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Looking at the history of learning disability services, one sees perennial reports about the use of antipsychotics to manage behaviour but no change to the practice.
Will we see the same with dementia care? If the use of antipsychotics to manage behaviour is to be reduced, it seems there is only any prospect of this occurring if it is made a real priority with significant resources.
The squeezed budgets and recruitment problems faced by care providers suggests more reliance on the use of antipsychotics to manage behaviour, not less.
Eloise Jones September 21, at 2: Catherine Clarke September 21, at 4: Research depicts antidepressants are linked with certain genetic variants which result in worsening behaviour such as akathisia, aggression, hallucinations, psychosis and suicideation.
Antipsychotics are metabolised through similar pathways to antidepressants and like wise can induce worsening behaviour. Because of lack of pharmacogenetic knowledge in the medical profession, the standard practice is therefore to increase the dose or add another antipsychotic which in turn increases patient distress.
There is another way to manage behaviour without resorting to toxic drugs Proutys Pre Therapy is a technique used with dementia and other patient groups.
If a doctor feel a drug is not appropriate they should not prescribe it. In the later stages some people are driven to wander until they literally drop, or are seized by anxiety that cannot be addressed except by medication.
If it were physical pain we would expect painkillers to be offered. I dont know why the softer drugs like lorazepam are not tried sometimes before haloperidol.
My gut feeling is that a little something to take the edge off anxiety would often work. I remember working in a residential home with an old lady who has been discharged from one of the large old mental hospitals. She was virtually immobile and staff were getting impatient. I was shocked to see she was on a huge side of chlorpromazine.
I phoned the gp and he was clearly shocked too. In days her mobility improved and there were no negative consequences. BIA John September 22, at It strikes me that there are a huge range of treatments out there for people which do not have to include the taking of medication.
These range from physiotherapy, heat treatments, acupuncture, exercise, light therapy… As Bill Nightingale correctly points out, many services have a long history of using such things as antipsychotics, sedatives and antidepressants to manage behaviour in patients and service-users.
It is clear that increased and more intensive research is now necessary in order to explore the reasons why this happens. I was bullied mercilessly at school and at work because I have a parent who has mental health issues. This suggests that there are many factors at play, here, that may lead to such inappropriate use.
The fact that this is occurring in care homes in deprived areas, may indicate that such care homes are inadequately and inappropriately staffed, and that they try to compensate for short-staffing, or for having poorly-qualified staff by chemically controlling residents.
Sometimes, it MAY be a symptoms of their dementia. However, it could just as easily be a sign of agitation caused by an untreated infection — such as a urinary infection, or a chest infection changes in behaviour, and especially signs of agitation and confusion, can be symptomatic of respiratory or urinary infection in elderly people.
It may be that a person with dementia finds it hard to articulate issues, and therefore cannot directly tell someone they are in pain, or feel ill. Care homes that are short-staffed, or which do not employ very well qualified staff, may fins that their employees do not pick up on such issues.
Yvonne Bonifas gives a good example of this by describing an elderly lady who presented as very slow moving, and almost immobile — much to the frustration of staff.
The irony is that although staff of the care home where this lady resided seemed to believe that she needed the medication she was on, it was the actual medication that was causing the presentation immobility that most annoyed them!
We should all try to make ourselves aware of the side-effects of medication that people we work with are taking. It strikes me as somewhat ridiculous that medications may be prescribed to control such things as dementia, or maybe anxiety, or depression, or ADD … but which may produce side-effects that are pretty similar to symptoms they are supposed to control!
These situations are both problematic. The addicted person becomes dependent on medication, meaning that it is very difficult to wean them off it.This unit assesses support for use of medication in social-care settings. It covers broad types, classifications and forms of medication, as well as safe handling and storage.
It addresses practical support for use of medication that reflects social-care principles and values, and includes the need for accurate recording and reporting.
The Health and Social Care Act – outlines the responsibilities of care managers to prevent risk from medicines. Types of drugs: Prescription only medicines .
hsc support use of medication in social care settings outcome 1 Identify the legislation that governs the use of medication in social care settings - The following legislations have a direct impact on the handling of medications within a social care setting: ·The Medicines Act basis for licensing, sale, supply and manufacture.
In addition to opioids, there are a number of other helper medications that palliative care specialists use to help control pain. They include: Non-steroidal anti-inflammatory drugs (NSAIDS). Health&Social Care (adult) Advanced Diploma including Dementia Pathway Unit CU Support Use of Medication in Social Care Settings There are four acts that governs the use of medication in social care settings.a.) The Medicine act -governs the manufacture & supply of medicines.
staff and to help care service staff working in residential care services who record medication administration and develop personal plans. This guidance gives common sense guidance on medication recording and personal plans.