Just think about it. Thirty per cent of dementia sufferers in aged care homes are prescribed anti-psychotic drugs – but only one in four need them.
That’s the conclusion of a University of New South Wales-led trial[1]. That’s despite guidelines suggesting they only be used as a ‘last resort’ and studies linking them to an increased risk of falls, stroke and even death.
So how did they get this result?
An innovative approach
The Halting Antipsychotic use in Long Term Care (HALT) project involved 140 residents across 23 NSW homes and aimed to see if the estimated 30 per cent of dementia sufferers on anti-psychotics could be reduced[2].
After the home, family and doctor all agreed the patient could take part, their dose was cut in half every week or two weeks in a one- or two-step process.
Nursing staff were trained to recognise the causes of behavioural and psychological symptoms (BPSD) such as delusions, aggression, delusions and agitation and to use alternative treatments to help manage residents’ behaviour.
Key to this was taking a person-centre approach that looked at understanding the residents and the reasons behind their behaviour.
These nurse “champions” then passed their knowledge onto other staff and worked together with residents’ families and medical teams. Patients were then assessed three, six and 12 months afterwards.
It’s an innovative idea for an issue that has traditionally seen psychiatric drugs used as a stop-gap.
For the participants in the study where data was available, over 60 per cent had been prescribed their current medication after they had gone into aged care.
An aged care sector under strain
But with over 50 per cent of aged care residents in Australia affected by dementia[3], it’s not hard to see why these drugs are so widely used.
A lack of funding for aged care has left our homes with fewer staff. Not enough nurses receive training in dementia care. Doctors and geriatricians are under pressure to keep residents calm and provide a ‘quick fix’.
It’s a challenge that’s only going to worsen too. The Government’s budget cuts of $1.2 billion will slash funding for the sector. Just two weeks ago, our Frank journalist Chris Baynes forecast an exodus of aged care workers following the introduction of the NDIS.
Our aged care homes need more staff, more training and more time with residents. Then, trials like this one that show promise in making life better for everyone involved will stand a real chance of being implemented.
SOURCES
[1] University of New South Wales media release: ‘Widespread antipsychotic use in nursing homes unnecessary, trial shows’ – July 26 2016
[2] ABC News: ‘Premature deaths linked to drugs in nursing homes’ – August 17 2012
[3] Alzheimer’s Australia: ‘Key facts and statistics 2016’ – updated February 2016
