Antipsychotic medications can be effective tools in managing serious mental health conditions, but they also carry risks for older adults.
Antipsychotic medications can be effective tools in managing serious mental health conditions, but they also carry significant risks for older adults. One of the strongest safeguards in long term care is ensuring that every staff member, not only nurses and clinicians, is trained to recognize early warning signs of adverse effects. Housekeeping, dietary, laundry, and activities teams interact with residents throughout the day and often notice changes long before they become clinically obvious.
In a long term care environment, every department plays a meaningful role in resident safety. Antipsychotic overdoses or adverse effects may not always appear dramatic. Subtle behavioral or physical changes can be the earliest indicators that something is wrong. Staff awareness is essential for F605 compliance and for protecting residents from preventable harm.
Housekeeping Staff
- Resident unusually drowsy or unresponsive during daily cleaning
- Excessive drooling or slurred speech
- Increase in spills or messiness due to motor control issues
Laundry Team
- Soiled clothes from incontinence episodes that are not typical for the resident
- Noticeable tremors or stiffness while handing off clothing
- Unclear speech or signs of mild disorientation
Dietary Staff
- Resident not eating or unable to feed themselves when they normally can
- Choking, chewing difficulty, or pocketing food
- Unusual behaviors such as grabbing food or refusing meals
Activities Staff
- Sudden loss of interest in preferred programs
- Difficulty remaining still or appearing overly sedated
- Facial movements or limb twitching observed during group activities
Nursing and Nursing Assistants
- Muscle rigidity, tremors, facial tics, or repetitive motions
- Unexplained falls, gait instability, or restlessness
- Confusion, changes in speech, or shifts in mental status
- Variations in vital signs including low blood pressure or bradycardia
What Everyone Should Do
If something does not seem right, staff should speak up immediately. A quick report to a nurse or supervisor can prompt timely assessment, prevent further harm, and support appropriate monitoring such as AIMS testing. A team approach ensures that no early sign is overlooked.
Polaris Consultants can help you incorporate this training into staff orientation and develop educational outlines for ongoing in-services. Every department should feel confident and empowered to recognize concerns and act quickly.
Sources
American Psychiatric Association: AIMS Tool
CMS State Operations Manual Appendix PP (April 2025)
AAPACN Psychotropic Guidance Summary
CMS Compliance Group
New England Journal of Medicine 2019 Tardive Dyskinesia and Antipsychotics
FDA Drug Safety Communications
