Always a last resort: Inquiry into the prescription of antipsychotic drugs to people with dementia living in care homesApril 4 2008
This report published by the All-Party Parliamentary Group on Dementia (APPG) examines the problem of the over prescription of antipsychotic drugs to people with dementia living in care homes and proposes workables solutions.
The inquiry found that over-prescribing is clearly a significant problem in many care homes. Evidence submitted to the inquiry highlights specific reasons for the use of antipsychotics. These drugs are prescribed as a response to the behavioural and psychological symptoms of dementia, experienced as a result not only of the condition, but also as a result of a wider and more complex set of problems external to the individual’s condition.
These problems include a lack of dementia care training for care home staff, which results in the staff not being able to support people with dementia, for example by providing person-centred care. Further problems include inadequate leadership in care homes, a lack of support from external services (including inadequate monitoring and review of prescriptions) and the exclusion of family and friends from decision-making.
The report makes a number of recommendations including:
- Dementia trainings hould bemandatory for all care home staff.
- Care homes must receive effective support from external services, including GPs, community psychiatric nurses, psychologists and psychiatrists, which should involve regular, pro-active visits to the care home.
- The use of antipsychotics for people with dementia must be included in Mental Capacity Act training for all care home staff.
- Protocols for the prescribing, monitoring and review of antipsychotic medication for people with dementia must be introduced.
- There should be compulsory regulation and audit of antipsychotic drugs for people with dementia.