Overmedication in Nursing Homes
Many Canadians find themselves, or their loved ones, requiring the services of skilled nursing facilities. Nursing homes commonly use medication to help deal with elderly patients and their healthcare needs. We put our trust in caregivers to ensure that residents in nursing facilities receive only their prescribed medication to treat their physical and mental conditions. Unfortunately, the overmedication of residents in nursing home care is prevalent in Canada.
Nursing home residents may be overprescribed medications for several reasons. One reason may be understaffing. In many nursing homes, there are fewer employees than necessary to provide proper care to all residents. Understaffing may result in overreliance on medications to alleviate pressures on the care team. Medication is commonly used to make residents easier to manage, to help nursing staff keep the resident restrained, or to ensure that the resident requires less hands-on care. When residents are unnecessarily prescribed medication, it can cause a rapid decline in physical or mental health.
If you, or your loved one, is being subjected to overmedication in a nursing home, a senior abuse lawyer can help build a case against the at-fault party to recover compensation for your losses.
What is Overmedication?
Overmedication is a form of nursing home abuse. Even though residents may take medication every day, they should never be given a higher dosage, unnecessary medications, or incorrect medications. To do so would be considered overmedication.
Nursing homes and/or nursing staff can be liable for the negligent actions or inactions that lead to overmedication. Nursing homes, on the one hand, have a legal duty to prevent overmedication by implementing proper policies and procedures, hiring appropriate staff, and providing necessary training. Any nursing home staff involved in administering medication can also be liable for negligently or intentionally giving too much medication to nursing home residents. Staff could include nurses and other caregivers, or sometimes even doctors.
Overmedication is common in drugs used to treat chronic illness, including:
- Diabetes
- Arthritis
- Insomnia
- Depression
- Cholesterol
- Heart Disease
- Hypertension
- Kidney Disease
- High Blood Sugar
- Thyroid Condition
Negligent Overmedication
Negligent overmedication means that the over prescription was done unintentionally. When a nursing or other caregiving staff member administers medication by mistake, it may give rise to a claim in negligence against the skilled nursing facility. For example, elderly patients are often on several different medications. It is possible for new or untrained staff members to make a mistake when providing medication.
Intentional Overmedication
In some situations, nursing home staff will intentionally overmedicate a patient. The staff could do so for purposes of easier management (using antipsychotic medications, sedating drugs, or painkillers), or because of their own ill motive. Cases involving intentional overmedication can be brought against the individual staff member as criminal charges, or they can proceed against the nursing home facility as a civil lawsuit.
Why Nursing Homes Overmedicate?
Unfortunately, most nursing homes overmedicate patients to make them easier to manage and attend to. Lacking available staff can result in the overreliance on behaviour, mood, or pain management medications. These medications are administered as a replacement for more attentive treatment by staff.
Inadequate training of staff may also be an underlying factor in overmedicating in nursing homes. The effect of inadequate training will only be compounded where there are additional understaffing issues. Nursing home staff are more susceptible to making mistakes if they are overworked and undertrained. In extreme cases, staff members or caregivers may also use or overuse tranquilizers, antipsychotic medication, chemical restraint, or other psych meds to sedate uncooperative residents.
Some examples of overmedication include:
- Not considering interactions with current medications
- Administered medication(s) for a mental illness without a medical diagnosis
- Staffing errors resulting in failure to administer the proper medication or dosage
- Ignorance of a patient’s right to refuse medication
- Failing to obtain informed consent
Failing to obtain informed consent can be a challenging basis for bringing a claim involving nursing home patients. Informed consent is the concept that a patient must be fully informed of the risks, outcomes, and alternatives prior to providing consent to a treatment or procedure. Failing to obtain consent will effectively mean that the treatment was performed without consent, and the provider can be held liable.
The process of obtaining informed consent is complicated in elderly patients because of the state of their mental health. Conditions like dementia or Alzheimer’s are common in elderly patients, and many of these patients lack the decisional capacity to be fully informed and agree to their understanding of the risks. Where a resident has no decisional capacity, a substitute decision maker should be available to step into their shoes, such a spouse or family member.
Dangers of Overmedicating Nursing Home Residents
Nursing home facilities often rely on medications such as antipsychotics, sedatives, or pain relievers to calm or restrain residents. Staff and caregivers who do not ensure that these medications are used for their proper and intended purposes can endanger the vulnerable nursing home residents.
Many nursing home residents take multiple prescription medications every day. These medications each come with dangers, warnings, side effects, and adverse reactions to other medications. The prescribing doctor has carefully considered a balance of the drug treatment that works for the resident. Overmedication by other caregivers can interfere with this balance. The effects of overmedication can be reduced functioning or mobility, increased depression or anxiety, and agitation.
Common risks of overmedication can be:
- Seizures
- Adverse drug reactions
- Overdose
- Disorientation
- Stroke
- Heart failure
- Low blood pressure
- Dizziness and falls
- Death
The influence or side effects of these types of drugs on a nursing home resident increases their risk of slips and falls that could cause other injuries.
Signs of Overmedication
The most common drugs that nursing homes use to manage patient behaviour are antipsychotic and sedative medications. These are most prescribed and administered to patients with Alzheimer’s and dementia but can also be prescribed to those with bipolar disorder. Many times, nursing home staff and caregivers use these drugs as chemical restraints. A chemical restraint means that the drug is used as a means of making a patient calm and manageable. However, there must always be a medical need for using a drug in this way.
Overmedication can be difficult to identify. The following are some signs of overmedication:
- Mood swings and unusual changes in behaviour
- Reclusive behaviour (self-isolating)
- Confusion or unresponsiveness
- Excessive tiredness
- Unexplained medical complications
If your loved one has been subjected to a chemical restraint for the convenience of staff, contact a lawyer at Valent Legal to advise you on your legal rights and options.
Laws Regulating Medications in Nursing Homes
Authorized prescribers of medications for residents of nursing homes are physicians, pharmacists, and nurse practitioners. Each of these prescribers must meet the applicable standard of care when prescribing and administering medication to their patients. Any substandard conduct (conduct that is not considered acceptable or reasonable in the scope of their practice) will help ground a civil claim in negligence. The standard of care owed by a prescriber will vary based on their field and the specific medication and circumstances.
The Nova Scotia Department of Health and Wellness has established Long-Term Care Program Requirements to guide nursing homes and residential care facilities. These Requirements set out the regulations of resident care and administration to ensure service quality, including the protection of residents from abuses such as overmedication. Nursing home residents have the right to be protected from elder abuse. Abuse is defined in the Protection for Persons in Care Regulations and includes “the administration, withholding or prescribing of medication for inappropriate purposes”. Other professional regulatory bodies, such as the Nova Scotia College of Nurses, have established their own guidelines for administration of medication by those within their discipline.
Filing a Claim for Overmedication in Nursing Homes
A nursing home abuse lawyer can investigate your claim and find medical experts to help prove the case for overmedication. You have two years from the date that you became aware of the overmedication to bring the claim forward. After that, you will not be able to proceed with a lawsuit unless you meet the strict requirements to extend the deadline.
The nursing home resident in a successful overmedication lawsuit could potentially recover damages for:
- Pain and suffering
- Emotional or psychological distress
- Lost income
- Cost of medical care
- Loss of ability to care for your home
Unfortunately, some cases involving overmedication result in wrongful death. The damage awards for these types of cases will differ. Families of residents will be limited to recover for the loss of care and companionship. A nursing home abuse lawyer at Valent Legal can help advise you on the viability of a wrongful death claim.
No one should have their autonomy and rights violated. Our team of personal injury lawyers stand up for victims of nursing home abuse because oftentimes they can’t do it themselves. Call to book a free case review to speak with a nursing home abuse lawyer at Valent Legal today. We can help you take action against the party responsible for overmedication to get the justice you deserve.
