- all other interventions have failed, such as treatments focusing on managing a person’s behavior or stimulating their senses, and
- the person is a threat to themselves or others.
We combed through Medicare data to see how prevalent prescriptions for antipsychotics were among older adults with dementia both in and outside of nursing homes. We found that about a third of those in a nursing home had a prescription for an antipsychotic. Outside of a nursing home? Around 14%. This makes nursing home residents more than twice as likely to receive antipsychotic drugs compared to people living in other settings.
(Excerpted from GAO-15-211)While people in nursing homes may have more severe dementia, that’s not necessarily why they are receiving more antipsychotics. Reasons for prescribing antipsychotics for dementia patients included distress or violence as a result of dementia. But experts also told us that a nursing home’s culture may encourage the use of antipsychotic drugs, and that some nursing home staff may not be aware of the risk of the drugs or have nondrug alternatives they can try. And all of these drugs came with a cost to the federal government—roughly $363 million through the Medicare Part D program in 2012. Sounding the alarm To help reduce antipsychotic use in nursing homes, several federal agencies within the Department of Health and Human Services are taking action, such as by
- providing more guidance and training for those who work with people with dementia,
- funding research related to dementia care, and
- setting goals to reduce antipsychotic drug use among nursing home residents.