Overmedication, like dosage errors, is a serious concern, especially for the elderly population. Unlike young, healthy people, the elderly frequently have a diminished ability to metabolize and eliminate medications in their system. A decrease in enzymatic activity in the elderly or liver damage may reduce the older adult’s ability to metabolize medication. If a senior has a lower ability to metabolize a medication, it’s half-life is prolonged and the risk of adverse drug reactions increases.
Overmedication in Nursing Homes
Additionally, the elderly may experience changes in their ability to eliminate medication secondary to compromised renal function. As the body ages, renal function declines as the result of physiological changes, such as a reduction in blood flow to the kidneys, a decrease in kidney mass, and a reduction in the size and number of working nephrons. Renal failure is a medical condition in which the kidneys fail to properly filter waste products from the blood. Since many medications are excreted renally, it’s imperative that the facility regularly performs laboratory testing to monitor kidney function and make dose adjustments accordingly.
Unfortunately, dosing errors are common in residents with renal impairment and can cause adverse effects and poor outcomes. Some nursing home facilities overmedicate residents in order to subdue unwanted behaviors. Behavioral disturbances, particularly in residents with dementia and Alzheimers may include restlessness, verbal or physical aggression, yelling out, and sleep disturbances. Facilities may prescribe powerful antipsychotic drugs to control this behavior. In some extreme cases, patients have been forcibly held down while being administered their medications. Intentionally overmedicating a resident to control unwanted behavior is nursing home abuse.
Excessive Doses in Nursing Homes Cause Injuries
Instead, preferred interventions for these types of behaviors include reassurance, redirection, establishing a routine, and explaining care prior to delivery. In other instances, poor staffing and untrained staff may negligently and unnecessarily order mind altering medications that can be dangerous to the elderly, such as anxiolytics or antipsychotics. Unnecessary uses can include insufficient rationale for ordering the drug as well as excessive doses, excessive duration, and inadequate monitoring of patients to whom the drug was given. Overmedication with antipsychotic drugs can lead to adverse side effects, such as increased risk of falls and over-sedation.
If you feel that your loved one is being overmedicated in a nursing home, first contact the local agency on aging, a government agency that specializes in senior citizen issues. These agencies employ Case Workers and Ombudsmen who investigate senior citizen abuse, especially in a nursing home situation. Then contact an attorney with experience investigating and litigating nursing home injury cases.