Quote from Imarisk2
I'm not quite sure what evidence evidence-based-practice is looking for, but someday folks will look back at this period of time and think our policies of undermedicating angry, hostile patients made no sense at all. It doesn't preserve their quality of life, their dignity, or their loved ones from suffering more, longer.
This is another example of something "we" (not those of us on this thread individually, but the larger healthcare community) brought on ourselves through abuses in the past. The current policies about restricting psych meds in long-term care settings are a result of policies and regulations introduced to correct the former practice of sedating everyone in SNFs just to keep them sedated, regardless; to make sure everyone was asleep by 7 PM and wasn't going to wake up until mid-morning, and they weren't going to have the energy or awareness to want much during the day. This was quite common a few decades ago, and the Feds and states finally got wise and decided something needed to be done
. I've worked as a state regulator myself, and I can tell you that policies created by government agencies to address problems like this tend to function as sledgehammers rather than scalpels -- they tend to go too far in the other direction. So, this is what we've got for now.
There are a lot of other examples of situations like this in psych; most of the policies and regulations that provders find so challenging and difficult to live with nowadays are a reaction to abuses of the past. Stick around a while; eventually, the pendulum will swing (too far) back in the other direction.
If there weren't always (it seems) "a few bad applies" in the barrel (of psych and/or SNF providers), and we all
did our jobs the way we know they should be done, maybe these kind of heavyhanded policies wouldn't become necessary.