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.


The Power of Memory (or “Smell-o-vision”)

I was addicted to tobacco for many years. Gave it up finally in 2002.  Have been addicted to coffee now since I was about nine years old. Yep. Nine!

Recently, I was sitting on my porch as I almost always do in all kinds of weather, having my first morning coffee. And, as I generally do, I inhaled deep draughts of the SMELL of coffee before I take that first delicious sip. I love the smell probably more than the taste.

A moment later, below me, on the neighbors porch, I heard that distinctive scratch of a striking match and in a moment, up wafts that lovely whiff of a freshly lit cigarette. Even now, ten years later, I love that smell.

I wondered why that is. I think I know. I link both those smells with my grandfather, Grandpa Jones.  It was his morning routine too — though not on my lovely apartment deck. He got up earlier than everyone else and I would creep down their creaky old stairs to find him in his white cotton undershirt and work pants belted too high up on his waist, sitting at the little white formica-topped table (with the gold flecks in it) in my grandmother’s bright yellow tiled kitchen. He would be quietly fiddling with his “weather band” radio looking for the local report to determine if today was a fishing day or a fixin’ day.  I didn’t care. It was fun to tag along with grandpa whether we were fishing or taking something apart on his workbench.  But the smells!  That’s what I remember even today. Grandpa’s freshly lit Pall Mall cigarette and his steaming, creamy coffee!  Oh sure, I remember the early morning light on his full head of snow-white hair and the scratchy whiskers he rubbed on my cheek when I climbed in his lap of his long, lanky six foot+ frame.  But I remember that sweet smell of burning leaf and brewed goodness with a clarity that I remember nothing else.

My grandfather lost his ability to do any of those things. Alzheimer’s robbed him of the ability to fish, fix, fiddle with the radio. He also sang a deep melodious bass in the church choir, recited endless funny nursery rhymes to us as children, and played the mandolin.  None of the man I recall remained in the end.

I was out of the country when he was robbed of these joys and he died soon thereafter in a nursing home where my grandmother and aunt had to place him because they could no longer care for him at home. This gentle man reduced to behaviors and outbursts that none had ever seen from him before. Gratefully, I never saw or experienced that Grandpa Jones.

My Grandpa Jones for me is forever that sweet smell. He is evoked for me every morning over coffee and my neighbors cigarette.

I’m walking in this years Alzheimer’s Walk to End Alzheimer’s for my Grandfather. And for my grandmother and Aunt who struggled so hard for so long to care for him. I’m walking for all the other families and caregivers. Because I still can.