The drugs don’t work. They certainly make things worse for the 45 per cent of people with dementia in care homes, who are prescribed neuroleptic drugs. Not only will they die sooner, but what is left of their personalities will be lost as the condition deteriorates more rapidly than without medication and they lose communication, mobility and thought processes.
People with Alzheimer’s can be physically and verbally aggressive. This is difficult for a carer to cope with, particularly if they are in poor health themselves. Much of the time their loved one seems like a stranger – and not a nice one. Hence the use of psychotics which are intended for people with schizophrenia and unlicensed for people with dementia. They can also increase the risk of stroke three times.
A five-year study by the King’s Fund has found that these drugs can reduce the life expectancy of people with Alzheimer’s. The other thing the study highlights is that the drugs are used largely in care homes, rather than by struggling carers, and not always in consultation with families.
Further, they tend to be prescribed by GPs rather than specialists. This opens up the debate about the mismanagement of medication in some care homes. Doubtless, it’s easier to manage a home where the residents are docile, and preferably not too mobile. Training staff to manage “challenging behaviour” would be a better option than drugs.
My experience of this with my mum is that homes struggle with someone with Alzheimer’s but who is physically fit and active. Those that care for this group of people usually have a locked-door policy for safety, but for someone who is used to walking daily, the pent-up energy and frustration of being unable to get out is released as aggression. And care staff don’t want to take out someone who is aggressive.
So the other option is medication. The person we took home was not the active octogenarian we took to respite just days earlier, but someone who needed carrying to bed by 4pm. So we stopped the medication prescribed in the home and we manage the behaviour with walks, or conversation, or music or tea and biscuits.
Better than sleeping your life away.
Jennifer Harvey is a day services co-ordinator working with people with learning difficulties