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HealthBridge, 1199 SEIU spar over use of antipsychotic drugs in elderly care centers

Antipsychotic drugs increase the risk of heart attack, stroke, serious bacterial infections and hip fractures when taken by the elderly. If that person also has Alzheimer’s or dementia, add a higher risk of death to the list.

Yet the drugs are often prescribed to Alzheimer’s and dementia patients to alleviate agitation and combative behavior, even though the drugs are not approved for this use. A Gazette review found that in 2010, about 45 percent of nursing homes in the Pioneer Valley — 20 homes — put at least a quarter of their residents without psychosis or a related condition on antipsychotic drugs.

While there is a national movement to get nursing home residents off antipsychotics, health care officials recognize the lack of available treatment alternatives and the need to train health care workers how to help aggrieved residents without drugs.

This weekend’s ad in the Globe is similar to other advertisements that have been running in newspapers such as the Hartford Courant and The Republican for a few months. The ads warn of the dangers of antipsychotic drug use and take HealthBridge Management to task for overseeing nursing homes and health care centers where antipsychotic use is high. The advertisements are being paid for by 1199 SEIU, which represents nearly 430,000 health care workers in Massachusetts, New York, New Jersey, Rhode Island, Connecticut, Maryland, Washington, D.C., and Florida.

At the Holyoke Rehabilitation Center managed by HealthBridge, 76.5 percent of long-term residents take anti-psychotic medications, according to the U.S. Centers for Medicare & Medicaid. The state average is 25.8 percent.

We “hope this public awareness campaign will encourage consumers, particularly those with loved ones in nursing homes, to learn more about the potential dangers of antipsychotic drugs,” said Jeff Hall, 1199 SEIU’s communications director, in an email to the Gazette. “As health care workers we encourage consumers to join us in advocating for the dignity and well-being of nursing home residents.”

In a statement, Lisa Crutchfield, HealthBridge Management’s senior vice president of labor relations, did not directly address the high use of anti-psychotic drugs at the Holyoke center — or the high rates at other centers it manages named in the ad, Lowell Health Care Center and Newton Health Care Center. But she said the ad campaign is full of “misleading information.”

Crutchfield said the union’s concern for residents is a cover for the group’s true motivation — securing a better contract for employees, something the two sides have been negotiating for 18 months.

The ads are “the latest example of the SEIU’s shameful campaign to discredit nursing homes nationwide that do not yield to outlandish union contract demands,” Crutchfield said in the statement.

The labor dispute has led to legal challenges in multiple states and an eight-month strike of about 600 workers at five HealthBridge care centers in Connecticut. The strike began in the summer when HealthBridge Management unilaterally ended the employee pension program and shifted health care cost burdens onto workers. The HealthBridge cuts were accompanied by a 2.2 percent wage increase, according to a report in the Hartford Courant. Striking employees returned to work Sunday after a court ordered HealthBridge to allow workers to return under the terms of their most recent contract while negotiations continue.

Hall said that although the union is in the midst of contentious labor negotiations, employees’ concern for the treatment of residents is a separate issue.

“It is unconscionable for this company to use its own unlawful treatment of workers as a means to avoid addressing legitimate questions they are facing on key resident-care issues,” Hall said.

Hall said the union will keep up its awareness campaign until HealthBridge engages in a “meaningful discussion” with the public and care-givers about the use of antipsychotic drugs at its centers.

HealthBridge manages 15 health care centers in Massachusetts, including the Calvin Coolidge Nursing and Rehabilitation Center for Northampton and Redstone Rehabilitation and Nursing Center in East Longmeadow.

Of the 15 centers, six are treating long-term care residents with antipsychotic drugs below the state average of 25.8 percent. At nine of the centers, the rate of antipsychotic drug treatment exceeds that of the state, according to the most recent information from the U.S. Centers for Medicare & Medicaid. At Calvin Coolidge, 23.1 percent of long-term residents are on antipsychotic drugs; 36.8 percent take the medication at Redstone.

Kristin Palpini can be contacted at kpalpini@gazettenet.com.

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