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Group Sign-On for Informed Consent

Twenty-six percent (26%) of all nursing home residents are given antipsychotic medications. Use is even higher (nearly 40%) among residents with dementia - the very individuals that the FDA warns are at serious risk of medical complications and death from taking antipsychotics. Yet far too often no one discusses these dangers with residents and their families or whether or not these medications should be given.

S. 3604, the Improving Dementia Care Treatment for Older Adults Act introduced by Senators Kohl (D-WI), Grassley (R-IA), and Blumenthal (D-CT), would require nursing homes to obtain informed consent before an antipsychotic medication is prescribed for a resident with dementia.

The Improving Dementia Care Treatment for Older Adults Act also includes other important provisions: education for prescribers, monthly reports on instances where antipsychotics are administered to nursing home residents with dementia for uses not approved by the FDA, and a study on the appropriate prescribing of antipsychotics for hospital patients.

If you represent an agency or group, please sign a letter in support of Senators Kohl, Grassley and Blumenthal's effort to just say KNOW!



October 19, 2012

Senator Herb Kohl
330 Hart Senate Office Building
Washington, DC 20510

Senator Chuck Grassley
135 Hart Senate Office Building
Washington, DC 20510

Senator Richard Blumenthal
702 Hart Senate Office Building
Washington, DC, 20510


RE: S. 3604, the Improving Dementia Care Treatment for Older Adults Act


Dear Senators Kohl, Grassley and Blumenthal:

The National Consumer Voice for Quality Long-Term Care (Consumer Voice) and the undersigned organizations are writing in support of S. 3604, the Improving Dementia Care Treatment for Older Adults Act of 2012. By requiring informed consent for antipsychotic use in nursing homes and implementing a multi-faceted approach to address the issue of misuse of antipsychotic medications, this legislation takes an important step toward improved dementia care. Given the complexity of this problem, we are aware that there is no one silver bullet; S. 3604 recognizes that reality by focusing on prescribers, hospitals, and other settings, as well as nursing homes – and at no cost to taxpayers. The Consumer Voice, a national non-profit organization that advocates for quality care and services for long-term care consumers in any setting, has made ending the improper and dangerous use of antipsychotics a top policy priority.

We are pleased that S. 3604 would require nursing homes to inform residents with dementia, or a health care agent/surrogate if applicable, about the possible side effects and risks associated with antipsychotics – as well as alternative treatment options. We hear frequently from families of nursing home residents that they were never told their loved one was going to be given an antipsychotic medication and the first they knew of it was when they found the resident over-sedated and unresponsive. Other family members report that they would have never agreed to let an antipsychotic be given to their loved one if they had known what it would do to them. Informed consent would better ensure that residents or their representatives receive the information they need to decide whether or not an antipsychotic medication should be given. In addition, S. 3604 would require monthly reports indicating the instances in which antipsychotics are prescribed for nursing home residents with dementia for a use not approved by the Food and Drug Administration. Such reports would help nursing homes better track their antipsychotic utilization rate and target problems more quickly.

While nearly 40% of individuals with dementia living in nursing homes receive antipsychotic drugs, we know that the overprescribing of antipsychotics is not limited to nursing homes. The Institute of Medicine study called for in S. 3604 would provide valuable data about antipsychotic utilization in hospitals, during transitions of care, and in other health settings. This information would tell us more about the extent and nature of the problem and provide a foundation for improving dementia care not only in nursing homes, but in other care settings as well.

We also support the prescriber education programs that S. 3604 would create. To change the way in which we care for individuals with dementia in nursing homes and other settings, we must change prescribing practices. For years ombudsmen, families and other advocates have noted incidents where the first and only response when a resident exhibits behavioral symptoms is for a nurse to call the doctor and ask for and receive a medication to “deal with” the problem. Far too frequently, antipsychotics are prescribed for behaviors without any attempt to determine and address what is causing the behavior. Over time, prescriber education could reduce the unnecessary use of these drugs in persons with behavioral and psychological symptoms related to dementia (BPSD). The programs established by S. 3604 would have the added advantage of being funded on an ongoing basis using a portion of the monies stemming from False Claims Act suits involving off-label use of antipsychotics.

The Consumer Voice and the organizations listed below thank you for introducing S. 3604 and stand ready to assist you in obtaining passage of this important legislation.

Sincerely,

The National Consumer Voice for Quality Long-Term Care

[Your Organization's Name Will Be Listed Here]
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