Jenna Moening
Professor Barnes
ENG 1201
24 March 19
I have worked as a certified nursing assistant for nearly two years in a specialized
became very frustrated with one of the residents who was getting anxious, frustrated, and slightly
combative and instead of calmly reassuring the resident and distracting to try to calm them down,
they immediately marched into the nurse's station and asked that the nurse gives the resident
whatever medication they could have to calm them down so they would be tolerable to take care
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of. After the nurse had administered the medication, within thirty minutes the resident had
calmed down so much they could not respond without slurring their words or not at all making
sense in response to the questions being asked to them, and even started to shuffle in their walk
and almost tripped a few times. Another thing that I have noticed is that some nurses simply
immediately administer the strong sedative medications even if the patient is not anxious or
combative to prevent the behavior occurring should the patient become agitated on their shift.
Beyond working as a CNA, my grandfather was affected by Alzheimer’s disease and was placed
into a care facility towards the end of his life, and I noticed how the nursing staff would medicate
him almost immediately when he would start to get anxious or combative with them. After
witnessing this in my employment and watching my close relative go through this, I thought that
this would be the perfect topic to research to learn more about and possibly even educate some of
my coworkers about the harmful effects which over medication has on the elderly patients we
take care of. I have now come to see different views on this topic. While there are times that
there are no other choices but to administer medications to sedate or relax a patient, there are
way more harmful effects than benefits to the elderly being over medicated with strong dosages
Over medication can happen to anyone in a variety of ways. It can occur by taking
unnecessary drugs or from taking too many drugs for the body to handle. Healthcare providers
different specialities do not communicate with each other and there are drugs that are prescribed
that is not really needed. Over medicating the elderly is a growing problem that is happening all
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over the United States in nursing facilities and even within home care services. With the increase
in medications that the elderly are taking, there is a higher risk for dangerous drug interactions to
occur inside their body, and the side effects could lead to more problems within their health
(Gorman).
Elderly patient’s bodies do not respond to medications like younger patients. According
to Dominick Bailey, a clinical pharmacist who specializes in geriatric care, when you give an
elderly patient a drug with a very long half-life, that drug is going to last even longer in their
Dr. Milta Little states that the elderly do not need as high of medication dosages as they might of
once taken because the organs of the body work differently when you are over the age of 65.
With this, the elderly patient may experience different side effects or interactions between the
medications. According to Dr. Angela Sanford, when the patient has been prescribed so many
medications, it affects the way they will think or move. She states that she tends to find that
elderly patients fall more and will get light headed or dizzy, along with the fact that their
thinking will become slower. In this same video, Dr. John Morley tells of his colleague in
Australia who did studies and found that “when you are older, if you are taking more than five
drugs, the sixth drug you have has a twenty five percent chance of making you better or a twenty
Laws against over medicating the elderly are in place, but they are just not being
enforced. In a speech by Daniel Levinson, Inspector General in the Department of Health and
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Human Services, he states that facilities are violating federal standards for unnecessary
administration of medication and that a lot of the institutions do not abide by the federal
regulations that are put in place to prevent over medication from happening. In an FDA study,
they found that “for one in five residents, nursing homes dispensed these drugs in a way that
violated the government’s standards for their use”(Levinson). An example of this is if the
prescribed dosage was too high or if the residents were on the medication for far longer than they
were supposed to be. In a Human Rights Watch report, author Hannah Flamm, a New York
University School of Law fellow at Human Rights Watch, said that it is fairly impossible for a
facility to achieve good quality care in compliance with the law without having a well-trained
staff. Along with this, Flamm said that healthcare staff defend administering antipsychotic drugs
by saying the see urgent signs of pain or stress as disruptive behavior that needs to be handled or
Elderly patients who have spoken up about their own personal stories of being over
medicated gives an inside look at what happens behind closed doors. One patient’s nightmare
includes the story of retired preschool teacher, Aleah Davis. In a KCETSoCalConnected
Youtube video, a reporter named Val Zavala interviews Davis and asks her questions pertaining
to her story with over medication. Davis tells that she had hallucinated and felt like she was at
the bottom of a stairwell on the floor. She recalls that during her hallucination, a doctor had told
her that she was alone, no one was coming to help her, and for her to give up trying to fight the
staff. She explained that she was being over medicated to the point that she was not even aware
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of what was going on or even if she was sitting upright or not. Zavala states in the video that
many times that these sedative drugs are being medicated, it is mainly to keep the patients
obedient. Davis had a friend, Jill, who did not take long to realize that something was going on
when she discovered that Davis did not have any history of dementia or mental problems. Yet,
she was confused and unable to communicate which did not make any sense. Jill asked to be
given the list of drugs that Davis was being given and realized that the drugs, one being
Haloperidol, which is a power antipsychotic used for schizophrenics, was being administered to
Davis without any reasonable explanation. These strong medications need a doctor’s prescription
and with the permission from the patient or the patient’s representative. However, this step is
often skipped in nursing facilities and the medication is given without consent. For Davis, no one
had asked for her permission or her representative, Jill. The doctor that Davis had did not come
and evaluate her or even come to see her in person before prescribing the medications she was
being given. Davis ended up getting a lawyer to sue the nursing facility she was living in during
Among the medications that are frequently seen in the prescriptions of elderly patients
who are over medicated, Haloperidol makes its way to the top of the list. Haloperidol, also
known as Haldol, is used to treat psychotic disorders in patients who have trouble deciphering
what is reality and what isn’t actually there. It can be used to treat motor or verbal tics in adults
or children who have Tourette’s. The medication is used to treat behaviors that are aggressive or
in hyperactive children that other medications/therapy does not work on. Haloperidol is
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decreasing abnormal excitement within the brain. On the warning label of Haloperidol, it states
that “studies have shown that older adults with dementia (a brain disorder that affects the ability
to remember, think clearly, communicate, and perform daily activities and that may cause
changes in mood and personality) who take antipsychotics (medications for mental illness) such
as haloperidol have an increased chance of death during treatment”(Haloperidol). The FDA does
not approve of elderly patients suffering with dementia and behavior problems to take
Haloperidol. There are many different side effects that could occur if the elderly patient is taking
this drug. Some include: blurred vision, loss of appetite, blank facial expression, agitation,
Symptoms of an overdose with this medication include loss of consciousness, sleepiness, stiff or
weak muscles, slowed breathing, or unusual, slowed, or uncontrollable movements of any part of
A second video found on Youtube discussed how nursing facilities can not use physical
restraints to hold a elderly patient down in their chairs or their beds. In a HumanRightsWatch
video, United States: Oversedation in Nursing Homes, one of the narrators, Hannah Flamm, with
Human Rights Watch, tells about how nursing staff members administer chemical restraints to
make more convenience for themselves and make their lives easier on their shifts even though
there are laws and prohibitions on the mistreatment of the drugs being given. In the video,
Flamm gives the statistic that, “In an average week, in nursing homes across the United States,
over 179,000 older people, most with dementia, are given antipsychotic drugs, often
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video, Tony Chicotel, with California Advocates for Nursing Home Reform, informs the
audience of the video that the FDA does approve antipsychotic drugs for the treatment of
psychosis, however they are used in nursing homes to keep patients, majority with dementia,
calm and easy to manage. Chicotel also states in the video that these antipsychotic drugs have an
FDA warning label stating that if the person taking the medication is elderly and suffering with
dementia, by taking the drug they almost double the risk of death. The former president of the
American Medical Directors Association explains that not only do the antipsychotic drugs not do
what the doctors are prescribing them to do, but the medications do more harm to the patients
Not only is over medication affecting the elderly patient’s body, but it is also hurting their
wallets. According to a 2014 action plan by the U.S. Department of Health and Human Services
“older adults account for about 35 percent of all hospital stays but more than half of the visits are
marred by drug-related complications” and “such complications add about three days to the
average stay”(Gorman). The Institute of Medicine determined in a 2006 study that “at least
400,000 preventable ‘adverse drug effects’ occur each year in American hospitals” and this can
result from the wrong medication being administered to them, or the wrong dose amount given to
them, which in turns “push health care costs up annually by about $3.5 billion (in 2006
dollars)”(Gorman). In a FDA report, they found that “about 14 percent of nursing home
residents, or nearly 305,000, had Medicare claims for antipsychotic drugs but a little more than
half of the antipsychotic drug claims for which Medicare paid should not have been covered
because the claimed drugs were not used for medically accepted indications or not documented
as provided to patients”(Levinson).
Even though tough situations occur that involve combativeness or aggression in a elderly
patient and it seems that there is no other options but to medicate to calm them down,
administering such strong medications actually do more harm than good to the elderly body and
in the worst of cases, cause death. Over medication should be taken seriously as drug adverse
effects could occur when taking so many drugs together. The elderly patient’s body reacts a lot
different compared to a younger patient with the drugs prescribed. Family members of those who
are or have been over medicated have spoke out and showed the effects that the medications and
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dosages did to their relative. They tell how much their friend, parent, or grandparent has changed
due to taking all the medications they are already prescribed and including the strong doses of
Haloperidol or other related antipsychotics. There are multiple symptoms to look out for when
telling if a loved one or patient is being over medicated. It’s so important as a healthcare
professional to watch the patient incase a reaction to another drug occurs or if they start to
decline due to the medication so that it’s quick to action if something were to happen. Just
because physical restraints have been banned within the healthcare facilities, chemical
In the United States, the elderly are being negatively affected by the misuse of
prescription medications. Such an exploit is not only immoral but is often in direct violation of
governed laws. Individuals should educate themselves on how to redirect aggressive patients
Works Cited
Gorman, Anna. “Has Overmedicating Seniors Become 'America's Other Drug Problem'?.”
medlineplus.gov/druginfo/meds/a682180.html.
www.youtube.com/watch?v=CcROGhtu33w.
Levinson, Daniel R. “Overmedication of Nursing Home Patients Troubling.” Work Plan |
Reports & Publications | Office of Inspector General | U.S. Department of Health and
Human Services, U.S. Department of Health and Human Services , 9 May 2011,
oig.hhs.gov/newsroom/testimony-and-speeches/levinson_051011.asp.
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Nilsson-Maki, Kjell. “Medication.” Medicate Cartoons and Comics - Funny Pictures from
www.cartoonstock.com/directory/m/medicate.asp.
Stockwell, Serena. “Nursing Homes Are Overmedicating People With Dementia.” AJN,
American Journal of Nursing, vol. 118, no. 5, May 2018, p. 14.,
doi:10.1097/01.naj.0000532816.04585.bb.