Paper for Nickel and Dimed: The Issue of Drugs in Nursing Homes

The Issue of Drugs in Nursing Homes

        In the past century, the U.S has taken great initiative in establishing nursing homes for elderly citizens. In recent studies conducted, the CDC [Centers for Disease Control and Prevention] estimated that there were about 1.4 million citizens, ages sixty-five and older, living in nursing homes. According to the CDC, if the number of citizens in nursing homes continues to increase, by 2030 the number could rise to about 3 million citizens (“Home and Recreational Safety”). Since nursing facilities are responsible for caring for a significant amount of the elderly population in America, one would expect the caretakers to understand what is best for their patients. However, recent studies have revealed that many nursing homes have threatened the health of patients with Alzheimer’s Disease and dementia by providing patients with medication. 

Nursing homes threaten the lives of patients with Alzheimer’s Disease and dementia by providing them with antipsychotic drugs. Rather than tending to the specific needs of mentally ill patients, several nursing facilities simply subdue the occasional outbursts of their patients with medication. Many of the workers at nursing homes find it more convenient to simply provide their patients with antipsychotic drugs in order to ease any discomfort that patients with mental deterioration may experience (Jaffe and Benincasa.). However, research suggests that antipsychotic drugs may actually be more harmful than helpful for patients with dementia and Alzheimer’s Disease. According to studies conducted in 2005 and 2008 by the FDA (First Division Association), an organization created to protect the health of human beings, antipsychotics increased the risk of death for older patients with Alzheimer’s Disease and other forms of dementia (Boyles). The FDA even issued a “black box warning” on antipsychotic pills, warning people that antipsychotics have the potential of also increasing the chances of heart failure and infections among patients with Alzheimer’s Disease. 

Recent research even suggests that Antipsychotic drugs are not even necessary for patients with forms of dementia.  About ninety percent of patients who experience mental deterioration experience behavioral and psychological issues, which are not cured by antipsychotic drugs. Antipsychotics were created to treat Schizophrenia and only reduce hallucinations and delusions, while soothing patients (“Antipsychotic Drugs”). These drugs are not even prescribed to treat dementia, however approximately nineteen percent of nursing homes in the United States continue to provide dementia patients with antipsychotics (Jaffe and Benincasa.). 

Several families, with loved ones in nursing homes, have been disturbed by the distribution of antipsychotic drugs in elderly facilities. Many families allowed their loved ones to receive these drugs because they did not realize that there were risks involved in consuming this medication. There have been several cases in which families have been disturbed by the effects of this medication on their loved ones with dementia. For instance, in a nursing facility near Sonora, California, the Sherman family was troubled by their mother’s change in behavior. The Shermans had agreed to allow Mrs. Sherman to receive medication, however they did not expect their elderly relative to act abnormally as a result of the drugs. Mrs. Sherman’s daughter, Marie Sherman, was pointedly upset by her mother’s condition, and noticed the effects of antipsychotics on her mother. She claimed that her mother seemed to be “out of her skin” and acting unusual. After spending time with her drugged mother, Marie stated, “I mean, she was calling for help. She was praying, ‘Our Father, who art in heaven, please, please help me. Please take me, please get me out. The Sherman family eventually learned that their mother was provided with a combination of antipsychotic drugs there were made to treat schizophrenia, not dementia (Jaffe and Benincasa.). In other case, one elderly women, Patricia Thomas, died after receiving too many drugs in a convalescent home in Ventura California. Mrs. Thomas had went into intensive care in order to treat a broken hip, however she was provided with a combination of drugs, including antipsychotics, that harmed her health. Kathi Levin, Mrs. Thomas’s daughter, noticed that her mother was not behaving normally, even for a woman with Alzheimer’s disease. Levin remarked: “"Yes, my mom had Alzheimer’s, but she wasn't out of it when she went into the nursing home. She could dress and feed herself, walk on her own. You could have a conversation with her. My mother went into Ventura for physical therapy. Instead, she was drugged up to make her submissive” (Goodwin). Evidently, Levine was not impressed by the treatment that her mother received in the elderly nursing facilities. She, like many other families, was pointedly disturbed with the nursing facilities issuing of antipsychotic drugs for their patients. 

Overall, the issue of issuing antipsychotic drugs in nursing homes continues to exist in the United States. Although many states are alert of this situation, the issue continues to exist. Almost 300,000 nursing homes are currently receiving antipsychotic drugs, and continue to distribute them to patients with Alzheimer’s Disease and dementia (Jaffe and Benincasa). This is an extreme issue as antipsychotic drugs are potentially harmful and unnecessary for patients with Alzheimer’s disease and cause increasing concerns among family members. Hopefully, as more concern is directed towards the issue of drugs within nursing homes, our nation will take initiative to completely stop this absurdity. Then families can relax, with the knowledge that their loved ones are being properly cared for. 

Works Cited: 

"Antipsychotic Drugs." Alzheimers Society. Alzheimer's Society, 2014. Web. 18 Dec. 2014.

Boyles, Salynn. "Dementia: Some Antipsychotic Drugs Riskier Than Others." 

WebMD. WebMD, 12 Feb. 2012. Web. 18 Dec. 2014.

Goodwin, Jan. "Antipsychotics Overprescribed in Nursing Homes - AARP." AARP. AARP Bulletin, 

Aug. 2014. Web. 18 Dec. 2014.

""Home and Recreational Safety"" Centers for Disease Control and Prevention. Centers for 

Disease Control and Prevention, 22 Sept. 2014. Web. 17 Dec. 2014.

Jaffe, Ina, and Robert Benincasa. "Old And Overmedicated: The Real Drug ‘

Problem In Nursing Homes." NPR. NPR, 8 Dec. 2014. Web. 17 Dec. 2014.

Selling in Minnesota Reflection

An individual's personality and behavior is greatly influenced by his/ her working environment. When an individual is surrounded by the same conditions every day, he/she often learns to adapt to these conditions. When a worker adjusts to the working environment, often time his/her personality is influenced by other workers and any obstacles involved in performing the job. For instance, in “Nickel and Dimed”, Barbara Ehrenreich realizes that her personality changes as she works at Walmart. While working at Walmart, Ehrenreich has no choice but to go by the name of “Barb” and evens finds herself thinking differently than she had before. She catches herself judging customers for carelessly discarding unwanted items on the store floor, and creating more work for the employees. She even makes crude comments regarding Walmart customers, clearly indicating that her responsibilities as a worker have transformed her attitude: “ Once I stand and watch helplessly while some rug rat pulls everything that he can reach off the racks, and the though that abortion is wasted on the unborn must show on my face, because his mother finally tells him to stop” (92). Clearly Ehrenreich’s work environment has shaped the way that she thinks. She expresses hatred towards a child who acts carelessly, by labeling him as a “rug rat” and raising the suggestion of aborting already born children. This suggestion comes across as absolutely extreme and conveys the impact of the working environment on Ehrenreich. Ehrenreich even confirms her change in attitude when she approaches a man in a wheel chair: “I’d gone back to the counter by the fitting room to pick up the next cart full of returns and found the gig whole answers the phone at the counter at night, a pensive young fellow in a wheelchair, staring into space, looking even sadder than usual. And my pensive thought was, At least you get to sit down.  This is not me, at least not any version I’d like to spend much time with…” (93-4). Evidently, Ehrenreich is aware that she has changed mentally as a result of the hard work that she must perform each day at Walmart. The conditions that she faces at Walmart are so extreme that she envies a man who sits in a wheel chair. Therefore, it is quite clear that one’s working environment can have a great impact on their personality and attitude towards life. 

Personally, I can understand how an individual would be different if he/she attended a different school than the one that they had grown up in. As I just moved to Mooresville this year from Connecticut, I can already see how my experience in Connecticut has caused me to have a different attitude and personality than those here. As I grew up in a small town in Connecticut, my school was very small and predominately white. Although my school consisted of mostly white students, it was also very culturally sensitive. Students were all taught to respect each other, and often got into trouble for small things that may not be punished here. Also, religion was a very sensitive topic in the North, and teachers were very careful to avoid discussing their beliefs or religion at all costs. When religion was discussed, it was from an unbiased point of view. Therefore, my experience in the Connecticut school systems taught me to be culturally sensitive and careful of discussing religion. However, the school systems in Mooresville are quite different. Students who have attended the Mooresville school systems seem to feel free with expressing their beliefs and views on society. Classes are even offered at the high school that examine the Bible, which might be considered offensive in Connecticut. I have adjusted to fit in the environment of Mooresville, however I think that my experience in Connecticut has made me more aware of the different cultures that exist in society. 

Reflection on "Why Stuff is not Salvation"

In today’s society, people are obsessed with materialistic goods. People are often too concerned with what they want rather than what they actually need. Rather than being satisfied with one item people constantly desire more. Unfortunately, items seem to lose their value when humans desire another item that seems better. A cycle begins to occur as people discard their old items and look for new ones. Also, this cycle can even lead to financial debt. When people make material goods their main priority, they do not put the items that they need first in their lives. This often leads to financial debt because these people do not know how to manage their money wisely, and choose to spend it on worthless items- such as toys, gadgets, etc. 

Although materialism seems to be a relevant theme in our society, it is not central to the lives of every family. For instance, in my household my parents try to not feed into materialism. One of the main reasons for this is because we have eight members in our family, and cannot afford to spend money on toys and gadgets that will end up on the floor. My sisters and I generally receive gifts only on Christmas and our birthdays, and must buy other things that we want with our own money. Our parents will provide us the items that we need, such as clothing and food, however if we want additional items that we do not absolutely need, we must buy it ourselves. As a result, the items that we possess are more valuable to us because we have to either work for them or they are special gifts from our parents.

Research URL: Medication in Nursing Homes

Link:
https://magic.piktochart.com/output/3851500-nursing-homes-and-drug-distrib

Reflection Journal: "Scrubbing In Maine"

Reflection on Religion in "Scrubbing in Maine" 

In the chapter “Scrubbing in Maine,” Ehrenreich often alludes to and discusses religion. In the beginning of the chapter, she refers to religion by describing a Christian revival service that she attends. Ehrenreich makes it clear that she is an atheist, and only attends the service for entertainment. However, although Ehrenreich is an atheist, she is disturbed by the fact that the speakers do not actually preach about Jesus Christ and his teachings. Ehrenreich even remarks: “But Jesus makes his appearance here only as a corpse; the living man, the wine-guzzling vagrant and precocious socialist, is never once mentioned, nor anything he ever had to say. Christ crucified rules, and it may be that the true business of modern Christianity is to crucify him again and again so that he can never get a word out of his mouth” (42). In this statement, it is clear that Ehrenreich is disturbed that these Christians do not even mention Christ in their revivals. Ehrenreich even uses imagery to convey her disgusted attitude towards modern Christianity. She claims that Christians are “crucifying” Jesus again and again so that he cannot get a word out. Consequently, readers understand that  although Ehrenreich is a self-proclaimed atheist, she is disgusted that Christians do not seem to preach their own religion. Ehrenreich’s disgust with the revival is even more apparent when she doesn’t even feel in the mood to ridicule it any further. She leaves the service early, and claims that she “…would like to stay around for the speaking in tongues, should it occur, but the mosquitoes, worked into a frenzy by all this talk of His blood, are launching a full-scale attack” (42). Ehrenreich’s sarcasm in this statement suggests that she is disappointed and saddened by the revival. She uses even uses irony by stating that the mosquitoes are enticed by the talk of Jesus’s blood. This is ironic because the revivalist speakers do not actually seem to discuss Jesus and His teachings at all. Ehrenreich is simply alluding to her belief that the revivalists are crucifying Jesus again and again, so He cannot “speak” and they do not have to share his teachings. 

Later in the chapter, Ehrenreich alludes to Christianity again while she is working as a maid. She tries to take her mind off of the vigorous tasks ahead of her by alluding to Jesus’s teachings: “I draw on Jesus who was barred from the tent revival, the one who said that the last shall be first and that, if someone asks for your cloak, give him your robe as well” (62). Ehrenreich seems to be well-educated in the Christian religion, despite her atheist views. Her knowledge in the Christian faith and disgust with the religious revival may even suggest that she is not personally against Jesus. She may simply be against modern religion. 

Overall, by discussing religion in this chapter, Ehrenreich suggests that modern religion is blown out of proportion. Modern Christians seem more focused around their personal desires rather than their faith and what Jesus had to say. This continues to serve as an issue in today’s society. As my father is a pastor, I am well aware that several churches refrain from teaching the Bible and even refuse to accept Christ as the savior and son of God. Nowadays, pastors seem more concerned with what the audience wants to hear rather than what scripture has to say. So in order to please their audiences and raise attendances, pastors will refrain from mentioning Jesus Christ and stick will simple messages. Evidently, as Ehrenreich suggests, modern Christians revolve less around the scripture and teachings that they are suppose to embrace. 

Writing into the Day: Alzheimer's Patients

In the book "Nickel and Dimed", Ehrenreich raises the issue regarding the treatment of patients in nursing homes. While working at a nursing home, Ehrenreich serves patients with Alzheimer's disease, and notices that there could be several flaws in her occupation. Ehrenreich realizes that it would not be difficult for a nurse to make a life-threatening mistake that would harm patients with Alzheimer's disease. Ehrenreich even provides information that supports her point of view in the text: "A report issued by the U.S. Department of Health and Human Services in July 2000 found most nursing homes dangerously understaffed, especially profit-making nursing homes, such as the one where I worked. Among the consequences of understaffing, according to the report, are increases in preventable problems like severe bedsores, malnutrition, dehydration, congestive heart failure, and infections" (40). Ehrenreich ultimately suggests that there are great risks involved in treating patients at nursing homes. She even suggests that her patients may not have been treated properly by other nurses, because they nurses are typically more concerned about getting paid than the condition of the home/patients.  There are also several reports from other sources  that claim that many other nursing homes do not care for their patients properly either. For instance, there have been some cases in which patients with Alzheimer's Disease have been provided with too much medication. It seems that nurses treat their patients'  outbursts by providing them with more medication, rather than attending to patients' specific needs. In one case, the DeLeon family in California became disturbed when they learned that their relative with Alzheimer's disease was provided with too much medication. This victim's relatives noticed that she was exhibiting odd behavior, even for a patient with Alzheimer's disease. According to her son-in-law, "But they [nurses] just kept giving her more and more...and I noticed when I used to go see her, she'd just kind of mumble, like she was lost" ("Old And Overmedicated: The Real Drug Problem In Nursing Homes"). It personally disturbs me that nurses have been reduced to providing their patients with medication, in order to solve "discomfort". I do not believe that this is a natural process, and firmly believe that nurses should be attending to their patients' needs themselves. People with Alzheimer's Disease may experience mental deterioration, however they are still human beings who deserve respect. Perhaps if the nurses did not rely so much on medication, we would actually be closer to finding a cure to Alzheimer's Disease. However it seems like we are nowhere close to finding a cure, and patients are constantly drugged by nurses, right in front of our eyes. 

Reflection on "Old and Overmedicated: The Real Drug Problem In Nursing Homes"

Reflection: "Old and Overmedicated: The Real Drug Problem in Nursing Homes" 

I personally think that its sad that workers at nursing homes are giving the elderly too many drugs. According to the article "Old and Overmedicate: The Real Drug Problem in Nursing Homes",  nursing facilities are supplying elderly people with too many drugs. Often times, the workers are doing so in order to subdue outbursts. For instance, according to Manuel DeLeon, " "They kept saying she [his elderly mother in law] was making too much noise, and that they give her this medicine to quiet her down." I think that it's sad that nursing homes are reduced to overdosing many patients, although it does relieve pain. I think that an overdosage of drugs might even cause patients to enter  even more of a state of confusion than before. An overdosage of drugs is not natural, and reflects the lack of care that some nurses may exhibit towards patients. Rather than spending time with patients and showing them care, nurses seem to rely entirely on medication to settle their patients outbursts. Perhaps if nursing homes connected with their patients, they would be able to meet their actual needs. 

Reflection on Introduction of "Nickel and Dimed"

1. Do you agree with the parameters she has set for her experiment?

I agree with the parameters that Barbara Ehrenreich has set for her experiment (regarding whether or not a person can live on minimum wage). The rules that Ehrenreich designed for experiment allow her to fully experience the effects of living on minimum wage. She does not have any advantage over those who must make the most with what they have. For instance, the first rule that Ehreinreich creates for herself prevents her from relying on previously learned skills. In her search for jobs, she would refrain from applying for jobs that she was already skilled in, or applying her education to the performance of her jobs. This would put her at the same level as those who were trying to sustain a living, without a high education. Ehreinreich also decided that she would have to perform her job to the best of her ability so she would not risk the chance of losing it. This would also put her on the same basis as those living on a low-income. Lastly, in order to conduct an effective experiment, Ehreinreich decided that she would have to find the cheapest living accommodation. This would allow her to efficiently save money and sustain a living while in poverty. 

2. What potential biases may exist, how does Ehrenreich try to account for these biases—and eliminate them from her study?

Ehrenreich presents the biased opinions that she is superior to other applicants for low-wage jobs, simply because she is educated. Ehrenreich accounts for these biases by verifying that she has an education, but also refuting the argument that she is superior to others. She eliminates the biases from her study, by claiming that her education is not relevant in the low-wage jobs she performs. She also firmly states that low-wage workers are no different from those who are educated. She does not have an advantage over low-wage workers because she does not have experience in the jobs that she applies for. Ehreinreich also claims that low-wage workers share the same feelings as educated workers, and should be treated equally. Overall, Ehrenreich refuses to agree that she is superior to low-wage workers and has an advantage over them, as a result of her education. 

3. What do you think her findings will be? Why?

I think that Barbara Ehreinreich will find that it is not possible for her to put herself in the same position as those forced to live on a low-wage income. In other words, Ehreinreich has an advantage over those forced to live on a low-wage income, and has the option to “cheat”. Ehreinreich is a white female with the ability to speak English and communicate well with others in an American society. Although she may not indicate her intelligence or experience in certain areas to her employees, she already has the advantage of being a white, English speaking citizen. This is a desirable trait for many employees who wish to have their workers to communicate with their buyers. In addition, Ehreinrich has the opportunity to “cheat” if need be. If this author cannot pay for a meal, she has the choice of using her credit card to pay for it. Also, she is picky with her accommodations and has the choice to end the project if she becomes homeless. Those who are truly living on a low-income do not have the option to return to a comfortable life. Therefore, Barbara Ehreinrich would not be truly experiencing the results of living off of a low-income. She would not be forced to make critical decisions, and see if she could survive on her own. Ultimately, the results may not be entirely accurate, if she claims that she was able to survive on a low-salary.