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American Society on Aging workshop on chemical restraint in long-term care

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On Friday, March 14, 2014, the American Society on Aging conference will host an interactive workshop on Chemical Restraint: Elder Abuse in Long-Term Care. The workshop will take place from 1:00 – 2:30 PM in Coronado A (4th floor, Harbor Tower) of the Manchester Grand Hyatt in San Diego. Workshop presenters are Robert Fettgather, PhD and Linda Kincaid, MPH.

The abstract for the workshop explains:

Overmedication and chemical restraint can destroy dignity and quality of life. Residents lose the ability to walk and become incontinent. Cognitive function declines and dearest memories are lost.

Chemical restraint is a systemic problem across assisted long-term care facilities. Staff benefits from conforming (drugged) residents, thereby increasing operational efficiency. Law enforcement and courts are hesitant to intervene. Families find no remedy at law until after the death of the victim.

The presenters will discuss case studies and their investigations of unlawful chemical restraint in long-term care facilities.

Reviews of Medicare claims for atypical antipsychotics for elderly nursing home residents found: 51% erroneous, 83% associated with off-label conditions, and 88% associated with a condition on the FDA “black box” warning.

In a California case study, a resident was given steadily increasing doses of Seroquel to “control behavior” that was due in part to other abuse. The facility LVN requested Ativan to control agitation from a urinary tract infection. Additional psychoactive drugs and narcotics were administered by unlicensed staff and without physician’s orders. Medication was often concealed in food.

The research demonstrated a need for education across all levels of medical care, long-term care, law enforcement, and social services agencies. Important points include: residents have a right to refuse unwanted medical care, residents have a right to refuse unwanted medication, administering mediation without informed consent is a crime, and chemical restraint is a crime. Knowledge from this session applies to all professions that address long-term care and elder rights.

Presenters list the following learning objectives for the workshop.

Chemical restraint is poor medical practice, and it is a crime. Residents in assisted living and skilled nursing facilities have the same right to be free from restraint as do individuals in their own homes.

Forcing a resident to take medication or concealing medication in food is a crime. Residents in assisted living and skilled nursing facilities have the same right to give informed consent as do individuals in their own homes.

Mental abuse of an elder is a crime. Residents in assisted living and skilled nursing facilities have the same right to respect and dignity as do individuals in their own homes.

California has enhanced civil penalties for elder abuse. However, lack of standing and exorbitant litigation costs place civil remedies beyond the reach of many victims.

California has enhanced criminal penalties for elder abuse. However, local law enforcement and prosecutors often consider elder abuse to be a civil matter. Criminal prosecution is rare.

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