‘Light Touch’ Needed on Meds

By Tom Korosec

Texas has made progress on reducing the use of antipsychotic drugs in nursing homes as a result of attention from federal and state regulators and consumer groups like AARP, as well as industry efforts.

AARP Texas will continue to advance the issue as a priority when the state Legislature begins its session Jan. 8.

“Sometimes physicians will prescribe antipsychotic drugs in an attempt to chemically sedate an individual in lieu of appropriate staff attention. This is a problem we are trying to reduce,” said Jon Weizenbaum, retired commissioner of the Texas

Department of Aging and Disability Services. As commissioner, Weizenbaum oversaw regulation of long-term care facilities. Now the 57-year-old is using his Austin experience and expertise in nursing home matters to help AARP accomplish its legislative goals as a member of the association’s Texas Executive Council.

Antipsychotic drug use for Texas nursing home residents dropped from nearly 29 percent in 2011 to less then 15 percent in 2017, according to the federal Centers for Medicare & Medicaid Services. Once rated as one of the worst for use of the drugs, the state now has a middling rank.

Legislative priorities
AARP Texas wants to require nursing homes to get written permission from a legal guardian, instead of just verbal consent, before a drug can be administered.

AARP also wants residents to be informed of the drug’s potential side effects and alternatives.

Common antipsychotic drugs can reduce cognition among people who are already challenged by dementia, cause elevated cholesterol levels and increase the risk of heart attack or stroke, explained Amanda Fredriksen, AARP Texas associate state director.

Weizenbaum is optimistic that this “light touch” requirement will gain lawmakers’ support. Providers and trade groups, he said, recognize that overuse of these drugs is a problem.

AARP Texas’ Tim Morstad, associate state director, is working on a second legislative priority: increasing the pay of investigators assigned to complaints of elder financial abuse.

Older Americans lose more than $3 billion every year because of financial abuse, according to a MetLife study. But the actual figure could be 10 or 12 times higher because the crime is so often underreported, Morstad said.

The abuse is often perpetrated by a family member, neighbor or friend the victim trusts, he said.
AARP Texas wants the state to spend $17.8 million over the next two years on pay raises for Adult Protective Services investigators.

The state responded to dramatic breakdowns at Texas’ child protection agency with hiring and pay raises. But that had the unintended effect of luring investigators away from protecting adults.

“Pay parity will help reduce turnover and increase the program’s capacity,” said Kez Wold, associate commissioner for adult protective services at the Texas Department of Family and Protective Services.

“Exploitation investigations in particular benefit from the expertise of experienced investigators,” Wold noted.

“Right now they don’t have the resources to pull off this crucial task,” Morstad said.

Tom Korosec is a writer living in Dallas.