Some readers may recall my previous column about the investigative series we published at the Arizona Republic in 1988 about how many sane elderly residents of nursing homes across America were regularly being pacified with powerful anti-psychotics such as Haldol and Mellaril.
The drugs--prescribed by doctors and usually administered "PRN" (as deemed necessary) by nurses when, in their opinion, residents became "troublesome"--left recipients dazed, slumping quietly with heads hung and sometimes drooling in a chair or wheelchair (hence the nickname "The Hammer" for Haldol).
One inexpensive pill eliminated a "disturbed" resident's questions and complaints to overworked nurses for hours. Families who visited never knew, or bothered inquiring, about the medications their loved ones were receiving. They trusted the homes and doctors.
Plus visitors expected to see older residents in chairs with their heads drooped, rationalizing that as normal behavior for ailing elderly men and women in a facility.
The results of our 24-page series went national, reaching New York City where hearings on the subject were held and changes were implemented.
But that was 35 years ago, which left plenty of time for those ripples of reform to subside.
I received a letter the other day from reader Floyd Fenix that told me, sure enough, déjà vu appears to be unfolding, at least in some areas.
"I know of no greater wrong, harm or evil thing anywhere in the U.S. than what is going on in our nursing homes," said Fenix. "Patients are intentionally overmedicated, turning them into zombies so short-of staff-homes do not have so much work. Patients that some staff don't like are medicated, patients that frequently need and ask for care are medicated, and additional patients are medicated at night. It is widespread and prevalent in the industry," he wrote.
Fenix said two experiences haunt him. "A father-in-law whose wife had just died checked himself into a good assisted-living facility as it was easier on him to live there than by himself. He was attracted to another patient and they became close friends. Her family did not want their mother friendly with another man and complained to the facility.
"From that point when we visited, he literally would fall asleep within a few minutes as we visited. He complained he was sleepy all the time. We drove three hours each way to get there to visit. All the visits were great until the friendship incident, and he was drugged from that time on.
"I told his son and asked him to do something, but nothing changed and he died in a short time after it started. He was in good health and physically fit."
Fenix said a female neighbor fell, broke a hip and went to a nursing facility. During the first week she remained very alert. She was cheerful and they visited as they always had. "Then they started medicating her in the afternoon (the home was short-handed during covid), and she told me they were giving her something and it was confusing her. She asked me to get them to stop or get her out of the facility.
"It got worse. I found her son and told him I thought they were medicating her heavily and it was making her confused, to lose her memory and fade in and out of consciousness. I asked him to help, but nothing happened. I went to see him two more times. She died. Other than her hip, in good health. She pleaded with me to help her. Begged me to get the medicine stopped or get her out of that facility. It haunts me.
"These are frail, vulnerable people," Fenix said. "It could happen to us; we all are approaching that age. It is happening to thousands right now and is so wrong."
Fenix was driven enough to research the damage caused by needlessly administering such powerful medications to older people. He found, "when sedated, they lose the important people contact and friendships and go into an isolated, lonely state that withdraws them into depression. It is killing them. Loneliness and isolation is equal to smoking 15 cigarettes a day [in affecting health]. ...
"Friendships, relationships and visiting--for anyone, not just the elderly--cause the pituitary gland in the brain to give off endorphins. Endorphins disrupt and prevent depression, make us happy, increase life expectancy, and improve health and cognitive function. Additionally, endorphins suppress receptors in the brain that register pain ... .
"Oxford University research in 2016 showed people with larger social networks had a higher pain tolerance, experienced more happiness and lived longer," Fenix wrote. "And Harvard University released a 75-year study of over 2,000 people that showed the body produces three hormones that govern happiness: Dopamine makes the body feel good, serotonin reduces depression, and endorphins make us happy and reduce pain."
Thanks, Floyd, for sharing your experiences and findings with readers and reminding me we have to remain ever vigilant to society's ills. Meanwhile, if we have a loved one in a nursing home, we can best show it by visiting regularly and asking to see a copy of what medications they are receiving, from whom and why.
Mike Masterson is a longtime Arkansas journalist, was editor of three Arkansas dailies and headed the master's journalism program at Ohio State University. Email him at mmasterson@arkansasonline.com.