Large numbers of nursing home residents are tethered to their beds or wheelchairs or given powerful tranquilizing drugs without documentation that they are needed, two new studies show.
Twelve nursing homes in southern Connecticut were studied by researchers at Yale University. At the start of the study, 59 percent of the residents were physically restrained. Within the next year, 31 percent of the remaining residents were restrained at some point.
The restraints are belts or vests that keep people in wheelchairs or beds. They are generally used to prevent patients from wandering, falling and hurting themselves, but experts said there was no evidence that they make the patients safer.
In a second study of 60 nursing homes in eight Western states, conducted by researchers at the University of Minnesota, about one resident in five received powerful tranquilizers, but in only half of these cases was there a written diagnosis justifying a medical need. The study was based on medical records for 1976 through 1985.
Both studies are being published today in the Journal of the American Medical Association.
Dr. Stephen F. Jencks, chief scientist at the research office of the federal Health Care Financing Administration in Baltimore, described the findings as disquieting in an accompanying editorial.
New federal rules that took effect last October require nursing homes, which house 1.5 million Americans, to use anti-psychotic drugs only when medically necessary, to document the medical necessity, and to make every effort to reduce the dose of the drugs.