Advocacy in Action (April 2024): The Abuse of Antipsychotic Medication

Libby Hastings • April 8, 2024

The latest data from the Long-Term Care Community Coalition paints a troubling picture of the prevalence of antipsychotic drug use among nursing home residents nationwide. Shockingly, over 250,000 residents are being administered these dangerous drugs, often without clinical justification. Antipsychotic drugs are too frequently used as chemical restraints, particularly among individuals with dementia or dementia-related diagnoses. Instead of receiving the services they are entitled to under federal law to live comfortably, residents are being sedated, robbing them of their autonomy and quality of life. 


Antipsychotics are drugs that are used to treat symptoms of psychosissuch as delusions (for example, hearing voices), hallucinations, paranoia, or confused thoughts. They are used in the treatment of schizophrenia, severe depression and severe anxiety. 


In Kansas, the situation is no less alarming. Approximately 117 nursing facilities out of 300 in our state have 20% or more of their residents on antipsychotic medication. CMS Region 7 (serves Iowa, Nebraska, Missouri, and Kansas) had the highest regional rate (24.7%). This misuse of medication not only violates the rights of residents but also puts their health and well-being at risk with potentially severe consequences.


Antipsychotic drugs are associated with a host of adverse outcomes in older adults, including heart attacks, strokes, Parkinsonism, falls, and even death. It is clear that the overuse of these drugs constitutes a serious threat to the safety and dignity of nursing home residents.


Furthermore, the data from the Long-Term Care Community Coalition underscores the need for increased oversight and accountability within the long-term care industry. The fact that non-risk-adjusted data show such a high prevalence of antipsychotic drug use, coupled with a significant increase in potentially fraudulent schizophrenia diagnoses (194% increase between 2015 and 2019), is deeply concerning. 


In the "Final Report of the Kansas Senior Care Task Force to the 2023 Kansas Legislature", the Kansas Senior Care Task Force, consisting of legislative and non-legislative members, recommended leveraging technology to connect highly specialized geriatric psychiatric prescribers across the state for consultation. The task force also recommended improving upon existing standard training and education by providing targeted education for surveyors, direct care workers, providers, prescribers, long-term care providers and caregivers on the use of prescribed psychotropic medication for older adults with dementia or geriatric behavior health conditions. 


We encourage all individuals to utilize the data provided by the Long-Term Care Community Coalition. In the data spreadsheet, you can filter by state and county. 


Thank you for your ongoing support in our mission to advocate for the rights and well-being of those in long-term care.


Alarming Rate of Antipsychotic Drugging in US Nursing Homes


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Advocacy in Action (June 2025): One Investigator, 70 cases, APS is Stretched Too Thin

May 29, 2025
In a recent article published by The Beacon, reporter Blaise Mesa spotlights a heartbreaking case that exemplifies both the critical importance and serious strain facing Kansas Adult Protective Services (APS). The article, “One elder abuse investigator has 70 cases. Kansas doesn’t say how swamped other caseworkers are,” tells the story of Shirley Crow, an 85-year-old woman with Alzheimer’s whose family trusted a caretaker to manage her daily medications and appointments. That trust was broken. Despite filing a report with APS, Shirley’s family received few updates. Weeks after their report, Shirley passed away. Her case remains open—one of 10,000 APS investigations initiated in Kansas each year. The assigned APS caseworker? She has 70 other cases. This is not a story about blame. As Shirley’s daughter-in-law, Stacy Crow, told The Beacon , “We got an investigator that I truly believe has a heart… I understand they have an overwhelming demand… I don’t fault them. I just want things to change.” And so do we. Systemic Overload and the Urgent Need for Reform The Kansas Department for Children and Families (DCF), which oversees APS, has not publicly disclosed average caseloads. While DCF clarified post-publication that they do track this information, they choose not to release it, citing confidentiality. The lack of transparency and standardization prevents meaningful accountability and reform. National standards suggest 20–25 cases per worker is a manageable caseload. Kansas APS staff, in some cases, are handling double or triple that amount. With cases increasing year over year— 18,056 in fiscal year 2025 alone—the risk of delayed intervention or missed warning signs only grows. This Is a Wake-Up Call. At KABC, we continue to push for better protections for older adults, more robust support for APS investigators, and greater transparency and accountability from state agencies. In our recent blog post, “ What Happens When You Report to Adult Protective Services? ” we outline the crucial role APS plays in protecting vulnerable adults and how reporting suspected abuse can quite literally save lives. To report suspected abuse, neglect, or exploitation of a vulnerable adult in Kansas: For older adults living at home in the community or in facilities licensed by the Kansas Department of Aging and Disability Services when the perpetrator is not a resident of or staff of the facility, report to the following: Adult Protective Services (APS): 1-800-922-5330 If an emergency, call your local law enforcement agency or 911 Reporting initiates a multi-step process involving a prompt in-person visit, interviews, and, when needed, development of a service or prevention plan. The goal of APS is to protect, not to punish- to connect individuals to medical care, housing, legal services, or safety planning. But APS cannot fulfill that mission if it's underfunded, overwhelmed, and operating in the dark.  What Needs to Change: Transparency: Kansas must publicly release average caseload data and investigation timelines. Support for APS Workers: State leaders must prioritize hiring and retaining qualified APS staff and ensure manageable caseloads. Federal Investment: Continued and expanded federal funding for APS is essential—not optional. Public Awareness: Communities need to understand when and how to report suspected abuse, and how they can be part of the safety net. The APS system should be a lifeline, not a last resort.

5 Questions to Ask When Choosing a Long-Term Care Facility

May 21, 2025
Choosing a long-term care facility for yourself or a loved one is one of the most important decisions you can make. Beyond basic safety and cleanliness, the right facility should support a person’s independence, dignity, and overall quality of life. To help you make an informed choice, here are five essential questions to ask, along with key follow-ups that can give you a deeper sense of what daily life will be like at the facility. 1. How does the facility support independence and person-centered care? Person-centered care means that residents are active participants in their care and daily routines. Ask: Can residents choose when to wake up and go to bed? Are meals and activities tailored to individual preferences? Is there flexibility for “early birds” and “night owls”? Look for signs that staff respect residents’ individuality—such as accommodating dietary preferences and encouraging participation in meaningful activities. 2. What medical and rehabilitation services are available on-site? Quality care goes beyond assistance with daily activities. Ask about: Access to hospice care and pain management Availability of wound care and ostomy specialists In-house physical, occupational, speech, and mental health therapies Staffing levels—how many nurses and aides are on duty at different times of day? These services can have a major impact on recovery, mobility, and comfort. 3. What is the atmosphere like during meals and activities? Daily life should be engaging and social. Ask to observe a meal or an activity session. Consider: Are residents out of their rooms and interacting with others? Do meals look appetizing and meet special dietary needs? Is assistance with eating provided promptly and respectfully? Also ask about field trips, volunteer involvement, and whether there is an active activities room or calendar of events. 4. What do current residents and families say about their experience? Talking to those already living in or visiting the facility can give you valuable insight. Ask residents: Do staff respond quickly when you call for help? Do you enjoy your meals and feel your privacy is respected? Are you involved in decisions about your care? Ask families: Are you promptly notified of any accidents or health changes? Do you feel comfortable raising concerns? Is there a Family Council and does the facility listen to it? 5. How transparent and responsive is the administration? A responsive leadership team is key to resolving issues and maintaining quality. When meeting with the Administrator or Director of Nursing, ask: How do you handle complaints? How are staff trained and how long do they typically stay? What’s your policy on resident rights, such as refusing treatment? You can also ask to review the admission contract, learn about costs and refund policies, and understand how care decisions are made if the resident is unable to speak for themselves. Want more questions to ask? Visit our full guide: Is This the Nursing Home to Choose?  It includes detailed sections on services, nursing care, residents' rights, and conversations to have with administrators, staff, and families. At Kansas Advocates for Better Care, we believe everyone deserves compassionate, dignified, and person-centered long-term care. Asking the right questions is the first step to getting it.