What to Know About Antipsychotic Use in Nursing Homes

In April 2017, AARP highlighted the misuse of psychotropic drugs, including antipsychotics, in nursing homes. Their report revealed that these extremely strong drugs are still used as restraints, given without the patient’s or guardian’s consent, and have led to a high number of fatalities.

AARP also investigated this issue three years ago in 2014. Their study found that as many as one in five patients in 15,500 nursing homes are still given antipsychotics for behavior management and dementia-related symptoms. Despite the Centers for Medicare & Medicaid Services’ efforts to reduce over-prescription since, you and your loved one should know your rights.

Off-Label Use

Prescribing antipsychotics for behavioral modification is one of the biggest red flags. Whether for the elderly, adults or children, the FDA has not yet approved such off-label use. Although doctors can legally recommend drugs for off-label use, drug companies cannot. Unfortunately, drug companies were the primary pushers of Risperdal and other atypical antipsychotics for use as behavioral restraints.

The most high-profile example is the $2.2 billion fine Johnson & Johnson received in 2013 for criminal and civil charges. Prior to this case, the drug manufacturer had marketed Risperdal to nursing homes without FDA approval and further compensated physicians and pharmacies who recommended the drug for this purpose. Yet, even though this case came to a resolution, doctors in nursing homes continue to use antipsychotics specifically for this purpose.

However, the FDA has not approved this drug for restraint and behavioral modification. It also carries a black box warning specifying that the elderly and patients with Alzheimer’s or dementia should not take these drugs, as they may trigger agitation, anxiety, confusion and even death.

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How Dangerous Is It to Drive Without a Seat Belt?

Many people believe that “buckling up” is the first logical step before driving off. Yet, as a recent New York Times article reveals, unintentional injuries in car accidents are the most common cause of death in children under 15 years of age. How do seat belts factor into this statistic? Data shows that, out of all car accident-related deaths, 43 percent of children were not buckled in.

Although some claim that seat belts are also responsible for injuries, they’re essential to wear for several reasons. Consider the following points, you next time you question whether or not to buckle up.

1. Safety in the Event of an Accident

Data shows that when a seat belt is correctly worn, it reduces the risk of fatal injuries for front seat occupants by 45 percent and moderate-to-critical injuries by 50 percent. For those in the back, rear seat belts reduce fatalities by 73 percent.

Yet, even with these benefits known, drivers and passengers continue to not wear them. As a result, out of the 22,441 passenger vehicle accidents in 2015, more than half of all teens and adults were unrestrained in the collision. Who’s more likely to not buckle up? While adults ages 18 to 34 and men are less likely to use a seat belt, teens are most commonly seen without their seat belts on.

2. Modeling Good Seat Belt Usage

Studies have found that when adults use seat belts, kids in the car are more likely to buckle up too. In fact, when adults use seat belts, children use them 92 percent of the time. When adults don’t fasten their seat belts, children only buckle up 72 percent out of the time.

3. More Drivers Now Use Seat Belts

Since 1994, seat belt usage has continued to increase. As of 2017, drivers buckle up 16.5 percent more often than they did over 20 years ago, which is a step in the right direction.

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How Proposed Medicaid Cuts Could Affect Nursing Homes

As many seniors are aware, the Better Care Reconciliation Act has been proposed by Senate Republicans to replace the Affordable Care Act (ACA). It is predicted to cut Medicaid spending by about $772 billion through 2026 – or about 25 percent over the next decade. Supporters, primarily targeting programs and care for pregnant women and children, claim that the changes won’t affect nursing home subsidies. On the other hand, opponents state that elder care, including long-term nursing home stays, amounts for about two-thirds of Medicaid payouts, so seniors will eventually see the effects – even if they’re not immediate.

Ultimately, the proposal would reduce current Medicaid expenditures 35 percent by 2036 and would cut down what’s considered a costly entitlement program. While House and Senate Republicans claim Medicaid is only for the extremely poor and gets abused by those attempting to game the system, figures show that:

  • One in four people using Medicaid currently are elderly or disabled. With more Baby Boomers entering retirement age, this percentage is predicted to increase.
  • In several states, Medicaid is the primary payer for as many as three-quarters of all seniors.
  • Currently, two-thirds of Medicaid spending goes toward elder care. Forty percent from total expenses goes toward nursing home stays.
  • Of the 1.3 million seniors in nursing homes, half use Medicaid in some form.

Along with the proposed changes, which would reduce federal spending by $4.2 trillion, the plan shifts more of Medicaid’s management to the states. This would result in more autonomy for a state to adjust and operate its programs. Proponents claim doing this would help the most vulnerable, while opponents believe it would push affordable care out of the reach of seniors and the disabled.

With all of these factors considered, seniors and the disabled could be facing:

Stricter Qualifications

Currently, under federal law, state Medicaid programs must cover nursing home stays and can assist with an in-home aide. Yet, with states assuming more control, health care experts predict that Medicaid could shift from its present open-ended model to one that’s capped. As a result, states would be able to decide how much or how little they could pay nursing facilities and access to Medicaid could become restricted. Potentially, it may turn into a program only for the disabled, not seniors needing insurance.

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Back to School Safety Tips For Drivers

We moved so quickly through the summer and all of a sudden, August is here! Time does fly and hopefully each one of you has had the chance for some summer fun during these last months. We have had opportunities for motorcycle rides and long quiet walks in the park. Golf is enjoyed by many, some of our staff have had the chance to play a few rounds this summer. Some of us have had vacations and come back to work well tanned and well rested.

August Is Back To School Month

As our summer draws to a close, back-to-school season is in full effect. Remember to safely share the roads with the school buses, bringing our kids to their classes. We also remind you to watch out for the kids who walk to school or ride their bicycles and provide children with the necessary knowledge to stay safe at school.

We all care so deeply about our kids. Let’s remind them to be careful. It is extremely important that they and the motorists around them take proper safety precautions.

Safe Driving Tips For School Zones

  • Be on the lookout for school zone signals and ALWAYS obey the speed limits.
  • When entering a school zone, be sure to slow down and obey all traffic laws.
  • Always stop for school buses that are loading or unloading children.
  • Watch out for school crossing guards and obey their signals.

At Trantolo & Trantolo, we are dedicated to safety, community and justice for families. We urge everyone, motorists and pedestrians alike, to avoid distractions in school zones. If you or a loved one has been injured, Let Our Family Help Your Family™. Contact one of our CT offices today.


Does Your Workplace Follow OSHA’s Safety Guidelines?

In 2016, the Occupational Safety and Health Administration (OSHA) updated its workplace safety guidelines, making a series of changes addressing slip and fall accidents, a common cause of workplace injuries. Presented at the 2016 National Safety Council Congress & Expo in Anaheim, CA, the document is particularly geared toward those in small- and medium-sized businesses and delineates a structure for tackling various safety and health issues in a range of workplaces.

In general, OSHA has implemented stricter standards for “general industry” businesses. Now similar to those used in the construction industry, these mandates involve greater assessment of workplace hazards and regular inspections to ensure companies comply with OSHA’s requirements. Additionally, they factor in advanced technologies, a more diverse workforce, sedentary jobs and resulting musculoskeletal disorders and the notion that allegedly “safe” environments, like healthcare and retail, come with certain hazards.

Although OSHA’s changes went into effect about a year ago, several companies appear to have been left out of the loop, following the older guidelines and inadequately protecting their workers. For a rundown of updates, here is what OSHA added or revised.

More Safety Protections

In previous decades, workplaces were only required to have guardrails in certain locations, such as high platforms, to protect workers from falls. The new guidelines added this long-standing protective mechanism to 15 other areas. OSHA claims this update will help 115 million workers.

Stricter Anti-Discrimination and Anti-Retaliation Rules

What prevents many employees from filing a workers’ compensation claim or telling a supervisor about safety hazards? The threat of retaliation, which could result in immediate termination, demotion or on-the-job abuses. Yet, OSHA further opens this window to include any post-accident drug testing and incentive programs that could potentially result in punishment or push-back.

What should employers and their workers know?

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