Do We Still Want Docile?

Sorry I went “missing” for a week, nothing unfortunate, just a holiday where I didn’t have the time or reliable access to the internet to sort my post out. I think its quite a while since I went a whole week without posting.

I’m back this week and many thanks to Kate Swaffer for bringing this to my attention. This month saw the release of a Human Rights Report into misuse of anti-psychotic medication in dementia care in USA

The report ‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia, estimates that every week in US nursing facilities, more than 179,000 people, mostly older and living with dementia, are given anti-psychotic drugs without a diagnosis for which their use is approved. Often, nursing facilities use these drugs without obtaining or even seeking informed consent. Using anti-psychotic medications as a “chemical restraint”—for the convenience of staff or to discipline residents— violates US federal regulations (and regulations in most EU countries including the UK) and may amount to cruel, inhuman, or degrading treatment under international human rights law.

Yet another reminder of the dangers of these drugs, a problem very effectively highlighted in UK healthcare on the publication of the Banerjee Report in 2009.

Things have been improving in the UK but it is still an issue worth highlighting and bringing to people’s attention. Particularly bearing in mind that the Department of Health in 2012 said antipsychotic use was still  “resulting in as many as 1,800 unnecessary deaths per year.” despite the improving awareness of the problem. Note that overprescribing of anti-psychotics is not confined to nursing homes. In fact many nursing homes have arrangements in place to minimise all over-prescribing that many healthcare professionals could learn from. See the HALT project in Sydney and this deprescribing anti-psychotics algorithm from Ontario if you want some inspiration for reducing anti-psychotic prescribing for the people living with dementia that you care for.

So I’ll leave you with a final thought,

How could we possibly think that it is a good idea to treat stress, distress and unmet needs using sedation?”

 

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Revisiting Deconditioning and Elder Abuse

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At the end of April 2017, I posted some information about a campaign aimed at trying to limit the extent of deconditioning syndrome by encouraging older people in hospital to get up and get dressed in their day clothes sooner in order to encourage more walking and safer walking early in rehabilitation called  #EndPJparalysis . In support of this campaign, this month Nursing Older People’s Research Focus page suggests some articles that you might want to read on this topic that support the campaign. Two of them are quite old but one is a recent French study has a strong message for all staff dealing with older people in Hospital. The article is

Sourdet, S., Lafont, C., Rolland, Y., Nourhashemi, F., Andrieu, S. and Vellas, B. (2015). Preventable iatrogenic disability in elderly patients during hospitalisation. Journal of the American Medical Directors Association16(8), pp.674-681.

Which you can access via Science Direct. You can take a look at the abstract here

Two other things of note this month. This week is Carers week and an interesting YouGov poll was conducted on behalf of eight major charities who are calling on the new UK Government and society to do more to recognise the important contribution that unpaid carers make. You can view and download the report called “Building a carer
friendly society” at the Carers Week website 

Finally, yesterday was World Elder Abuse Awareness Day and the WHO have estimated that as many as 1 in 6 older people are affected by abuse. They have created a page in support of this day that includes a link to a report published in Lancet Global Health which you can download and read on elder abuse prevalence at  WHO Elder Abuse Awareness

There Infographic is also great.