How’s this for unconventional: The Ecumen chain of 15 Minnesota nursing homes has launched Project Awakenings, which calls for treating residents’ behavioral problems without resorting to antipsychotic drugs. The problems are real. Residents have physical and mental disorders, and they are often in pain, frightened, alone, and confused. In the worst cases, they react with violence (including biting or hitting), screaming, crying, moaning, and other troublesome behavior.

Typically, nursing facilities treat these disruptive residents by medicating them with antipsychotic medication. As reported by an article on StarTribune.com, to achieve peace, residents were often:

…drugged into a stupor — sleepy, lethargic, with little interest in food, activities and other people.

“You see that in just about any nursing home,” said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minnesota. “But what kind of quality of life is that?”

Lanigan worked with experts and physicians to find a better way. Instead of treating (or over-treating) with drugs, Lanigan’s facility began treating residents with aromatherapy, massage, games, exercise, personal attention, better pain control, and other therapies. So revolutionary! So ridiculously simple!

Within six months, this new type of therapy went from “experimental” to “innovative.” Antipsychotic drugs were eliminated, and antidepressant use was cut by half.

The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.”

Now the home’s operator, Shoreview-based Ecumen, has started a project called Awakenings throughout its 15 long-term care nursing homes. It’s based on Lanigan’s work and funded with a two-year, $3.7 million state grant.

According to the article, doctors simply prescribe sedating drugs because it is the easiest, quickest way to achieve behavioral calm. And some nursing home owners say they can’t afford to replace drugs with personal attention because it requires too much staff time. That argument, however, doesn’t hold up.

“Our guess is that it will take the equivalent of two extra people at each home, spread across all job categories,” said Finn, Ecuman’s vice president. “Can we afford it? We think we have to, because it’s the right thing.”

Now weigh the cost of two employees agains- the more than $5 billion Medicare spends each year on antipsychotic drugs…at least half of which are prescribed inappropriately. But if it keeps the residents calm, what’s the big deal?

“There’s a bunch of problems, not least of which is those drugs can kill you,” said Dr. Mark Kunik at Baylor College of Medicine in Houston who spoke last month at the Gerontological Society of America’s annual meeting in New Orleans.

Even people with well-documented illnesses can be helped with the treatments of Project Awakenings.

“Whether you have Alzheimer’s or not, there’s a reason people get frustrated or upset — pain, urinary tract infections, hunger, fear of strangers or loud noises or strange settings, maybe drug interactions,” Kunik said. “If you figure that out, you likely can find a safer, nonpharmacologic treatment.”

What a brilliant idea this is! Lanigan should get nationwide recognition for taking the initiative to solve a problem that plagued the patients, the nursing home, and — by extension — all the rest of us through Medicare costs.

The attorneys of HensonFuerst look forward to the day when overmedicating difficult patients to the point of sedation is universally reviled. All it takes is a little compassion and empathy. If it were you…or your parents…or your brother, which treatment would you prefer? Pills that knock you out, cause side effects, and perhaps make your health worse? Or personalized attention, pain control, massage, and exercise programs that let you enjoy life once again? It’s a no-brainer.

Stories like this are why HensonFuerst Attorneys fight everyday for the rights of nursing home residents who may have been abused, neglected, or harmed by inappropriate treatment. We will continue to be the voice of nursing home residents who cannot yet speak for themselves.

If you suspect that someone you know has been the victim of any mistreatment in a nursing home, HensonFuerst is proud to offer dedicated nursing home abuse information on our website (http://www.lawmed.com/). And our attorneys are available by phone 24/7 at 1-800-4LAW-MED. If you have questions, HensonFuerst has answers.

An article on the WRAL webite today reports that an excessive amount of morphine contributed to the death of a patient in the Alzheimer’s unit of Britthaven of Chapel Hill nursing home.

In February, patients were drug tested when managers expressed concern about the way the patients were acting. Of 25 Alzheimer’s patients, nine tested positive for opiates. (Morphine is a type of opiate.)  Three of the patients were removed from the nursing home and hospitalized, and one of those patients–Rachel Holliday–died on February 16, 2010. On autopsy, the medical examiner found extremely high doses of morphine in Ms. Holliday’s system, even though she was not scheduled to receive that medication at all.

The North Carolina State Bureau of Investigation (SBI) is still analyzing evidence in the case; the medical examiner did not rule out homicide.

Everyone at HensonFuerst is outraged and heartsick at these findings, and our prayers go out to the family members affected. Britthaven of Chapel Hill has been providing substandard care for a long while, as evidenced by its Medicare rating: an overall 1 out of 5 stars. It is also a “Special Focus Facility,” which means that they have a history of persistent poor quality of care. Every patient deserves the best possible care, and Britthaven of Chapel Hill has not been keeping up with the implicit promise made by every special care facility: That they will take care of your loved one.

Obviously, there has been a serious disconnect somewhere along the way. Is the staff undertrained or incompetent?  Do the corporate heads not care enough improve the facility?

HensonFuerst is also investigating cases involving Britthaven of Chapel Hill nursing home patients receiving opiates. If you are concerned about a loved one who resides in this or any other facility, please give us a call. We want to help.

You can reach our nursing home abuse team by calling 1-800-4-LAW-MED.

One of the many lessons of the still-developing story of Britthaven of Chapel Hill is that sick, elderly nursing home residents may be easy targets if the nursing staff wants to slip an extra pill or two into their patients’ medication allotment to ensure that the residents remain unresponsive and sleepy–a form of chemical restraint.

There is currently an investigation by the N.C. State Bureau of Investigation (SBI) about how patients in the Alzheimer’s unit of Britthaven of Chapel Hill wound up testing positive for strong opiate narcotic medications… drugs that had not been prescribed.  Several of the nursing home residents were hospitalized, and one died. (Read more and see our videos about this case here: HensonFuerst Britthaven videos and stories.)

The state of Massachusetts has a similar problem. According to the Boston Globe, nearly 2,500 nursing home residents were given powerful antipsychotic drugs that were not intended or recommended for their medical conditions. Data from the Centers for Medicare and Medicaid Services show that thousands of Massachusetts nursing home residents were given these psychotropic medications that–and here’s the similarity with Britthaven–could act as chemical restraints and had not been prescribed.

Earlier this year, the U.S. Department of Justice filed lawsuit against pharmaceutical giant Johnson & Johnson for paying kickbacks to Omnicare Inc., the nation’s largest pharmacy that specializes in dispensing drugs to nursing home patients. How did they learn about it? Good-hearted whistleblowers stood up and spoke for the helpless–and drugged–patients.  (Read more here: DoJ press release)

It’s all starting to sound like the plot for a movie: Kickbacks… chemical restraints… helpless patients… narcotics… lawsuits… whistleblowers.

It’s not a movie, it is the reality of our parents and grandparents, the people we love who can no longer care for themselves. We commend the whistleblowers, and anyone else who sticks up for nursing home residents. In our eyes, they are heros. The lesson for the rest of us is to monitor medications of our loved ones. If your family member is in a nursing home:

• Question every medication. Ask what it is, which doctor prescribed it, and what it is supposed to treat.
• Know the schedule. For each medications prescribed, know what the pill or capsule is supposed to look like, what dosage is prescribed, and how often the medication is to be taken. If it helps you to remember, take photographs of the pills–not all round, white pills are the same.
• Question changes. Don’t assume that a doctor authorized a change…if anything changes and you have not been informed, ask. Watch especially if the medication differs from day to day.
• Watch for side effects and changes in behavior. Is your loved one sleeping more than usual? Eating less? Acting “out of it” in ways that are unusual? It is common to assume that all changes are related to a disease… sometimes it is a side effect of medication.
• If you don’t get satisfactory answers, ask someone else. If your loved one is in immediate danger, call 911. And if you believe that your loved one is being abused, call a lawyer who can help you figure out what is going on.

According to Catherine Goldman, senior practitioner with Wake County Human Services, the home needs sharp regulatory eyes trained on it to protect residents.

“These folks are at risk,” Goldman said Wednesday. Consequently, the home has a no-star rating due to problems like a smoking-related building fire, high rates of medication mistakes, electrical hazards and food described for the record as “nasty,” according to state and county records.

Click to read Tommy Goldsmith’s article in today’s News & Observer.

The nursing home abuse lawyers at HensonFuerst pass along these 10 rights to which every person in nursing care, their families or caregivers, are  entitled.  The rights are:

1.      The right to be well aware of the resident’s health status, medications and conditions;

2.      The right to keep confidential and safe the resident’s medical records;

3.      The right to manage and handle one’s own money;

4.      The right to reject in partaking in studies meant for experimentation;

5.      The right to reject services not included in care plan;

6.      The right to have medical reports and files accessible to the resident;

7.      The right to have the resident’s physician of record make a visit;

8.      The right to express any unease or concern about the care and treatment provided in the nursing home;

9.      The right for residents to send and receive mails, use a telephone, and share a room with spouse;

10.  The right to complain against any staff member without fear.

The HensonFuerst nursing home abuse lawyers stand ready to protect the rights of persons in nursing home care, their families or caregivers.

Jennelle Dixson is a nursing home ombudsman who looks out for residents too frail or too afraid to speak up about problems such as inattentive caregivers, dirty bedding and long delays in getting medication. Ombudsmen are among the most important watchdogs of the nursing home industry. The frequent prods and nudges they give nursing home administrators can have almost as much influence on the quality of care as the annual inspections that government regulators make. Viewers to the HensonFuerst Nursing Home blog are encouraged to make inquiries about the role of ombudsmen in care facility being considered, or used, to provide care for family and friends.

Click to read the entire story from The Dallas Morning News