What happened in a bucolic nursing home nestled in the California mountains starting in 2003 shocked investigators. When residents at the Kern Valley Nursing Home complained or annoyed nursing director Gwen Hughes, prosecutors say she chemically restrained them with powerful anti-psychotic drugs. Her methods were so severe, three residents died.
Phyllis Peters' mother Fannie Mae Brinkley was a feisty 97-year-old who suddenly lost energy. "I'd say, 'I can't get my mom awake,'" Peters remembers. "She just won't rouse, she's lethargic."
No one told Peters that her mother had been given a powerful anti-seizure drug that prosecutors say killed her.
Peters says of her mother today, "I'm absolutely convinced she would have lived to be 100. Absolutely."
California Attorney General Jerry Brown says that Hughes ordered one patient drugged just for glaring at her, and another for throwing a carton of milk. Some residents were left drooling, dehydrated, and dangerously thin.
According to Brown, "In a couple cases, elderly people were actually held down, restrained against their will, and given excessive amounts of medicine to keep them quiet."
Even more shocking -- Hughes had been fired for over-drugging once before, from a nursing home in nearby Fresno, Calif. The administrator of that nursing home said they told her next employer only the dates she worked there, out of fear of lawsuits.
On Tuesday, three nursing home officials appeared at a hearing on charges of elder abuse at the Kern Valley facility from 2003 to 2007 -- Gwen Hughes, as well as administrator Pamela Ott and staff physician, Dr. Hoshang Pormir. The three defendants each face up to 11 years in prison, and all have pleaded not guilty. A preliminary hearing is set for March 9, 2010.
Additionally, a former pharmacist at the facility, Debbi Gayle Hayes, accepted a plea bargain on the condition that she testifies for the prosecution.
What happened in the rural California nursing home may be an extreme case, but experts say over-drugging is common nationwide, and the number of nursing home residents who are given these drugs is rising.
It has been estimated that nursing homes give anti-psychotics to one in every four patients. Some suggest that the drugs are replacing physical restraints, which are now illegal except as a last resort.
Toby Edelman, from the watchdog Center for Medicare Advocacy, says, "They're hiding the restraints. A physical restraint is visible, but a chemical restraint is not."
Using a chemical purely as a restraint is also illegal, but they are so widely used that the lawyer for Pormir, the doctor in the California case, plans to cite the drugs' widespread use as part of his defense.
His attorney, Dennis Thelen, says, "To suggest that using psychotropic medication is contrary to a patient's best interest is just flatly contradicted by what happens every day in the United States, yesterday, right now, and tomorrow."
A Food and Drug Administration official estimates that unnecessary anti-psychotics kill 15,000 nursing home patients each year, including Fannie Mae Brinkley.
There are steps you can take to make sure your loved one isn't at risk. Click the links below for more information.
Elder Justice Coalition http://www.elderjusticecoalition.gov
National Committee for the Prevention of Elder Abuse http://www.preventelderabuse.org
National Adult Protective Services Association http://www.apsnetwork.org/
National Center on Elder Abuse http://www.ncea.aoa.gov
National Association of State Units on Aging www.nasua.org
National Academy of Elder Law Attorneys www.naela.org
National Association of State Long-Term Care Ombudsman Programs http://www.nasop.org/
Nursing Home Comparison Tool from Medicare http://www.medicare.gov/NHCompare
Center for Medicare Advocacy www.medicareadvocacy.org
Directory of State Resources from the National Center on Elder Abuse http://www.ncea.aoa.gov/NCEAroot/Main_Site/Find_Help/State_Resources.aspx