Powerful anti-psychotic drugs intended to treat schizophrenia are reportedly being regularly used to “chemically cosh” elderly dementia patients.
Sube Banerjee, professor of mental health and ageing at the Institute of Psychiatry at King’s College London, has said people are being kept on the drugs for far too long.
His warning echoes research suggesting such drugs can double the risk of death and triple the risk of stroke. Professor Banerjee said: “This is a major NHS issue. There are a lot of people treated with drugs that are potentially harmful.”
The drugs are prescribed to control symptoms such as aggression, agitation and hallucinations, but critics say they are often given to sedate people.
A government review estimates that 180,000 people with dementia are thought to be on the medicines, with only around 36,000 getting any benefit. Overprescribing is linked to 1,800 deaths a year.
One would hope someone at the DH makes the link between this report, the recently announced delay in registration of care home staff by DH, and the cost of providing high quality residential care versus the eternally squeezed commissioning budgets of local authorities.
Those who specialize in the care of people with dementia, running a specialist assessment unit would regularly get very disturbed people’s medication needs brought down and fine tuned, before sending them off to a care home. This was where the decisions to administer “as needed” (prn) medication (usually on top of the normal dose) were made by people with no understanding of the drugs and usually no professional qualifications- unlike NHS units where these decisions were taken by qualified mental health nurses skilled in assessment (a crazy anomaly, and bound to put vulnerable people at risk).
Add to this the low paid, overworked and under trained care home staff who ask the GP for “something to settle him” and so psychotropic drugs are prescribed, often with little expertise. Any monitoring of benefits and side effects is by those same unqualified care staff that often don’t have a clue. There was a case where extra constipation medication was given by a care worker who believed that it was prescribed to help calm someone down! You have no idea how bad it can gets.
The drive for community based support means that often those in care homes are going to be people with dementia, some of whom will become restless or agitated. Properly supervised medication can have a role, but homes must be properly supported to meet the needs of people with dementia without the need for so much sedation.
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