“Chemical Restraints” & The Overuse of Antipsychotic Drugs In Nursing Homes

Pills spilling out of pill prescription bottle

A cause for increasing concern in the nation’s nursing homes is the use of antipsychotic drugs to control the behavior of elders. They are sometimes termed “chemical restraints.” In fact, any drug that is “used for discipline or convenience and not required to treat medical symptoms” is a chemical restraint. Use of these drugs in this way often violates the law and may be the basis for a legal suit.

In this context, discipline is defined broadly, encompassing any action taken by a facility for the purpose of imposing a punishment or penalty. Intent must be evaluated for there to be a finding of the use of chemical restraints. In other words, in a legal case, you must prove that caregivers actually knew the outcome of their conduct by giving the elderly resident too many antipsychotic drugs. Intent, however, can be sometimes be inferred from conduct. When the intent is based on convenience rather than discipline, one must look to the interests at play. If the interest is a reduction of the burdens of the staff of the facility rather than the health and well-being of the patient, then the drugs are being used for the purpose of convenience. As with discipline, a purpose of convenience redefines the use of antipsychotic drugs as chemical restraints.

Justifications Offered For The Use Of Chemical Restraints In Nursing Homes

Some healthcare professionals regard medications as a less invasive option to the use of traditional physical restraints for the behavior of agitated patients. When medication is used to restrain in place of physical methods, it is a “chemical restraint.” The use of this practice is not black and white; sometimes it can be beneficial and a better option than physical restraints.

However, there is the risk for healthcare facilities and professionals to abuse the use antipsychotic drugs to restrain, forcing them on patients unnecessarily. In such cases, the use of antipsychotic drugs as chemical restraints amounts to malpractice. As with any kind of malpractice, at-fault parties can be held legally responsible for any harm and abuse suffered. If you suspect you or a loved one have been the victim of the inappropriate use of chemical restraints in a nursing home, consult with an experienced nursing home abuse and neglect attorney about your legal options.

Harmful Effects of Chemical Restraints

The reason chemical restraints pose such a significant problem in the nation’s nursing homes is because of their many harmful effects. Chemical restraints may impair one’s ability to think or speak clearly. This is especially the case when multiple drugs are used, or when a patient, due to age or other individual factors, is highly susceptible to one or more drugs. As with the mind, the body can be harmed by chemical restraints. Dulled motor skills can put one at risk of a fall – an incident that can have devastating effects on a nursing home resident. To make matters worse, injuries sustained in a chemical restraint-related fall will likely lead to further medications, and bring the risk of further impaired mental and physical function. Other adverse effects of chemical restraints include:

-Orthostatic/Postural Hypotension
-Movement Disorders
-Mental Impairment
-Functional Decline

Understanding The Laws Governing The Use Of Chemical Restraints

A key piece of legislation concerning the use of antipsychotic drugs as a form of chemical restraint is the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), which contains the Nursing Home Bill of Rights. The Act and Bill of Rights applied to residents of facilities certified for participation in Medicaid and Medicare – the main funding sources of long-term care.

On the issue of chemical restraints, the Nursing Home Bill of Rights mandates that residents shall have the “right of be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints for purposes of discipline or convenience.” The use of medication in nursing homes is common and beneficial when used properly in plan designed to promote a residents physical, mental, and psychosocial well-being. This plan must meet comprehensive clinical standards, and be put in place by an interdisciplinary geriatric team made up of a doctor, nurse, pharmacist, and various therapists.

What To Do If You Or A Loved One Have Been The Victim Of The Unlawful Use Of Chemical Restraints

The misuse of antipsychotic drugs to chemically restrain for the purpose of discipline or convenience is a form of medical malpractice. If you or a loved one have been the victim of this form of abuse, reach out to an experienced medical malpractice attorney.

You may be able to recover both financial compensation and non-economic damages from the parties at fault. This is one of the most complex areas of law, so you will need an experienced attorney to handle the process of obtaining the compensation you need and deserve, and holding individuals and institutions responsible for their wrongful conduct. An attorney will interview you or your loved one about your medical conditions and the treatment you have received, gather and review your complete medical records, and consult with a medical expert about whether you have a claim for mistreatment. The process takes time, so it is important that you reach out to a skilled attorney as soon as possible.