Recognizing Overmedication
Picture

Sometimes drugs are prescribed for nursing home residents to alleviate anxiety, angry behavior, screaming, delusions and paranoia. Under law, when these medications are used when less aggressive treatment could be effective, they are considered to be "chemical restraints." According to Department of Health regulations, all other methods of behavioral intervention must be tried to relieve the symptoms before drugs are used.

According to Department of Health regulations, all other methods of behavioral intervention must be tried to relieve the symptoms before drugs are used.

The drugs that are used to control these symptoms are very powerful and have side effects. If they are carefully prescribed and vigorously monitored these "psychoactive" medications can sometimes be effective in reducing the  residents’ symptoms.

Problems often arise when the psychiatrist prescribes a new drug and only part of the staff is informed. Aides, who provide the majority of direct care, might not attribute subtle changes in functioning to overmedication because they are not aware of the new drugs.
 

SOME SYMPTOMS OF OVERMEDICATION ARE:

  • Slowed reaction: speech, movement and thought
  • Sleeplessness
  • Increased confusion
  • Unsteady gait
  • Constipation
  • Dry mouth
  • Blurry vision
  • Increased agitation
  • Uncontrollable repetitive movement of the tongue, feet, hands and trunk
  • Hallucinations

    Elderly people metabolize drugs slowly. Even a medication that has been working well for a while can become toxic if it builds up in their bodies.

WHAT YOU SHOULD DO:

  1. Work with the home to analyze the difficult behaviors and try all non-drug interventions before medications are prescribed.
  2. Know all medications your relative receives. Insist on being informed before new drug therapy is begun.
  3. Ask the psychiatrist about the potential side effects.
  4. Observe carefully for adverse symptoms. Talk with the aides about their observations.
  5. If you think you see a problem, tell the medical staff` immediately.
  6. If the side effects cause secondary problems, i.e., an unsteady gait may lead to falls and fractures, make sure the home takes the necessary steps to keep the resident safe until the drug has worn off.
     

If you believe your relative is overmedicated or need more information about this problem call the FRIA Hotline.
© 1998 - 1999, FRIA

[ Next Bulletin ]