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:
Work with the home to analyze the difficult behaviors
and try all non-drug interventions before medications are
prescribed.
Know all medications your relative receives. Insist on
being informed before new drug therapy is begun.
Ask the psychiatrist about the potential side effects.
Observe carefully for adverse symptoms. Talk with the
aides about their observations.
If you think you see a problem, tell the medical staff`
immediately.
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.
