It's hard to believe when you meet the vibrant 94-year-old Meta Miller today. But then her daughter Carol Johnson begins describing just how bad it got as she struggled to manage her mom's dementia at home for seven weeks before Thanksgiving in 2006.
"She would roam the house all night with her cane, talking to imaginary people, knocking things down, yelling at me, accusing me of horrible things -- my own mom," Johnson recalled with tears. "And it just got worse when she went to the first nursing home. That's when she started screaming."
To cope, thousands of nursing homes nationwide are doing what a hospice program and then a nursing home did for Miller: using powerful antipsychotic drugs to quiet disruptive people with dementia -- at times a step that's easier and cheaper than taking staff time to fix the problem.
The practice is alarming Medicaid officials. Last year, they ordered state nursing home inspectors to crack down on it.
Of the state's 398 nursing homes, 38 percent were cited last year for using such medications inappropriately, up from 27 percent in 2006.
So dangerous are the drugs that the Food and Drug Administration requires some to carry a "black box warning" that they heighten risk of death for older patients, a warning that it might extend to all antipsychotic drugs. They also increase the risk of confusion and falling.
The drugs often are prescribed whether the resident is psychotic or not.