If your parent or someone you care for is in an assisted living or long term care home, you need to be aware of what medications they are on. The CBC news site out of Edmonton Alberta posted an article March 6,2012 that warned families to be aware of what their parents were being prescribed if they had dementia. An inquest in Edmonton found that a 61-year old woman died after she was given a double dose of a prescribed medication routinely used as an anti-psychotic drug.
An autopsy report, obtained by CBC News, showed the woman’s death was an “adverse reaction to Olanzapine,” often known by its trade name, Zyprexa.
Olanzapine has been found to increase the risk of death in elderly patients with dementia by 60%.
I knew this information because my mother was routinely prescribed a medication in the xx family for what I can only describe as annoying behaviour. She was not physically aggressive. The only thing staff and residents had to be concerned about was her sometimes abusive tongue.
At the time, my mother was in a private assisted living home waiting for Long Term Care. Our family became more and more concerned as she became increasingly placid, laying in bed all day and really needing to be encouraged to even get up and eat. The thought that she might be over medicated was a concern raised by my family who were able to visit here everyday. I was 3.5 hours away.
I called the staff one day and asked for a list of all of her medications including the doses she was being prescribed. I sat in front of the computer and researched each one. As I did, I became increasingly alarmed. She was on a drug that was clearly on a list of medications health care officials were being warned not to use. It was an anti-psychotic drug and she was not psychotic. Cranky? Yes. But psychotic? No. The reasons were simple: the drugs were not designed for use with patients with dementia and they could cause death. In fact I read a warning about the drug my mother was on. It indicated there could be a slightly increased risk of serious, possibly fatal side effects such as stroke or heart failure when this particular medication was used in elderly patients with dementia. Considering she was regularly treated for congestive heart failure, I had more than a couple of questions.
I asked for the medication to be discontinued. They did wean her off of it. But I found that on at least 3 more occasions the drug was prescribed again.
In June 2005, Health Canada issued an advisory stating that Olanzapine, and other similar drugs, “are not approved for treating behavioural disorders in elderly patients with dementia.” Several studies confirmed that residents of long-term care facilities were being routinely over medicated or inappropriately sedated. We could certainly confirm that claim.
A pattern developed. Whenever my mother was hospitalized, which was at least two or three times a year, her medications would be reviewed. A number of medications would be stopped. A new medication plan would be written out and sent back to the home with her. And then the drugs would slowly be piled on again. I would call for a review of what she was taking. I would ask for something to be discontinued. It was – until her demanding behavior became tiring for staff again.
I did not know until I read it in the CBC article that each time she was put back on the medication, I should have received a phone call to discuss the need for the drug and the potential side effects. But of course I would have said ‘do not prescribe it.’
Anti-psychotic drugs are commonly prescribed to elderly dementia patients despite the fact Health Canada, or its American counterpart, the United States Food and Drug Administration, does not approve them.
Dr. Paula Rochon, a senior scientist at Women’s College Research Institute in Toronto, told the CBC reporter about one-third of all long-term care residents in Canada will be prescribed anti-psychotics. Those resident will be twice as likely to be hospitalized, or die, if they have been newly started on anti-psychotic therapy.
Do you know what medications are being prescribed to a family member in an assisted living or long term care facility? For that matter, do you know what they are being prescribed if they are still living at home alone or with a caregiver? You should.
I understand from my research that there are some circumstances, particularly when a patient has delusions and hallucinations that such strong drugs are required and may need to be used after the family has been consulted.
Working in a residence with the elderly and with patients who have dementia is not easy. I understand that. And no, I have often said I could not do it. But we have to find a way to keep the people we are caring for safe. After all, we make the decision that care in a facility is better for them. But if they fall due to over medication, what have we accomplished? The costs of treating falls by seniors are enormous – but that is for another article.Back To Top