The Use and Abuse of Antipsychotic Drugs in the Elderly

The use and abuse of antipsychotic drugs, particularly in the elderly, is a widespread problem.

Physical restraints are generally illegal, especially in the aged and frail because it is so easy injure them using physical bed restraints (tying them to the bed!) They have frail bones and its easy to tear their delicate skin. Not to mention it is degrading and inhumane.  We just don’t tie people up in nursing homes anymore.

Nevertheless, institutions are often horrifically understaffed and those on staff are overworked. So institutions have figured out ways to control their sometimes unruly residents by tying them down invisibly. Particularly those residents suffering from Alzheimer’s or other forms of dementia. Chemical restraints. Specifically, medications that sedate and  make the residents more docile, or simply sleep through the day. The most commonly prescribed of these are antipsychotic drugs – Seroquel, one of the newer class of antipsychotics is one example. Haldol, an older class of antipsychotics is another. There are long lists of these and similar drugs that the FDA has warned should NOT be used in the elderly or dementia patients.  Indeed Seroquel, Haldol and their many “cousins” are dangerous for the elderly and dementia patients especially. So much so that the FDA has mandated a “black box” warning about the use of such drugs. in the elderly.

If you are looking after or advocating for an elder, particularly if they are living in an Assisted Living Facility or Nursing Home, you should be aware of this issue and be on the lookout for it. It is a very widespread problem.

There are people in our community better versed in this topic than I.  Recently, some good friends and colleagues recorded a TV program on the use of antipsychotic drugs in the elderly. I highly recommend it to anyone dealing with an aging loved one. It features:  Elder Law Attorney Claire Curry,  Dr. Mary Evans, geriatrician and president of the Virginia Association of Medical Directors, nurse Love Berkley, long term care specialist, and Emily Chewning, whose father suffered from dementia, was subjected to the misuse of antipsychotic drugs.

This is a widespread problem and happening in our own community every day.  If you suspect your loved one is improperly being prescribed antipsychotic drugs, please contact me and I will be happy to help you sort through what can be done or refer you to an appropriate agency that you can work with to make sure your friend or family member is safe and being appropriately medicated.


Prosecuting Elder Exploitation in Virginia

Sheriff's Department
We need all the tools at our disposal: Law enforcement, prosecutors, APS, private parties reporting suspicious circumstances to curb financial exploitation of our elders.

The Virginia State Crime Commission recently completed its task of reporting on efforts to enact laws to protect vulnerable elders from financial exploitation.

You can read their easy to read and understand report here

Only recently issued on November 13th it includes a really nice summary of what’s happening in OTHER states and what has been introduced in Virginia’s Legislature regarding laws to protect vulnerable adults from financial exploitation. None have successfully been enacted into law in Virginia. Yet.

My personal opinion is that it would be nice to have some criminal laws with a bit more “teeth” in them to go after perpetrators of financial exploitation against the elderly. I would sometimes like to take a baseball bat to them, but that would probably land ME in jail so that’s out.  But at a bare minimum, heightened sentencing for elder-swindling seems worth considering.  We do it for other forms of “aggravated” crimes.

Also, I thought it was interesting that they found that “An exploitation that involves a power of attorney appears to be easier to prosecute than one where there is no fiduciary duty between the parties.”    Plenty of that kind of exploitation going on around here! One of the issues might be to look at who is writing the PoA’s and who honored them – even when they suspected foul play.  I recently had a new client tell me that another attorney told her that her husband, recently admitted to a locked “memory” unit with advanced stage Alzheimer’s disease, could execute a new Power of Attorney in her favor as long as he could mark an “X” on the paper and have two witnesses sign it before a notary. Seriously. An attorney gave her that “advice.” And got paid for his trouble too.

The Commission found that, in the meantime, (that is, while we wait for better criminal laws)  it is possible to successfully prosecute under the existing theft crime laws: embezzlement, larceny, larceny by trick, and false pretenses. Perhaps there are a couple of more….  fraud, credit card fraud, check kiting. There are even a few FEDERAL crimes one might prosecute if a scheme is perpetrated by postal system, over the “wires” (includes internet) or interstate.

I reckon we oughta’ get on it.  Law Enforcement? Commonwealth’s Attorneys? Are you with me?