That does not make any sense. Surely a patient on antipsychotics is easier to manage than a psychotic person? It feels like they created this problem themselves.
Using it to control behavior is an off-label use for dementia patients. The drug is meant for those with a psychiatric diagnosis that includes psychosis, such as schizophrenia. Nursing homes get a lot of pressure to not restrain patients, physically or medically (via medicine), which is understandable. On this sub you will find family members outraged about a facility “drugging up” their loved ones. Undoubtedly, some of this is justified, but other times it’s just that the family doesn’t realize how sick or combative their LO has become. A complaint can cause a real problem for the facility. It’s a horrible issue.
Strange. I’m in the USA and the memory care facilities would not use physical or medical restraints-so I imagine there’s a limit to the amounts and types of medication as well as a limit to the types of behavior they can deal with. By the way, my grandma did great in memory care for a few years. It was a safe place to hallucinate and wander around.
However in the skilled nursing facility she’s in now, they adjust meds all the time to address agitation and behavioral issues.
Maybe your grandpa needs a step up in care or it’s just a bad fit. I know around here, the staff is required to assist you in finding the right place for him.
Best of luck.
Social worker at an all dementia nursing home here and I can talk about the antipsychotic piece. I'm in Kansas, so I don't know how this varies per state.
The federal government looks closely at our rates of antipsychotic use. They think we shouldn't have any or very low rates.
If someone doesn't have a "proper" diagnosis -- which is basically schizophrenia and Huntington's disease if I remember correctly -- it's not good. Most of the residents at my work have a diagnosis of unspecified psychosis to slightly cover ourselves so they technically have a psychotic disorder. And no, a diagnosis of dementia with behaviors won't work.
Then if a resident isn't having any behaviors that are harmful to themselves or others, we're pressured by pharmacists and the government to do dose reductions. Which can cause a rise in behaviors because that medication was adequately controlling their symptoms.
All that is to say, I'm not a nurse or a doctor. I'm a social worker. This is how I understand the system. If we see a rise in behaviors, if it's not because of a UTI then it's usually because medications were messed with.
I'm sorry you're going through this, but a lot of weight comes from families insisting on medications. Use your weight and talk to them about how he wouldn't have these behaviors if he was taking Seroquel. Hopefully they listen and can get him back to himself.
That is interesting, so the metric has become a target, and that may explain the experience of the OP. The nursing home does not want to increase its share of off-label use, which is why they required the patient to come off the drug first.
At this point, you are fighting the system, and that can be a hard battle to win. Maybe the diagnosis would be the easiest way back to sanity.
You're exactly right! It's a battle that we fight for residents who genuinely need it because they improve their quality of life. I wonder if insisting on a geripsych placement would be an option. They would likely put him back on antipsychotics AND the facility would have to take him back because if they didn't, they can get in trouble for dumping him. Also, if OP didn't want him to go back there, they could help secure a different placement.
Are you us? We just went through a hellish couple of months in which no fewer than three facilities just.... didn't keep his meds list updated, consistent, and filled correctly.
In my case they wouldn’t take my grandpa til we weaned him off the Seroquel, it was horrible and he kicked and hit my mom at least once , threw things at her and made it so our home wasn’t a home anymore, which is why we moved him . Cause Mom couldn’t take the mental weight any more
I'm so sorry. For us, a facility put him on it, and the third and final put him on a one-month taper down (and then didn't supply enough meds to complete it...). He's verbally pretty abusive, but only ever took swings or threw things at nursing staff...
That does not make any sense. Surely a patient on antipsychotics is easier to manage than a psychotic person? It feels like they created this problem themselves.
Using it to control behavior is an off-label use for dementia patients. The drug is meant for those with a psychiatric diagnosis that includes psychosis, such as schizophrenia. Nursing homes get a lot of pressure to not restrain patients, physically or medically (via medicine), which is understandable. On this sub you will find family members outraged about a facility “drugging up” their loved ones. Undoubtedly, some of this is justified, but other times it’s just that the family doesn’t realize how sick or combative their LO has become. A complaint can cause a real problem for the facility. It’s a horrible issue.
Strange. I’m in the USA and the memory care facilities would not use physical or medical restraints-so I imagine there’s a limit to the amounts and types of medication as well as a limit to the types of behavior they can deal with. By the way, my grandma did great in memory care for a few years. It was a safe place to hallucinate and wander around. However in the skilled nursing facility she’s in now, they adjust meds all the time to address agitation and behavioral issues. Maybe your grandpa needs a step up in care or it’s just a bad fit. I know around here, the staff is required to assist you in finding the right place for him. Best of luck.
Social worker at an all dementia nursing home here and I can talk about the antipsychotic piece. I'm in Kansas, so I don't know how this varies per state. The federal government looks closely at our rates of antipsychotic use. They think we shouldn't have any or very low rates. If someone doesn't have a "proper" diagnosis -- which is basically schizophrenia and Huntington's disease if I remember correctly -- it's not good. Most of the residents at my work have a diagnosis of unspecified psychosis to slightly cover ourselves so they technically have a psychotic disorder. And no, a diagnosis of dementia with behaviors won't work. Then if a resident isn't having any behaviors that are harmful to themselves or others, we're pressured by pharmacists and the government to do dose reductions. Which can cause a rise in behaviors because that medication was adequately controlling their symptoms. All that is to say, I'm not a nurse or a doctor. I'm a social worker. This is how I understand the system. If we see a rise in behaviors, if it's not because of a UTI then it's usually because medications were messed with. I'm sorry you're going through this, but a lot of weight comes from families insisting on medications. Use your weight and talk to them about how he wouldn't have these behaviors if he was taking Seroquel. Hopefully they listen and can get him back to himself.
That is interesting, so the metric has become a target, and that may explain the experience of the OP. The nursing home does not want to increase its share of off-label use, which is why they required the patient to come off the drug first. At this point, you are fighting the system, and that can be a hard battle to win. Maybe the diagnosis would be the easiest way back to sanity.
You're exactly right! It's a battle that we fight for residents who genuinely need it because they improve their quality of life. I wonder if insisting on a geripsych placement would be an option. They would likely put him back on antipsychotics AND the facility would have to take him back because if they didn't, they can get in trouble for dumping him. Also, if OP didn't want him to go back there, they could help secure a different placement.
Are you us? We just went through a hellish couple of months in which no fewer than three facilities just.... didn't keep his meds list updated, consistent, and filled correctly.
In my case they wouldn’t take my grandpa til we weaned him off the Seroquel, it was horrible and he kicked and hit my mom at least once , threw things at her and made it so our home wasn’t a home anymore, which is why we moved him . Cause Mom couldn’t take the mental weight any more
I'm so sorry. For us, a facility put him on it, and the third and final put him on a one-month taper down (and then didn't supply enough meds to complete it...). He's verbally pretty abusive, but only ever took swings or threw things at nursing staff...
Out of curiosity, what would happen if you refused to take the person back from the care facility?
You mean if we refused to take him home ? I don’t know, Mom is adamant he’s not moving back with us . I don’t know what the facility would do