Human Rights Watch investigates misuse of drugs on people with dementia in US care homes

Human Rights Watch investigates misuse of drugs on people with dementia in US care homes

Tuesday  5 February 2018

Nursing homes across the United States routinely give antipsychotic drugs to residents with dementia to control their behaviour, despite rules against the misuse of drugs as “chemical restraints,” GADAA member Human Rights Watch said in a report released today. This abusive practice remains widespread, even though the use of antipsychotic drugs on older people with dementia is associated with a nearly doubled risk of death.

The 157-page report, ‘‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia’ estimates that every week in US nursing facilities, more than 179,000 people, mostly older and living with dementia, are given antipsychotic drugs without an appropriate diagnosis. Facilities administer these drugs in many cases without obtaining informed consent from residents or their families.

“People with dementia are often sedated to make life easier for overworked nursing home staff, and the government does little to protect vulnerable residents from such abuse. All too often, staff justify using antipsychotic drugs on people with dementia because they interpret urgent expressions of pain or distress as disruptive behavior that needs to be suppressed.” Hannah Flamm, NYU School of Law fellow at Human Rights Watch.

Using antipsychotic medications as a “chemical restraint” – for the convenience of staff or to discipline residents – violates federal regulations and can amount to cruel, inhuman, or degrading treatment under international human rights law. The practicalities of obtaining consent from an older person with dementia can be fraught. However, in many of the cases Human Rights Watch documented, nursing facilities made no effort to obtain meaningful, informed consent from the individual or a health proxy before administering the medications in cases where it clearly would have been possible to do so. Yet even when nursing homes are found to have broken these rules, they are rarely punished.

“Physical restraints are banned but now many nursing facilities are using chemical restraints instead.” Hannah Flamm, NYU School of Law fellow at Human Rights Watch.

Governments and international civil society actors must not discount the human rights abuses of people living with dementia around the world.

Human Rights Watch has released a film to accompany the report. The film features Karla who saw the transformation of her mother who is living with dementia after she was taken off anti-psychotic drugs. “I’ve got my Mom back, as much as I can ever have her back.”

Charlene & Allen Wagner. Copyright Human Rights Watch

Allen was diagnosed with Lewy Body Dementia and has been taking anti-psychotic drugs since 2009. Allen’s wife Charlene reports that in one nursing home he was drugged to the point he couldn’t talk. “She [care home manager] said this is what they do at this nursing home,” said Charlene. “If he was going to be taken completely off of it, I’d be afraid that they would kick him out of the nursing home and there’s no place to go but home. I need 24hr care at home and can’t afford it.”


The Global Dementia Action Plan, unanimously adopted by World Health Organization (WHO) member states in May 2017, includes targets for every government to prioritise dementia awareness, diagnosis, care and research. We urge governments to work with people with dementia and Alzheimer associations to achieve the best possible response to the plan.

International civil society also needs to play its part to address stigma and deliver change for people living with dementia. We need as many voices as possible to spread the word that dementia is a global health, social care and rights issue that can no longer be ignored.

Join the Global Alzheimer’s & Dementia Action Alliance: