers are probably
increasing," said Barbara Cass, the state health department's program
manager
for the Medicare survey program.
But Connecticut nursing homes do not have especially high numbers of
residents diagnosed
with dementia or other psychiatric conditions in comparison with other
states, according
to federal data. In 2006, 46 percent of Connecticut's nursing home
residents
had a dementia diagnosis -- slightly higher than the national average
of 45 percent,
but lower than 22 other states. About 15 percent of Connecticut's
nursing home
residents had other psychiatric diagnoses, lower than the national
average of 20.5
percent.
Those figures account for residents with specific diagnoses, but they
do not include
all residents who exhibit dementia-related behavioral problems.
Dr. Harry Morgan, a geriatric psychiatrist in Glastonbury, said he was
disturbed
to learn that Connecticut ranks high in its rate of dispensing
antipsychotics to
residents without diagnoses. He said that the protocol he advocates as
a consultant
to nursing homes calls for clinicians to try behavioral interventions
and examine
possible physical causes for agitation before considering
antipsychotics.
"There are times in which patients with dementing illnesses are in
such distress,
to do nothing would be inhumane," Morgan said. "But in some nursing
homes,
what you see is a knee-jerk reaction -- they'll put someone on a
neuroleptic
[or antipsychotic] ... in hopes of a quick fix tonight."
"The use of these medicines can be appropriate, but it is not
appropriate to
use them as an alternative to adequate staffing," Morgan said. "People
shouldn't approach them as a first-line treatment. ...We have to work to
drive
down the usage of antipsychotic drugs."
Toby Edelman, an attorney with the Center for Medicare Advocacy Inc.
in Washington
said that in the 20 years since the nursing-home reform law was
passed, the industry
has focused more on reducing the prevalence of physical restraints
than on limiting
chemical restraints.
Medication "is not as visible as physical restraints, so it's used as
a
substitute," Edelman said. "That's hardly what the [reform act] was
intended to do."
Edelman and Harrington said that a high prevalence of antipsychotic
use in a nursing
home can be an indicator of inadequate staffing. Non-pharmacological
interventions
for residents with dementia, such as recreational activities, exercise
and one-on-one
attention, require extra staff.
"You have to have the time to spend with people," Harrington said.
On average, nursing homes in Connecticut provide about 3.7 hours of
care per resident
a day -- 1.4 hours by licensed or registered nurses, and 2.3 hours by
certified nursing
assistants.
Other states have taken steps to boost staffing to levels recommended
in a study
commissioned by the federal government: 4.1 hours of care per resident
a day.
Connecticut homes have had little incentive to boost staffing, in part
because state
law requires only 1.9 hours of nursing care a day. The state health
department has
rarely ordered individual homes to increase their staffing levels.
But federal data do suggest that Connecticut is more aggressive than
other states
in citing nursing homes for administering unnecessary antipsychotic
drugs and other
medications.
In the latest surveys, state health inspectors cited 21.7 percent of
Connecticut's
244 licensed homes for administering "unnecessary drugs" to residents,
a rate higher than the regional average of 14.7 percent and the
national average
of 18 percent. Although unnecessary drugs can include all kinds of
medication, the
citation frequently is issued for improper use of psychoactive drugs.
Cass, the health department program manager, said that Connecticut has
been "very
astute" in identifying unnecessary drug violations, in part because
the state
uses a more in-depth inspection process than many other states. In
each nursing
home, inspectors closely review the medication records of a sampling
of residents
to ensure that there are appropriate diagnoses, she said. In addition,
the health
department flags homes with high rates of prescribing antipsychotics
and conducts
"more focused reviews" of those facilities.
Inspection data show that the state has issued more than 110 citations
to nursing
homes since October 2005 for administering unnecessary drugs. Eleven
homes have
been cited twice for that violation, with the second citation coming
within a year
of the first. Among the homes cited twice was Wethersfield Health Care
Center, which
was included on a recent federal list of 54 of the most poorly
performing nursing
homes nationwide.
Eight homes owned by Haven Healthcare have been cited for unnecessary
drugs in the
past two years, federal records show. Haven's chain of 15 Connecticut
homes
filed for bankruptcy in November after The Courant's stories detailed
the chain's
repeated patient-care deficiencies, lower-than-average staffing and
serious financial
problems.
The improper use of psychotropic drugs at one Haven home in Torrington
led the health
department to issue a consent order against the home in December 2006
that mandated
closer monitoring of residents receiving antipsychotics. State health
inspectors
had cited the home for seven cases in which it failed to justify the
use of antipsychotic,
antidepressant or sedative medications, or to monitor residents for
side effects.
In one of those cases, a resident receiving five such medications,
without an appropriate
diagnosis, was found to be in such declining health that hospice was
called -- until
a physician was alerted and ordered a reduction in the drugs. The
resident's
mental state then rebounded: "The agitation and anxiety are gone, the
resident
is much more alert [and] vital signs are stable," the state health
inspection
report says.
More recently, in November 2007, state health inspectors imposed a
consent order
and two years' probation on Haven's home in New Haven for myriad
violations,
among them failing to justify and monitor the use of antipsychotic
medications prescribed
to two residents. The New Haven home also was cited for low staffing
levels.
Nationally, the rate of prescribing psychoactive drugs in nursing
homes has been
rising in recent years, with a 2005 study showing that antipsychotic
use in 2000-01
had reached the highest level in more than a decade. That study,
headed by a University
of Massachusetts Medical School researcher, found that about one-third
of nursing
home residents receiving antipsychotics had "inappropriate
indications"
for the drugs.
In 2005, the taxpayer-funded Medicaid program -- the main payer for
drugs prescribed
in nursing homes -- spent more than $5 billion on antipsychotics such
as Risperdal
and Seroquel, which retail for several dollars per pill.
Since the FDA warnings, some doctors increasingly have turned to
antidepressants
to treat the agitation and psychotic symptoms associated with
dementia. Morgan said
that depression can be an underlying cause of agitation, and he noted
that antidepressants
don't carry the adverse side effects -- or expense -- of antipsychotics.
Morgan said that although most Connecticut nursing homes have a large
proportion
of residents with dementia-related symptoms -- 50 percent to 70
percent, in his estimation
-- many homes "don't think of themselves as dementia-care facilities,
in
terms of having special expertise" or extensive training for staff.
That needs
to change, he said.
"We have to begin to shift the model of dementia care away from
skilled-nursing
facilities, so that we also focus on behavioral interventions [and]
recreational
and interpersonal activities," Morgan said. "Staffing certainly has to
be looked at, but so does the training of that staff."
Contact Lisa Chedekel at lche...@courant.com.
Copyright (c) 2008, The Hartford Courant
cowabun...@yahoo.com
YOURSELF A FAVOR AND SCROLL ON BY
Foley Hearts Chuck
wrote:
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>
> Subject: COURANT: Killing old people with the psych drugs
>
> Date: Mar 2, 2008 6:06 AM
>
> They know what they're doing. They're trying to kill these patients,
> since
> the heavy drugging causes heart damage and weakness. It happens to be
> against the
> American Psychiatric Association's guidelines to treat dementia with
> CNS depressants:http://www.actionlyme.org/PHILLIPS_AND_MARCUS_PERJURY.htm
> This is exactly what Yale's James Phillips and DMHAS' Kenneth Marcus
> perjured
> themselves about during my bag job.
> It's more than a bit off the charts cowardly for a Freudian to perjure
> himself
> to avoid a malpractice lawsuit:http://www.actionlyme.org/KFORSCHNER_ON_FDA_EXHIBIT_A.htm
>
> They're trying to kill these patients with these drugs, and certainly
> Ely-Lilly
> knows it, since that was what the big cover-up and lawsuits were
> about, which were
> reprinted in the New York Times, and which had to be retracted due to
> a judge's
>
> Many people saved this Ely Lilly data before they were ordered removed
> the web,
> including myself.
>
> It would have been better just to read the science I gave the State,
> since now the
> State is eligible for all sorts of wrongful death suits, including
> that of the Burgos
> boy who hanged hinself in the pediatric prison, after DCF bagged him
> again and threw
> him in jail because he refused the psych meds duh DCF was forcing on
>
> You can see how popular the examination of this psychiatric baloney
> is:http://www.actionlyme.org/08_Feb_top_AL_pages.htmhttp://www.actionlyme.org/AL_2007.htm
>
>
> read more »
cowabungabartn...@yahoo.com
>
> read more �- Hide quoted text -
>
> - Show quoted text -
lipanz
> IGNORE KRAZY KATHLEEN'S OFF TOPIC CROSS POSTED GARBAGE SPAM DO
> YOURSELF A FAVOR AND SCROLL ON BY
Kathleen is not crazy. That article is absolutely correct. Absolutely
correct. I've seen it. Plus a lot of hospitals after they messed up
on the patient and they know they are going to die send them then to a
nursing home there plus also leaving off (no accident) one of the
patients most important meds. Kathleen may be under a lot of stress
but I'll tell you she speaks the truth. Let her go. She has a right
to post also off topics just like you do. Let go.................They
say the truth hurts.
cowabun...@yahoo.com
Kathleen: The following are NOT permitted:
1. Off topic materials except for an occcasional post with OT
2. Posts with offensive defamatory materials in the title
3.Posts with offensive defamatory materials in the post itself
4. Cross posting
5. Insane conspiracy theories
6. Your lies
Foley Hearts Chuck
>
> Date: Mar 2, 2008 6:06 AM
>
> They know what they're doing. They're trying to kill these patients,
> since
> the heavy drugging causes heart damage and weakness. It happens to be
> against the
> American Psychiatric Association's guidelines to treat dementia with
> CNS depressants:http://www.actionlyme.org/PHILLIPS_AND_MARCUS_PERJURY.htm
> This is exactly what Yale's James Phillips and DMHAS' Kenneth Marcus
> perjured
> themselves about during my bag job.
> It's more than a bit off the charts cowardly for a Freudian to perjure
> himself
> to avoid a malpractice lawsuit:http://www.actionlyme.org/KFORSCHNER_ON_FDA_EXHIBIT_A.htm
>
> They're trying to kill these patients with these drugs, and certainly
> Ely-Lilly
> knows it, since that was what the big cover-up and lawsuits were
> about, which were
> reprinted in the New York Times, and which had to be retracted due to
> a judge's
>
> Many people saved this Ely Lilly data before they were ordered removed
> the web,
> including myself.
>
> It would have been better just to read the science I gave the State,
> since now the
> State is eligible for all sorts of wrongful death suits, including
> that of the Burgos
> boy who hanged hinself in the pediatric prison, after DCF bagged him
> again and threw
> him in jail because he refused the psych meds duh DCF was forcing on
>
> You can see how popular the examination of this psychiatric baloney
>
> Kathleen M. Dicksonhttp://www.actionlyme.org/JAMES_PHILLIPS_HOMEPAGE.htm
>
> read more »