In the third in a series of articles to raise awareness about psychiatric abuse during mental health month, watchdog wants the cruelty of electroshocking the elderly as treatment for dementia stopped. Banning it could save lives.
As part of Mental Health Month, the Citizens Commission on Human Rights International’s latest featured article on its website is about the dangers of electroshocking the elderly, the indications for which have expanded to knocking out aggressive behavior in the aged suffering dementia. CCHR urges greater oversight of this abuse and wants families who’s elderly parents or grandparents have been subjected to electroshock, also known as electroconvulsive therapy (ECT) and harmed by it to report this to the watchdog group. In a series of actions to raise public awareness about mental health abuse and how to report it, the group has updated its website to make it more user friendly, including on mobile phones, at www.cchrint.org.
Giving electroshock to treat “agitation in Alzheimer’s disease” and “other kinds of dementia,” is not an indication approved by the Food and Drug Administration (FDA), but as the FDA does not regulate medicine, psychiatrists can administer the potential brain-damaging practice anyway they choose. ECT, which uses up to 460 volts of electricity to shock the brain, can cause confusion and memory loss—already found in dementia and, therefore, these could be worsened.
Jan Eastgate, international president of CCHR, says that “shocking a defenseless elderly person—already confused by dementia—because of their behavior is punishment, not medicine.” Eastgate has personal experience of this, after her grandmother, who was in a nursing home and was electroshocked: “Her husband, my grandfather had died, she then suffered excruciatingly painful shingles and onset dementia. In the nursing home, her agitated and confused demeanor was not tolerated and she was cruelly shocked and subsequently died in 1974.”
In the U.S., the number of elderly receiving electroshock increases after they reach age 65, when Medicare benefits kick in. It’s a “market that’s been exploited” with elderly women on Medicare, The New York Times reported.[1]
Medicare listed 20,436 beneficiaries were given electroshock in 2018. Nearly 116,000 ECT treatments were delivered. Between 2016 and 2018, the program paid $31 million to physicians (not including anesthesiologists that render the patient unconscious before treatment) for administering and monitoring ECT.[2]
According to a New York Times article, elderly persons are given electroshock when they’ve been prescribed “so many other drugs that they cannot safely add a powerful psychiatric drug.” A psychiatrist spelled out another reason for electroshocking them: It’s “a big money-maker,” he said.[3]
CCHR has long-been concerned about and documented the psychiatric abuse of the elderly, producing a short video about this, available online.
Antipsychotics have come under Centers for Medicare & Medicaid Services (CMS) scrutiny because of their excessive prescribing to the elderly, and can induce agitation. This has meant that indications for electroshock treatment could be expanded. As a recent article purported, extreme agitation in the elderly can make it very difficult to care for the person, especially if they may unwittingly harm those around them. The study in the International Journal of Geriatric Psychiatry upon which the article was based, recommended electroshock as a treatment for “behavioral disturbances” in dementia, theorizing that it may reduce agitation.
“So, too, could a blow to the head or blunt force trauma,” Eastgate retorts. “We wouldn’t allow a doctor to club our frail elderly to change their behavior, but this is what is happening across the country using electroshock in the name of mental health care.”
She warned that ECT usage in the elderly likely increases given that the the Centers for Medicare & Medicaid Services (CMS) has needed to step in to curb the antipsychotic abuse of the elderly.[4] The drugs are so damaging that the FDA issued a Black Box warning that they can cause premature death in those with dementia taking them.[5]
Federal law prohibits the use of antipsychotics and other psychoactive drugs for the convenience of staff, often called “chemical restraint.”[6] As such, electroshocking may be seen as an “alternative,” but has an even greater devastating impact on their lives, CCHR says.
A psychiatrist writing in Ethical Human Psychology and Psychiatry said that “ECT is especially devastating to the vulnerable brain and body of the elderly…. As would be predicted based on the fragility of the older brain, ECT causes more severe brain dysfunction in the elderly.”[7]
CCHR says Mental Health Month should be looking at the abuses in the system, in order to change them and to protect lives, in this case the elderly who deserve to live out their years without fear of being “bludgeoned” with electroshock or prematurely killed by a psychotropic drug.
CCHR, which was established in 1969 and has obtained over 190 laws worldwide to help prevent, detect and address psychiatric abuses, wants public awareness of the issues the elderly face in the mental health system and practices like electroshock banned. Sign the petition here.
References:
[1] https://www.cchrint.org/2017/01/03/electroshocking-elderly-cchr-questions-potential-lethal-effects/ citing: Duff Wilson, “F.D.A. Is Studying the Risk of Electroshock Devices,” The New York Times, 23 Jan. 2011, http://www.nytimes.com/2011/01/24/business/24shock.html
[2] Medicare Provider Utilization and Payment Data: Physician and Other Supplier, Centers for Medicare and Medicaid Services, CY 2016 through CY 2018, https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-provider-charge-data/physician-and-other-supplier.html
[3] Op. cit., Duff Wilson, The New York Times, 23 Jan. 2011
[4] “CMS must refine data on antipsychotic drug use in nursing homes, OIG says,” McKnight’s Long Term Care News, 7 May 2021, https://www.mcknights.com/news/clinical-news/cms-must-refine-data-on-antipsychotic-drug-use-in-nursing-homes-oig-says/
[5] https://www.verywellmind.com/antipsychotic-medications-black-box-warning-379657
[6] “Old And Overmedicated: The Real Drug Problem In Nursing Homes,” NPR, 8 Dec. 2014, https://www.npr.org/sections/health-shots/2014/12/08/368524824/old-and-overmedicated-the-real-drug-problem-in-nursing-homes
[7] https://www.cchrint.org/2017/01/03/electroshocking-elderly-cchr-questions-potential-lethal-effects/ citing, “The FDA Should Test the Safety of ECT Machines,” Ethical Human Psychology and Psychiatry, Volume 12, Number 2, 2010; http://www.ingentaconnect.com/content/springer/ehpp/2010/00000012/
00000002/art00007?crawler=true