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Avoiding Drugs as Chemical Restraints: Stories

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This page will include stories of good care without drugs as shared by long-term care residents, family members, and friends advocating to prevent the misuse of antipsychotic drugs in their nursing home and ensuring they receive quality long-term care. 

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Last August (2020), my significant other was transferred to a facility in Alexandria, MN. Instead of getting to know him and what he could and could not tolerate, they started drugging him right away with the antipsychotic drug Haldol to control his behavior, even though he did not have a psychotic mental illness. What he could not tolerate was his painful paralyzed right arm being pushed, pulled and shoved, or his left arm being held down to force blood draws, finger sticks, etc. The left arm is the only limb he has movement in. The drug knocks him out, sometimes for days. He started saying "I can't think" and had trouble focusing his eyes. He also started exhibiting other side effects such as uncontrollable muscle movements.

After a month they isolated him from me, claiming he agreed to have no visits or phone calls from me, his significant other of 13 years. He told me on the phone the same day I could no longer visit, that he did not agree to that, called it BS and said, "I would never do that to you." The next day his phone quit getting answered, even though he answered it 2-3 times a day before that. I learned from the chaplain they keep the ringer on his phone turned off. He has told the chaplain several times that he does want me to come visit, but this lockout continues today--nearly a year later. They let his son visit for three hours on Sunday mornings. 

They are still continuing to use Haldol and have mentioned treating some vague "mental illness" to his family, trying to cover up the fact that they started using it and continue using it as a chemical restraint. His son has confirmed it is being used to control his behaviors. The facility has not provided any mental health services to my significant other, nor help with communication which was severely affected by a stroke. They locked out the one person, me, who could understand a lot of what he tried to say because I had been with him nearly every day since his stroke in December 2018.

Aids and nurses couldn't understand him so they mostly just ignored him, or misinterpreted what he was trying to say, such as "headache" when he was trying to say "head up" because he was coughing. The response was, "I'll bring you a tylenol later." Now, I've been told he "rarely speaks."

My significant other had been in three previous nursing homes and none used Haldol on him.

Donna, a friend of a nursing home resident in Minnesota


When I enter a facility to see clients as their nurse practitioner, I often ask the nurses to come and get me if they have a client exhibiting challenging neuropsychiatric symptoms associated with dementia. I do this so I can demonstrate to them appropriate non-pharmacologic interventions. I will never forget the former NFL player we had on a memory care unit. The nurses said he had refused a bath for two months and they were scared to try to persuade him. They wanted me to prescribe something to sedate him so they could give him a bath and examine his skin.  I started my interaction with him by talking about football. I asked if he had ever sprained his ankles and used a whirlpool as treatment. He said of course. I looked at his ankle and said "You know coach says we need to get these ankles back in the whirlpool." He responded with "okay if coach says so."

We entered the shower room and I removed his socks and shoes and turned on the water. He said "I am going to get my pants wet." I responded with you are right. "Let's just take those off and your boxers too."  He entered the tub and said "this water is going past my ankles." I said "yes, your knees need a whirlpool too." This entire time I am talking with him about football and all of his past injuries. Eventually he complained that his shirt was getting wet and we removed. Before long the bath was over.

Creativity and patience are the answer for neuropsychiatric symptoms.

Amy, a nurse practitioner in Kansas


When I was a long-term care Ombudsman my program held trainings on chemical restraints. Our trainer made the point that most residents who acted out did so in response to a stimulus and if the staff took the time to discover what keyed the resident, they could then eliminate much of the disruptive behavior.

I filed that away somewhere in my mental database and a few years later I used it when my father was in the hospital. In the middle of the night my dad had walked toward the door of his room and somehow pulled down the TV set that hung on the wall.

His doctor, a reasonably cautious man, told us he wanted to order Haldol. My alarm went off and I said, “Tell you what. I’ll spend some nights with him in his hospital room. If he gets restless beyond control, I’ll ask for the Haldol. Otherwise, don’t have it administered.” The doctor and hospital staff agreed (skeptically, I am sure).

The first night in the room, I woke up to my dad struggling restlessly. I’m sure he was not far from becoming a problem. Then I noticed he had slid down in his bed and his legs were bent; his feet were against the footboard; and I went immediately to the nurse. Together, we pulled my dad up to the top of the bed and he relaxed and slept. I arranged with the nurse that I might call on him again that night. After a few hours, I called the nurse again and it worked. After that, the nursing staff checked on him periodically and worked their magic. All went well and they never used the Haldol.

Family member and Long-Term Care Ombudsman