got a fish. >> reporter: andy gallagher, al jazerra, big pine key florida. now for the viewers joining us in the united states "america tonight" is up next. and whenever you are there is lots more on our website. aljazerra.com. get the latest on all of the stories we are covering there, plenty of news, analysis and perspective. >> on an "america tonight" special report: drugging america. >> marv and linda lost their son jason last august. >> i never thought he was going to die. >> the tomah va told them his death was caused by an aneurysm. >> despite the va's most serious warning, they found the nursing home residents with dementia

received antiscottics. >> daddy, come on wake up. >> is not waking up. i'm like what the heck happened to my father. what happened, why is he not waking up. >> thanks for joining us for a special report drugging america. tonight we focus on two kinds of patients. veterans and the elderly, who are especially vulnerable to the practice of bad medicine. those of us who have had to parent our parents, fear that they will live out their final days in a drug stupor. what's worse, evidence that many nursing homes use strong antiscottics on elderly dementia patients a full decade after they were first warned not to. in an exclusive investigation, "america tonight's" sheila macvicar found the results can be catastrophic. >> here's dad right after surgery. >> patrice gillgen captured this

with her father, jerry gillgen. went by ambulance to an assisted living facility south of los angeles. >> how you feeling? >> well, just a little bright. >> jerry gillgen also suffered from dementia and accompanying bouts of confusion. but in the first day in his facility his family said he was alert and lucid. >> daddy? dad? >> just one day later. patrice gillgen found a very different man. >> he's not waking up. i'm like what the heck happened to my father? what happened? why is he not waking up? >> jerry gillgen's wife was shocked. >> we took him into the home, it was the best place because his brother was there. the day later, he was a

vegetable. staring in space drugged out. >> reporter: drugged out on medications like haldol and seraquel, approved for patients with schizophrenia and bipolar disorder. not for dementia. strongest warning a black box warning telling physicians not to prescribe antipsychotic drugs for patients with dementia because they can cause heart failure infections and death. >> they were giving my dad all this stuff why, what was their goal to kill him? >> "america tonight" filed a freedom of information request asking the fda for adverse reactions to antiscottics. they don't prove cause and effect but there were dozens of cases of elderly patients with dementia who died after receiving antiscottics.

>> next day notes from nurse. haldol three times morphine one time. >> jerry g gillgen's prescription was as needed every six hours. written bring a doctor who never saw him. despite the fda's most serious warning the government accountability office found one in three nursing home patients were given antiscottics. >> they are given for the benefit of the facility, to manage them. >> five days after he arrived at the assisted living facility gillgen fell getting outs of bed. a greater risk of falling is one of the side effects of antiscottics. he was transported back to mission hospital.

the same place he had had his brain surgery. >> we're glad you're back, glad you're awake. >> reporter: two and a half weeks after he arrived in the hospital jerry gillgen opened his eyes for the first time. >> he wasn't the same. >> state investigators later determined gillgen had been overly pled caited. overly medicated. >> they took away everything,. >> they robbed him. >> all nursing home residents have a right to be involved in their plan of care and to be free from the unnecessary use of medications. >> thomas hamilton oversees nursing home and assisted living facilities for medicare. >> there is a body of research that has found correlation between lower staffing levels

and higher use of scottics. in addition to the staff is training of staff and understanding of staff in medication use. >> higher use decreasing the quality of care scores. the medicare initiative has broad overall use in nursing home residents down from 24% to 20% nationally. but some homes still report that up to 70% of their patients are on antiscottics. anti anti antisigh antipsychotics if. >> if medicare would stop paying for it it wouldn't be administered. >> why pay for drugs. >> we are looking at other settings in addition to nursing

homes to figure out ways to are reduce lienls reliance on antipsychotics . >> janine, after falling and hurting her back she wound up here rose point health and wellness near sacramento. >> i went there to ask them if that was their policy to use antipsychotics, that wouldn't be the facility for us. >> even before your mother went into that nursing home you told them no antipsychotics? >> that's correct. >> and -- >> they said we would never do that. >> yet within hours of arriving, zizo did receive an antipsychotic. an injection of haldol.

>> i went there and the employee said your mother was psychotic we had no choice but to give your mother haldol. when she said that to me, it knocked the wind out of me. >> the administrator wouldn't talk to us but medical records show zizzo could not even get out of bed without the assistance of at least two people. >> we started noticing major cognitive issues and then it just started going downhill pretty rapidly after that. >> janine zizzo died 17 days after she arrived at roseville point. what pursued persuades you that haldol

was at the root of your mother'smother's death? >> because everything that happened to her started after the administration of haldol. >> for the convenience of overwhelmed staff. >> rather than a gun or a knife or a bat, was the administration of haldol. even more egregious than a criminal laying in wait, was somebody that did it to my mother in a position of trust. to me, that's worse. >> jerry gillgen, lying calmly with his head on his pillow as he tells a caregiver he does not want the medication. >> my mom received a phone call from the home stating that you know they like to use this word combative. >> advocate carol herrmann says it is an all too common scenario. doctors receiving calls in the middle of the night from nursing

homes. >> they listen to whatever the person at the other end of the phone, which is the director of nursing, which says, mrs. smith is acting out. prescribe an antipsychotic because it knocks them out. >> posing a threat. at the facility in mancato minnesota they say there's another way. the nonprofit has reduced the use of antipsychotics, from 18% to 6% of residents. special training paid for by a state grant. >> we truly do not believe in medications to manage behaviors. >> behaviors like agitation or anxiety are seen as attempts to communicate, to be understood not managed with chemical restraits. >> they are trying oget a message out.

you just have to listen differently than in the past. >> one resident became distraught, who thought she heard a baby cry. on a whim, picked up a doll and said, why don't you hold the baby, and she held it for two hours. we have these babies that are pretty real feeling, it's got the right weight in the right spots. >> it feels like it's a baby you want to put the baby up on your shoulder. >> avoiding antipsychotics has given the residents their lives back. >> you give the gift of life back to the residents. if you are sleeping all day you're not having relationships anymore. >> the blue one? >> mary lynn devan's father moved here from another facility antipsychotics. >> do you feel like you have a

little bit more of your dad back? >> some days, some days when he was on any of the meds especially the haldol i don't know who he was, it wasn't him. it wasn't him at all. now, even whether he doesn't know who we are, it's still him. >> before he died, jerry gillgen went to a nursing home that didn't use antipsychotics, and his family saw glimpses of his old self. >> i remember one night i got a phone call about 10:00 at night and i thought oh, something happened. and she said jerry is in the office, he wanted to call me. i said how you doing? he said okay, he said i'm hanging out with the nurse. i said i'll see you tomorrow. >> sheila macvicar, al jazeera.

>> an update to our story about chantix, ahead. later hear the va hospital known to some being patients as candyland. >> did tomah have a habit of dispensing more medications than patients needed? >> yes. >> how patients served suffer.

>> in our fast forward segment,dying to quit. hundreds have people have used the pill chantix, some say it does work but there could be threatening and life endangering side effects. >> i started walking around the house screaming yelling crying. i was threatening suicide, threatening to jump out of a moving car. then the police came and the

paramedics and they had to tie me up. put restraints on me. >> hearst wound up in this hospital, five days in a locked psychiatric ward. according to u.s. food and drug administration documents obtained by "america tonight" under the freedom of information act, 544 suicides have been reported to the fda as adverse events. associated with chantix in the last time years. fda documents also show 1869 attempted suicides associate ed with chantix. we should point out these adverse event reports don't prove chanti chantix causes side effects of any way. >> how sure are you this drug caused the breakdown? >> without a doubt i went off the deep end.

it changed my mind it changed my brain it caused this absolutely, i'm absolutely positive that it was the chantix chantix. >> fast forward to a new warning from the fda. drinking and chantix don't mix. can lead to aggressive behavior even amnesia. chantix already carries a black box warning, that's fda's strongest. next in our special report drugging america, prescriptions undermonitorred. >> he took a drug to get up in the morning, keep him going and then he had to take many drugs to knock him out at night, he couldn't sleep. >> "america tonight's" christof putzel on overmedicating americans at a hospital meant to serve them. >> discipline... >> that's what i wanna hear... >> strength... >> give me all you got... >> respect....

>> now... >> bootcamp >> stop your'e whining... >> for bad kids... >> they get a little dirty... so what... >> dangerous... >> we have shackles with spit bag... >> they're still having nightmares >> if you can't straighten out your kids... >> they're mine >> al jazeera america presents camp last resort on al jazeera america >> this is the true definition of tough love

>> the veterans administration the va, holds itself proud to serve those who have served. mismanagement poor treatment have led to the ouster of its chief. now death of a 81 vet at the va "america tonight's" christof putzel found it is a tragedy that is bound to raise new questions about how to fix the va. >> i never thought he was going to die. >> reporter: march and linda

is lost their son. he didn't die overseas, he died at the tomah medical center in central wisconsin. >> he was lying on his side, i said jason what's the matter with you? he said sh sh sh. i said what's wrong with him, he can't even talk. she said we gave him some medication for the migraine, he'll be all right in a couple of hours. >> reporter: but he wasn't all right. efforts to revive him failed. the state autopsy revealed something, mixed drug toxicity. >> right here, drugs positive in his system. >> every one is a medication that the va prescribed to him. >> reporter: all told the medical examiner found 13 different medications in jason's system. >> reporter: what was the

reason that you were given about why he was prescribed so many different medications? >> he was bipolar supposedly. >> add. >> add. >> there were a list of things which we were surprised because he never had any of those symptoms before any of those diagnosis ever. it was almost like at the end they had him so drugged up he took a drug to get up in the morning and keep him going and then he had to take many drugs to knock him out at night because he couldn't sleep. it was just a vicious circle. >> reporter: jaifn was jason was one veteran held at a facility that kept its patients. doped up. he got married and had a daughter and joined marv in the family construction business

building homes in stevens point wisconsin. but as a result of an injury in service led him to years of treatment in the va. jason text exed his father for help. >> i'm so anxious, i couldn't take it anymore. i'm worse than when i came in. he died august 30th on saturday. >> reporter: one witness to jason's last year was kristin, a former tomah housekeeper who is speaking out about what she saw. >> i saw him sit up in bed and seemed like he was fine, he was mumbling and i didn't think anything of it. he was in a ward where people don't die. it's an in and out ward. >> navy veteran who several years earlier had also received substance abuse treatment on the very same ward. >> i took his trash out, shut

his door and two hours later he was dead. a nurse had gone in there just to check on him and just like that, he was dead. >> reporter: so after he died did you have to go back into his room ? >> it was like a zoo, it was really bad running around everywhere, nursing staff, screaming and yelling. i stayed out of the way watching the whole thing, though. giving him cpr. the blood everywhere. >> reporter: the death of jason and a subsequent report by the center for investigative reporting set off a fire storm. in january bob mcdonald, secretary of ves vet

rans veterans affairs. the head of the investigation, dr. david hoolihan. >> did you ever have any interaction with dr. hoolihan? >> after my son audit he called me actually and expressed his condolences for my son jawfn and i think -- jason and i think a day or two later we got the autopsy report back too. he said i'm kind of puzzled about this, did you by any chance give your son some extra meds? i'm like no, i'm here fighting for a reduction in meds and he's asking me that. >> reporter: it turned out that months before, the veterans affairs had looked into dr. hoolihan's actions, the oig had found that dr. hoolihan and

one of his nurse practitioners, had been overmedicating. kristin saw patients every day whom she thought was overmedicated. >> the patients a lot of them were just walking around like zombies. i couldn't understand why there were so many patients that were just being their -- in their bed all day long. >> reporter: kristin said she resigned from the tomah va under pressure from her supervisors, part of a climate against anyone speaking outs. >> did tomah had a practice of dispensing pills that others would wouldn't? >> yes. >> so people knew to go to tomah if they wanted meds? >> i heard all the time that hoolihan was giving the stuff

out all the time like candy. >> "america tonight" reached out to dr. hoolihan for comment. his attorney said all the requests for interviews needed to go through tomah va. but tomah va said the requests would be from the doctor himself. >> where is the doctor now? >> he's been reassigned. not prescribing medications. >> since 2004 the year before dr. hoolihan became chief of staff the number of opiate prescriptions handed out at the tomah va increased by five times, despite the fact that fewer veterans were seeking care at the facility. >> five years before jason was found dead of mixed drug toxicity, inspector general released a report saying the

chief of staff here in tomah was prescribing an abnormal amount of opiates to patients. shouldn't that have been a red flag? >> we took very seriously the issues raised in the oag report and we took action to address the oag report recommendation, including redirecting the chief of staff, and a psychiatric nurse practitioner's patient load or high opiate patient load to another provider. >> but they continued to prescribe a tremendous amount of drugs including opiates to the patients. >> so we actually then put a pain management physician to oversee the highest -- the patients with the highest opiate usage at the facility to make sure that we're separating their psychiatric care from their pain care. >> would you say it worked? >> i think we've seen tremendous strides in how the facility's addressing opiate usage with our veteran patients. >> shortly after this interview the va announced the results of

the clinical review of tomah that had been ordered in january. it found unsatisfactory levels of patient care prescribing of opiates at two and a half times the national average, for jason's family those findings came too late. >> did you voice your concern to the va about the amount of prescriptions he was receiving? >> all the time. >> i always voiced concern about the amount of meds but seemed like i lost. >> to honor the service and sacrifice ever their son jason christof putzel, al jazeera. >> that's our "america tonight's" special report drugging america. tell us what you think at aljazeera.com/americatonight. talk to us on twitter or facebook and come back. we'll have more of "america tonight," tomorrow.

the red cross warns of what it calls unbelievable destruction after cyclone pam moves through the southsouth pacific. ♪ ♪ hello, this is al jazerra. i am live from our headquarters in dough ma. also ahead on the program egypt launches a campaign to help boost its struggling economy and the pledges are pouring n a march of support in brazil for embattled president. this is not just murder it's torture and murder. >> and conservationist in the u.s. try to solve