Do residents who experience dementia benefit from anti-psychotic medication?

November 12, 2009 — Professor Sube Banerjee, author of a review of UK dementia treatment, says up to 150,000 sufferers are prescribed anti-psychotic drugs unnecessarily Aged Care Crisis draws attention to a UK review (November 2009) into the use of anti-psychotic medications which found that the overprescribing of drugs is linked to 1800 deaths a year. The drugs, developed for treating people with schizophrenia, are sometime used to calm residents with dementia. The review found that only a fifth of those on sedative medications were receiving any benefit.

Related:

• Anti-psychotic drugs linked to deaths
  [ABC: AM - 12 November, 2009]
  
• Download: The use of antipsychotic medication for people with dementia: Time for action.
  A report for the Minister of State for Care Services by Professor Sube Banerjee. (PDF, 798kb)
• Download: Government response to Professor Sube Banerjee's report on the prescribing of
  anti-psychotic drugs to people with dementia (PDF, 23kb)
• 'Chemical cosh' drugs 'killing thousands a year'
  Four in five of the 180,000 patients given the antipsychotics should not be on the medications, it warns. The drugs, which have a strong sedative effect, are commonly given to dementia patients in care homes and hospitals, but studies show they can triple the risk of having a stroke

Older adults who take psychotropic medications more likely to experience falls

Older adults who take several types of psychotropic medications—such as antidepressants or sedatives—appear more likely to experience falls, according to an analysis of previous studies reported in the November 23 2009 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Miscellaneous articles

• Residential Aged Care (RAC) Coronial Communique - April 2008 (Physical Restraint - read the instructions)
• Restraint Toolkit (TMF Health Quality Institute)
• Antipsychotic Drugs Abused as Chemical Restraints for Elderly (November 2007 - Wall Street Journal)

Research

Use of physical restraints with cognitively impaired nursing home residents

J Adv Nurs. 2004 Feb;45(3):246-51.  Hamers JP, Gulpers MJ, Strik W. Associate Professor, Department of Health Care Studies, Section of Nursing Science, Universiteit Maastricht, Maastricht, The Netherlands.
Abstract: AIM: The aim of the study was to examine the prevalence of physical restraint use in cognitively impaired nursing home residents, the manner in which restraints are used, reasons for using them, and relationships between residents' characteristics and use of physical restraints. METHODS: A point prevalence study was conducted on the use of physical restraints among all residents cared for in two Dutch nursing homes and one nursing home unit (n = 265). Data about the nursing home residents and the use of restraints were collected by means of a questionnaire, which was filled in by the nurses. The response rate was 98%. The mean age of residents was 81 years (sd = 8.6), 74% of whom were female. RESULTS: One or more restraints were used with 49% of the residents. The most frequently used physical restraints were bed rails, a waist belt, and a chair with a table. In almost all situations (90%), residents were continuously restrained and restraints were used for longer than 3 months. The most common reason (90%) for use of restraints was to prevent falls. Logistic regression analysis revealed that use of restraints was highly associated with poor mobility, care dependency and risk of falling in the opinion of nursing staff. CONCLUSIONS: The results of this study are comparable with those of other studies. However, since recent studies have reported that physical restraints are inadequate to prevent falls, recommendations are made to re-evaluate critically the use of restraints and to conduct future research into a responsible and safe way of decreasing the use of physical restraints. PMID: 14720241 [PubMed - indexed for MEDLINE]