Admiral Nurses - Still Waiting For The Promised DH Urgent Review Of Anti-Psychotics 'The Drug Of Last Resort' For People With Dementia, UK

Main Category: Alzheimer's / Dementia
Also Included In: Caregivers / Homecare
Article Date: 16 Aug 2009 - 0:00 PDT

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The charity for dementia and Admiral Nurses strongly supported the call for a change in practice when, in June 2008, the Department of Health (DH) announced it was to undertake an urgent review of the prescribing of anti-psychotic drugs for people with dementia. The DH stated that the review would assess the scale of inappropriate prescribing, and the reasons behind misuse of this type of medication. Anti-psychotic drugs have significant risk factors for people with dementia a particularly vulnerable group, many of whom are resident in care homes where specialist knowledge of drug treatments is often lacking.

"More than one year on we are still waiting for this review into this important issue on which both carers and professionals alike need clear guidance," says Ian Weatherhead, Lead Admiral Nurse for Admiral Nursing DIRECT - a national helpline operated exclusively by Admiral Nurses, who are specialists in dementia care.

Ian adds: "In very specific circumstances, anti-psychotic drugs have an important role to play when prescribed and used appropriately but they must always be considered as a last resort. This means a detailed assessment must be carried out so that other potential causes of behaviour change - often called 'challenging behaviour' - have been discounted, such as changes in environment, infection, constipation, anxiety and depression.

"Anti-psychotic drugs, with their known side effects, must always and only ever be used for the benefit of the person with dementia and not for the benefit of care staff."

Admiral Nursing DIRECT takes a large volume of calls every week from carers of people with dementia, people with dementia themselves, and professional staff. Many people contact the helpline with questions and concerns about medication, including anti-psychotics.

Hilary Woodhead, who leads on the development of training and learning partnerships for the charity for dementia, states: "It is vital that training and education for staff caring for people with dementia becomes a reality for all those working in front-line roles, in the community and in residential care and hospital settings. This is a cross-cutting theme in the National Dementia Strategy. Training programmes must encompass information about the appropriate use of anti-psychotic drugs to help ensure that the person with dementia remains the central focus of care."

Further advice from Admiral Nurses and Admiral Nursing DIRECT on the use of anti-psychotic drugs states:

• In some cases where distressing symptoms such as hallucinations and/or severe agitation are clearly evident as a result of the dementia, and not caused by other factors, then anti-psychotics may be of help but these need to be used carefully at appropriate doses and be reviewed regularly.


• Family members of people with dementia should be fully involved in any decisions taken about treatment and care wherever possible so that important information about the person and their history form an integral part of the assessment. Carers should be involved and kept informed regarding reviews of and recommended changes in medication.


• If anyone is concerned about any medication that is being prescribed for someone with dementia then they should request an immediate review of the medication by the responsible medical officer before any action is taken.


• Caring for people with dementia is different from caring for people who are older and frail. Specialist help is required together with focused training to ensure appropriate decisions are made concerning care and medication. Skills and knowledge concerning use of medications such as anti-psychotics must be made available to those working in care home and primary care settings. Admiral Nurses are well placed to work in partnership to provide that specialist help and training.

Source
Admiral Nurses