Nursing homes, ‘questionable’ medications

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The caregivers and children of nursing-home patients who have advanced dementia should know that they have the authority to challenge and ultimately decide what types of medications that their loved ones use, medical specialists tell Consumers Digest.

A September 2014 study in Journal of the American Medical Association Internal Medicine found that 53.9 percent of U.S. nursing homes prescribed medications that provided no added comfort for terminally ill patients. Fortunately, caregivers and children can take steps to reduce the likelihood that a nursing-home patient will be given an unneeded medication.

Dr. Greg Sachs, who is a geriatrician and a palliative-care specialist at Indiana University School of Medicine, says families should review with nursing-home staff what medications their loved one is given—in particular medications that might have been appropriate earlier but, at advanced stages of dementia and other diseases, might serve a purpose no longer.

The study notes the medications that most commonly are prescribed unnecessarily include cholinesterase inhibitors, memantine hydrochloride and lipid-reducing agents.

Dr. Damon Raskin, who is the medical director at Fireside Convalescent Hospital and Good Shepherd nursing home, adds that doctors who make monthly rounds “don’t scrutinize prescription charts every time through, so it’s instrumental that family members address changes in a patient’s behavior and see what can be done about medications. You have a lot of authority to make changes.”

K. Carlson