One in five long-term nursing home residents in Maine are still receiving antipsychotic medication, despite statewide efforts to reduce reliance on these drugs. Maine initially made progress, reducing antipsychotic use from 27% of long-term nursing home residents in 2011 to 17% in 2017. However, the rate increased back to 20% in 2024, higher than the national average of 14.7%, making Maine the sixth highest across all states according to data from the U.S. Centers for Medicare and Medicaid Services. As of November, Maine’s rate is now 12th highest in the country, with South Dakota at 24% and Wyoming at 22%.
Risks and Quality Concerns
Antipsychotics, such as Risperdal and Seroquel, are designed to manage psychosis and delusions but can be particularly problematic for older adults by increasing their risk of drowsiness, confusion, and falling. Side effects can include tremors and heart and circulatory problems. The use of antipsychotic medications among nursing home residents is considered “an indicator of nursing home quality” by the Centers for Medicare and Medicaid Services. Research shows that lower-rated nursing homes prescribe antipsychotic medication more often than high-performing five-star facilities. Dr. Susan Wehry, associate clinical professor at the University of New England and a board-certified geriatric psychiatrist, notes that antipsychotics are sometimes necessary to prevent residents from harming themselves or others, but such occasions are rare.
Implementation Barriers
Reducing antipsychotic use has proven difficult because residents often arrive at facilities with existing prescriptions. Physicians not directly affiliated with long-term care facilities frequently diagnose and prescribe these medications prior to resident admission. Nursing homes must navigate the complex process of determining whether and how to wean residents off medications. Experts cite staffing shortages, reliance on temporary agency staffing, MaineCare underfunding, and the COVID-19 pandemic’s redirection of attention as barriers to reducing use.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.centralmaine.com/2026/01/20/use-of-antipsychotic-meds-in-nursing-homes-remains-flat/