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According to a report from WRAL TV news in North Carolina, a Chapel Hill nursing home has been referred to the State Police for investigation. This was prompted by several residents from the nursing home being seen in the emergency room of a local hospital where they tested positive for powerful pain relievers that had not been prescribed for them. The nursing home in question serves primarily Alzheimer’s patients.

As a nursing home abuse and neglect lawyer, one thing that I would suspect immediately is that the staff was using these pain medications as a chemical restraint. Alzheimer’s patients can be difficult to control and because their disease works on the mind first, many Alzheimer’s patients are fairly active physically. Giving them powerful pain medications can serve to sedate them and make them easier to control.

The basic problem with this is that doing so endangers the health and well-being of the nursing home residents and violates federal regulations. Federal regulations provide that nursing home residents shall not be provided medications for the convenience of the staff. When medications are given to nursing home residents for the purpose of sedating them and making them easier to control, it restrains them in the same way that tying them to a bed does. Both physical and chemical restraints place the health and safety of the nursing home residents at risk.

Giving a nursing home resident drugs that they have not been prescribed for them for the purpose of making them more pliable and easier to control places their safety and well-being at risk in several ways:

  • It increases the risk of a drug interaction. If neither the attending physician nor the reviewing pharmacist know that the resident is receiving the pain medications, how are they supposed to monitor for drug interactions and determine whether the prescribed medication regimen is appropriate for the resident?
  • It increases the risk that the resident will develop pressure ulcers. Sedating the resident reduces their mobility and activity, and immobility predisposes nursing homes residents to having skin breakdowns.
  • It increases the risk of falling due to loss of balance, strength, and alertness. Many nursing home residents suffer hip fractures. A surprising number of nursing home residents do not survive hip fractures or their complications, so this is a major risk to the well-being of the nursing home residents.

The staff people who are responsible for doing this deserve jail time for what they did, but the management of this nursing home needs to answer some questions, too. The types of pain medications that turned up on the drug screens at the hospital are controlled substances which must be inventories and accounted for. When these drugs went missing, what did management do about it?

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