They Want Docile: Human Rights Watch investigates U.S. nursing homes

HRW has been investigating U.S. nursing homes

When I hear the name “Human Rights Watch,” a well-known, highly-respected nonprofit organization, I expect to hear about authoritarian dictatorships, human traffickers, or abuses of unarmed civilians in war-torn areas of the world. So I was surprised, and a little alarmed, to find that Human Rights Watch has been investigating U.S. nursing homes.

Last month the organization, which has been uncovering and highlighting human rights abuses all over the world for four decades, published an in-depth report showing that many U.S. nursing homes are forcing patients to take antipsychotic drugs, for which they have no appropriate diagnosis.

The HRW report, They Want Docile, asserts that because state and federal laws now strictly limit nursing homes’ ability to tie patients down with physical restraints – a practice that was once common and widespread – many facilities are using medications as “chemical restraints” to make patients passive and easy to handle.

Not only are these drugs being used for an “off-label” purpose, the federal Food and Drug Administration has determined that giving antipsychotic medications to people with dementia nearly doubles the person’s risk of dying. And it’s clear from interviews with family members and patients that the drugs dramatically reduce the individual’s ability to function, participate in their own care, and engage in life.

These are exactly the reasons why the ICS dementia program is based on the principle of caring for members with Alzheimer’s or other forms of dementia using non-pharmacological interventions, whenever possible. We do this both because it creates the best possible quality of life for our members and also because we want to help members avoid medication side effects that can increase their risk of falls or even exacerbate cognitive loss. Rather than rely on drugs, our dementia specialists focus on each individual, getting to know what their unmet needs are, and capitalizing on their strengths.

Among the most alarming details in HRC’s reports are:

  • Nursing homes often threaten to discharge patients if their families object to the medications.
  • The drugs are routinely given without the patient’s informed consent.
  • They are used for an “off-label” purpose – to keep people quiet and manageable – not to treat psychosis.
  • In some nursing homes up to 80 percent of residents are receiving medications inappropriately.

Watch the video to see patients’ and family members’ experiences, and to learn more from the HRC staff who investigated this issue.

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