Antipsychotic Medication As an Answer to Elderly Depression, Loneliness

"In the days before nursing homes became so highly regulated, many facilities used medications to chemically sedate their residents. Elders who were calm and slept a lot were easier to manage and required less attention from staff members. Therefore, many homes considered drugging patients to be both efficient and cost effective."

"Anti-psychotics and sedatives were frequently prescribed to calm patients, especially those who had Alzheimer’s disease or other forms of dementia. In some cases, a low dose may have been beneficial for residents and staff alike, but these medications are very powerful. They can affect seniors and dementia patients differently compared to the general population, and some even carry black box warnings, indicating that adverse reactions may cause injury or death."

Carol Bradley Bursack, Minding Our Elders, AgingCare 

"[An] additional 1,000 residents are being prescribed antipsychotics who were not on the medication before the pandemic."

"[Such] knee-jerk reactions to try and medicate the distress of residents in nursing homes [during the COVID-19 pandemic] are a serious concern."

"[Antipsychotics come with a] black-box warning [for the elderly. They increase the] risk of stroke, falls and all-cause mortality, and are not recommended for frail, older adults [such as those with dementia, who make up about 70 per cent of nursing-home residents in Ontario]."

Toronto geriatrician Dr. Nathan Stall

 

During the pandemic, nursing homes have seen fit for safety reasons during a time of high viral contagion, to restrict visits from outside sources to elderly residents of long-term care homes. In some instances, residents have been confined to their rooms in a contagion-preventive measures, and see no one but the personal care worker assigned to them, on an irregular basis. They fall into a state of confusion and depression, and are consequentially drugged to make them more complacent, less aware, the drugs leading them to long periods of sleep when overworked and/or insufficient staff haven't the time to look after their needs.

This, at a time when nursing and long-term care institutions lack modern upgrades in hygiene practices, where in many homes, they place their residents in double-, triple- and more -occupied rooms with shared bathrooms where it is difficult to maintain distancing, much less adequate hygiene. Nursing homes throughout Ontario, throughout Canada, account for fully 80 percent of the national deaths attributed to COVID-19, among their frail, elderly residents. They are badly understaffed, unequipped and trained to be able to handle their patients at this critical time of a global pandemic.

The practise of dispensing drugs in this manner has been criticized in the past for using drugs to pacify elderly patients so that they require less care and fewer concerns, and the practise, given bad publicity, was seen to abate. Since the SARS-CoV-2 epidemic has entered country after country, threatening the elderly and the health-compromised, psychotropic medications prescribed for older people has once again entered the scene. Care homes see older people's emotional turmoil, a lapse in cognitive abilities, and have once again turned to drugging patients.

Antipsychotics, antidepressants and benzodiazepines like Valium or Klonopin are in increasing use. Scientific research shows links between social isolation and loneliness, contributing to physical and mental health deterioration and often contributing to the development of dementia -- including Alzheimer's. Above all, when the elderly are confused and isolated and the opportunity to see and touch those who love them is removed, a critical element of human need is denied them.

Lenora Cline, 88, Alzheimer’s  Ed Kashi/Human Rights Watch

Seeing the use of these drugs as a remedy for the acute state of disequilibrium in the elderly, may keep them quiet, but its deleterious effects on the elderly can be just as devastating as contracting COVID-19. A dramatic increase in the use of medications to older people was found through a study of care homes in Ontario. In the United States, clinical studies have pointed to serious side-effects of antipsychotics; nervous system problems, cognitive decline, strokes and an increased risk of death in those with dementia. Benzodiazepine is associated with increased falls, pneumonia and death in the elderly.

"The effects of prolonged social isolation during lockdowns", including restrictions on visits from loved ones and suspension of social activities and group dining is linked to the increase of harm to the elderly in long-term care homes, according to the Ontario study. Similar findings were reached in the United Kingdom when it was noted increased loneliness and human touch deprivation during the pandemic led to an increase in drug use "probably in response to worsened agitation and psychosis" associated with restrictions due to COVID-19.

Research from 2017-18 in the United States and 2018-19 in Australia discovered psychotropic medications to be overused in nursing homes, according to documentation by Human Rights Watch. Typically, the medication comes into use when residents become more of a burden of care, the drugs leading to more compliant behaviour, the patients more easily handled. "Chemical restraint" is what medication used for the purpose of behaviour control lacking a therapeutic purpose, is referred as.