New Study Shows Common Medications Cause Cognitive Problems in Elderly

I’ve written before about how important it is to know what prescription medications are being administered in nursing homes and long term rehab facilities. Many do not have good efficacy, may be dangerous, or may cause problems when mixed with other medications. A new study indicates it is now also important to find out what over the counter (OTC) medications are being given.

The study, reported in the Observer, showed a link between certain medications in the class called anticholinergics and cognitive impairment in the elderly. OTC medications in this class include Dimetapp, Dramamine, Benadryl, and Unisom. This class of medications also includes the prescription medications Toviaz, Paxil and Seroquel. In the study, people using these types of medicines exhibited reduced brain function and increased brain atrophy. Specifically, the study showed that use of these meds affected immediate memory recall and cognition, and may also induce cell death.

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The Lurking Dangers of Blood Thinners in Nursing Homes

Often, elderly people are prescribed blood thinners, otherwise known as anti-coagulants, like Coumadin and several others. While these drugs can significantly help with conditions such as DVTs (deep vein thrombosis) and strokes, they also present unanticipated dangers. If you have a loved one who is on one of these medications, it is important to know the dangers that can occur with their regular use.

It shouldn’t be much of a surprise to learn that the number one issue safety issue for the elderly is the risk of falling. When the elderly fall, it can be very dangerous for two primary reasons. First, they can suffer bone fractures, most particularly to the hip. Hip fractures lead to immobility and many times death as a result. Second, if there is a head trauma, there can be internal bleeding in the brain. This is called either a subdural hematoma or epidural hematoma, depending on where the blood is pooling in the skull.

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When on Antibiotics in Nursing Home or Hospital Watch for Diarrhea – It Could Be C-Diff

One of the most common illnesses I see in nursing homes is C-Diff – a bacteria that can cause severe dehydration or death.  C-Diff is most common in nursing homes and hospitals, and 80% of fatalities from C-Diff are in people over 65.  A recent article in the LA Times reports a recent study and gives the important statistics.

Anytime a person receives antibiotics C-Diff can become a problem.  C-Diff is resistant to most antibiotics (C-Diff is short for the Latin name Clostridium difficile – a Latin word meaning difficult, stubborn, or unreasonable).  We all have lots of bacteria in our gut, but when a person is on antibiotics the rest of the bacteria in the gut are killed, leaving the C-Diff as the only bacteria.  There is nothing to compete with the C-Diff and it proliferates.  Unfortunately, one of the side effects of the C-Diff breaking down food in the gut is toxic, and the body tries to rid itself of the poison with diarrhea.

If you have a loved one who just got antibiotics, be on the lookout for diarrhea.  Many times a person suffering from C-Diff will have diarrhea that is green or black, and it most likely has a very strong distinctive odor.

The most important thing is to be sure your resident is properly hydrated.  By knowing the symptoms of C-Diff you may save your loved one’s life.  We’ve had cases where un-trained staff miss these obvious symptoms, and in some cases even give people suffering from C-Diff anti-diarrhea medication so the toxins stay in the body, further poisoning a person.  Any diarrhea after antibiotics should be of concern. Stark & Stark’s Nursing Home Litigation Group has handled many cases of neglect and issues that arrise such as this, contact us today for a free consultation.

 

The True Cost of Anti-Psychotics and Tort “Reform”

A recent series of disturbing stories by NPR report finding with objective data what many of us practitioners know already – that in many substandard facilities residents are over medicated with sometimes dangerous medications just to keep them quiet.  This is disturbing because these medications are sometimes powerful, dangerous, and ineffective.  Some even get “black box” warnings from the FDA.  It is a subject I’ve written about before and you can find the full article here.

The most recent NPR article points out that Texas ranks the highest in the United States for residents receiving anti-psychotic medications.  Interestingly, Texas also has caps on non-economic damages of $250,000 – i.e., no matter how negligent a company is and how much pain and suffering they cause, they are capped at $250K in non-economic damages.  Is this a coincidence?

With caps on damages, nursing home companies can more easily factor in lawsuits as a “cost of doing business” as opposed to spending more money to do right by people.  With no caps on damages, juries are free to award what they believe are just damages based on the facts.  The uncertainty of a jury verdict often forces companies to spend the money to do the right thing.  With caps, they know exactly what they’re facing.  It’s yet another reason caps do nothing but hurt people.

Knowing your resident’s medications and the side effects is important.  Don’t be afraid to ask about them in care conferences.

Know Your Resident’s Medications

Many times I meet with families who were not told about medication changes or what a resident was prescribed.  It is easy to know what a resident is prescribed.  There is a document called a Medication Administration Record.  Nursing home staff refer to this document as a MAR.  It lists what a person is prescribed, what dosage, and when and how gave the medication.

This information is important to know for many reasons, one of which was recently highlighted in an excellent article in the LA Times.  A new study reported on in the LA Times showed the use of certain medications for anxiety and sleep increase risk of Alzheimer’s.   Unfortunately, the medications – the class called benzodiazepines that includes Xanax, Ativan, Valium, and Klonopin – are common prescribed in nursing homes.

The study indicated that those who took high doses for short periods of time, or lower doses, did not show problems.  It seems as though the problems are for those who took long-acting or high doses over several months.  You can read the full article here.

Prescription of Megace to Nursing Home Residents Linked to Fraud and Horrific Corporate Irresponsibility

In one of the worst examples we have seen involving the abuse of the elderly, a company whose product was only approved to promote weight gain for HIV patients started to aggressively promote Megace to frail and elderly nursing home residents when the HIV population began to dwindle. Knowing the dangerous side effects of this supplement (ie death), this represents a tragic example of profits over people. To read more, click here.

New Study Shows Many People Unknowingly Receiving Medications For “Off Label” Uses

Ask any family member caring for an elderly parent with dementia about the number of medications prescribed and it’s likely to be quite a few. It is important to know what someone is prescribed and what for. A new study shows that roughly 20% of medications are prescribed “off label”. You can read an article discussing the study here.

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