Excessive sleep pill use sparks concern in nursing facilities

Children visiting elderly parents in long-term care hospitals often find them asleep and wonder why. Hospitals usually explain that the parent had a restless night or was given medication for delirium. Seeing a parent deeply asleep during the day can raise suspicions that unnecessary sleep medication was administered without family knowledge. Data show long-term care hospitals prescribe far more sleep medication than general hospitals.

Data submitted to the National Assembly by the Health Insurance Review and Assessment Service show that the 100 long-term care hospitals with the highest sleep medication prescriptions last year averaged 122.4 prescriptions per patient. That is 22 times higher than the 5.6 prescriptions per patient at the top 100 general hospitals and about 19 times higher than the 6.45 prescriptions per patient at hospitals treating seriously ill patients. While longer stays in long-term care hospitals could partly explain higher overall prescriptions, the gap compared with hospitals caring for severe cases is difficult to justify.

Long-term care hospitals say patients with dementia or delirium may act out at night, risking falls or disturbing others, which can justify higher medication use. However, overprescription can cause side effects and reduced physical activity, posing health risks. During COVID-19, when family visits were restricted, the rise in sleep medication prescriptions drew concern. Experts stress that strict monitoring of medication types and dosages is necessary to ensure treatment, not chemical restraint.

One in six long-term care patients remains hospitalized not out of medical necessity but because there is no one to care for them at home. When partial insurance coverage for long-term care nursing costs begins in the second half of next year, these “social hospitalizations” are expected to increase. To reduce reliance on expensive long-term care facilities with low patient satisfaction, policies should strengthen home and community care systems and promote health programs that lower demand for institutional care.