Families, the Elderly and Psychotropic Drugs

When elder family members reside in skilled care facilities or nursing homes the usage and effects of particular medications may not be well-understood by them or their family members.  It may be challenging to achieve the patient's informed consent for various medications, particularly if the patient is agitated.

Rachel Toberty, a Regent Law 2013 graduate, recently researched the law surrounding this issue of informed consent and the use and administration of psychotropic drugs.  In her article entitled "Informed Consent and the Use of Psychoactive Drugs in Nursing Homes," Toberty discusses these concerns in the context of California state law:

The over use of psychotropic medications in nursing homes is hardly a new phenomenon, but recently it has garnered media attention and even the attention of the California Attorney General, Kamal D. Harris. Demonstrating that this problem has the ear of the California Attorney General’s office, Harris charged Gwen D. Hughes, a former nursing home director, with inappropriately medicating patients at a Kern County nursing home. Hughes subsequently was sentenced to three years in state prison. It was alleged that while Hughes was working as the nursing home director at Kern Valley Healthcare District’s facility in Lake Isabella she ordered the director of the pharmacy to write prescriptions for psychotropic medication for twenty three patients.

These prescriptions were found not to be for legitimate health or therapeutic reasons, but rather to keep the residents quiet. According to the California Attorney General’s office, the drugs were given to patients who were 'noisy, prone to wandering, who complained about conditions or were argumentative.'  All twenty three of the patients administered the drugs had adverse reactions to the drugs and further investigation related that the drugs had hastened the death of at least three of the patients. This brief news story demonstrates the enormity of the over use of psychotropic medications in nursing homes and their harmful effects. It offers insight into the epidemic of the over medication of residents in nursing homes. In examining the problem of the over medication of elderly patients in nursing homes with psychoactive drugs, this article will examine whether informed consent laws are properly protecting vulnerable elderly patients in California nursing homes.
In seeking answers to this question and examining why this has become such an issue in California, this article will detail the scope of the use of psychotropic medications in nursing homes, the dangers associated with their overuse, the laws in California designed to protect elderly patients through the requirements of informed consent, and finally offer some practical suggestions for lawyers with elderly clients and families wanting to protect their loved ones.
Read more of the article here, or view the accompanying presentation.


Family restoration requires families to protect elderly family members in medication administration. Being informed of not only the desired effects of the medication, but the undesirable effects as well is important to the protection of elders, and of the family.

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