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.

Medicare has announced that it will stop paying for negligent medical mistakes that are “reasonably preventable”.  This will include injuries from falls, serious decubitus ulcers,  and other common signs of abuse and neglect that are seen in nursing homes.  The New Your Times covered this announcement, click HERE.