25th Jan 2018
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Doctors want ban on drugs leading to dementia deaths
Author: Olga Galacho
Dementia drug leads to early death

Antipsychotics are leading to the premature deaths of as many patients with dementia as those helped by the prescribed drugs, a senior geriatrician says.

Renewing a call for antipsychotics to be avoided as the first treatment for behavioural and psychological symptoms of dementia, President of the Australian and New Zealand Society for Geriatric Medicine (ANZSGM), Associate Professor Eddy Strivens, told YourLifeChoices the drugs were of little value to patients not suffering psychosis.

The drugs, which are strong tranquilisers, were designed to treat people with schizophrenia and bipolar disorder who largely experienced hallucinations or delusions.

Dementia patients displaying agitation or aggression may be reacting to an unmet need rather than showing symptoms of psychosis, Prof Strivens said.

“The ANZSGM wants to stimulate the conversation around reducing the use of antipsychotics because there is evidence linking them with a risk of increased morbidity,” he said.

“Often, a patient with dementia may be reacting to something in their physical environment and this is mistaken for psychotic behaviour.

“The patient may merely be precipitated by hunger, thirst, bright lights, constipation or side-effects of other medications.

“In some people, confusion can arise from having a salt or electrolyte imbalance in their blood, as is sometimes seen with diabetics or patients with thyroid problems.”

Prof Strivens believes that before antipsychotics are prescribed, a thorough assessment of the patient ought to be conducted by their GP or specialist.

“They need to look at the behaviour and decide whether it is a consequence of an unmet need,” he said.

“Then they can go about designing an alternative treatment involving person-centred care.”

Figures showing that prescriptions of antipsychotics had grown almost 360 per cent in the 24 years to 2016 have drawn criticism that Australian doctors are over-medicating patients with the strong sedatives.

“We believe they don’t work well and practitioners ought to consider non-drug interventions first,” Prof Strivens said.

Referencing a UK report by Professor Sube Banerjee, of London’s King’s College, he said that national leadership was required to begin rolling back the use of the drugs in nursing homes.

Restricting the use of anti-psychotics is one of a five-plank manifesto called Evolve that the ANZSGM supports.

According to the document: “People with dementia may exhibit aggression, resistance to care and other challenging or disruptive behaviours. In such instances, the modest effectiveness of atypical antipsychotics may be offset by the higher risks for adverse events and mortality. Non-pharmacological interventions can be an effective substitute for antipsychotic medications. Use of these drugs should therefore be limited to cases where non-pharmacologic measures have failed and patients pose an imminent threat to themselves or others.”

Do you think that prescribing antipsychotics to dementia patients can solve their behavioural issues? Who benefits most from these sedative drugs: the patients or their carers? Do you think prescribing antipsychotics should be more tightly regulated?

Opinion: Government must review lethal dementia treatment

More than a decade after warnings were issued about doctors inappropriately dosing dementia patients with strong sedatives, it is astounding that they need to be reminded to stop this abhorrent practice, again.

Lately, the Australian and New Zealand Society for Geriatric Medicine (ANZSGM) has had to issue another alert that anti-psychotic drugs can precipitate the deaths of patients with dementia. When will practitioners supposedly caring for frail, elderly patients stop this abuse?

These patients are likely to be in residential care or hospitals. The peak body advocating for best-practice care of these patients is alarmed at the rampant prescription of antipsychotics. And we should worry, too, because there, but for the grace of God go all of us, at some future point.

Antipsychotics help patients with bipolar or schizophrenic disorders. The drugs ameliorate the downside of their delusionary thoughts. But if you do not suffer these psychological illnesses, then those medications will not ease your suffering. They may quell certain  behaviours – agitation, aggression – but they will do nothing to address the underlying cause of distress, according to various studies. Some of those studies even suggest that they will pre-empt death, if a patient is misdiagnosed and improperly medicated.

Sadly, the unmet needs of patients with dementia are in many cases being ignored for the sake of the convenience of their carers and medical practitioners. Patients are being drugged into a pliable, stupefied state so that they can be “managed” more easily.

According to the ANZSGM, what practitioners ought to be doing is more closely examining why these patients are troubled. Prominent geriatricians are suggesting that these patients are expressing a frustration about their physical environments or uncontrollable bodily functions.

The organisation is pleading with those who care for frail, elderly patients to more closely examine the needs of this vulnerable cohort. They want to see better assessments, more non-drug therapies, treatments that focus on psychological remedies, and improved attention to the very personal needs of this growing demographic.

And let’s face it … more of us are going to end up in that category as modern medicine keeps some of our vital functions working while others deteriorate.

What our society needs is a more incisive look at how to manage dementia patients without stripping them of their last remaining cognitive abilities, and precipitating their deaths through the prescription of dangerous tranquilisers.

I’m calling out the Minister for Aged Care, Ken Wyatt, to do something meaningful with his responsibility towards elderly Australians. If he fails to address this growing problem, future generations may judge his ministry as responsible for the early demise of thousands of people.

What are you going to do, Mr Wyatt? Are you going to ban the automatic prescription of strong tranquilisers for patients with dementia? Are you going to mandate better assessment of how to meet the needs of the growing number of patients suffering from dementia? Tell us, Minister. Because if you call yourself the Minister for Aged Care, you better be doing something constructive for the vulnerable people you have been charged to advocate for.

(article updated 25/01/18 10.30am)

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    COMMENTS

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    Ted Wards
    25th Jan 2018
    10:48am
    Interesting dilemma. Most doctors are in the pockets of big pharma
    Ahjay
    25th Jan 2018
    1:01pm
    Money speaks all languages.
    Virginia
    25th Jan 2018
    11:30am
    If I had dementia I would want to be put down
    Hasbeen
    25th Jan 2018
    12:18pm
    I could be unkind & suggest that many doctors want to keep you alive, because they have to stop charging you after your death.

    Thus those who give anything that improves your life short term, even if it kills you sooner, are by far the best to have.

    Personally I'll take a year of reasonable cognitive life rather than 5 of being a vegetable.
    Triss
    25th Jan 2018
    2:47pm
    Even if you wanted to put down, Virginia, it has to be your choice and your permission not someone else’s decision.
    Knows-a-lot
    25th Jan 2018
    4:54pm
    She can decide that before she loses her mind and state her wishes in a formal document.
    Lookfar
    25th Jan 2018
    11:33am
    The ANZSGM proposals definitely sound a bit better than Dame Edna Everidges' instructions to the nursing home she was taking her dear old Dad to, (forced to, he's a bit past you know) - 'just hose him down once or twice a day and roll him up in some carpet, he'll be no trouble".
    Well, some doctors need to be put on the spot and have explained to them that that was a joke, to bring peoples attention to certain inhumane attitudes, not an injunction to behave likewise.
    Triss
    25th Jan 2018
    11:33am
    That’s the trouble with going into any kind of care/medical facility, control is removed from you to the medica staff who can dose you without your permission.
    OnlyDaughter
    25th Jan 2018
    2:09pm
    Sorry Triss but you are not correct. In Australia, no one can "dose you" without your permission in any care/medical facility. If you have been deemed to have lost capacity by doctors - the ability to make informed decisions for yourself regarding financial or health matters due to brain damage/dementia - and previously you had made an Enduring Power of Attorney or an Advanced Health Directive naming personal care attorney/s, then this person/these people legally take over and look after your medical care. If no EPOA is in place, in Queensland a court appoints a guardian to do this. Personal Health Attorneys and Guardians appointed by courts cannot force you to take medication. Whilst doctors may prescribe medication and care staff may bring it to you for you to take, no one can force you to take any medication.
    Triss
    25th Jan 2018
    3:12pm
    But the article seems to read that patients have been receiving massive amounts of drugs without they, or their families, being properly informed of the side effects. Had they had that information, in many cases permission would have been refused so technically patients were medicated without their informed consent.
    OnlyDaughter
    25th Jan 2018
    3:25pm
    Drugs in aged care or medical facility have to be given at the prescribed dose and if this is found not to happen, charges are laid. These anti-psychotic drugs would have been administered over a long term and would have had a cumulative effect. As the drug breaks down it is still effective in a person's system. Every drug that we take has potential side effects and this even includes natural remedies. All prescription drugs either have an information brochure enclosed or a link for you to go online to get the information brochure. This brochure states all the side effects. I always check the medication prescribed for my Mum to see what it is supposed to do, its dosage and its side effects. Anti-psychotic drugs have long been known to have an adverse effect on dementia patients so this article is not new news. Please don't think that if you have to go into care, over dosing on drugs is going to happen to you.
    TREBOR
    25th Jan 2018
    7:31pm
    We're talking about doctors prescribing to dementia patients here.... how much real say does such a patient get in their medications?
    Amelia
    25th Jan 2018
    11:39am
    The comment about most doctors being in the pockets of big pharma is absolute rubbish. Fake news at its worst.In 40 years of practice I am yet to find myself in anyone's pocket, and this applies to the vast majority of my colleagues.
    I am pleased that action is being taken to reduce the use of antipsychotics in the elderly. However most aged care facilities are grossly understaffed, having a handful of poorly paid care givers without the necessary training to manage difficult behaviours, and these days there is often no registered nurse available. Action needs to be taken on staffing, and of course education of nurses, carers and GPs in the correct assessment and management of the aged. It all costs money, and it is up to the Government and owners of aged care facilities to deal with the deficiencies in staffing and training by improved funding.
    TREBOR
    25th Jan 2018
    11:58am
    Totally agree with your views on facilities.... while ever these are profit based, and geared to ensure maximum profits for the 'owners', these problems will persist.

    The problem, of course, is that additional training and staffing will cause a rise in costs, so it's a very difficult path, and would require massive funding by government, too much of which would, as usual, be subverted into too many pockets along the way.

    As in Aid funding - sometimes less than 5% reaches the coal face, so any government funding call needs to be very carefully looked at and kept under constant review - another cost factor.

    Where do we go with aged care? The current system is working in a minority of cases, but what are the alternatives? State-funded and operated institutions?
    Ella
    25th Jan 2018
    8:57pm
    Yes agree with this observation. As an RN all my working life with a stint in aged care the biggest problem with caring for dementia patients is both understaffing and lack of good education and training in staff. Badly handled dementia patients can react aggressively quite easily thus leading to pressure on doctors to prescribe medication in order for staff to more easily handle these people. I can't see this situation improving in the near future with cuts to aged care funding.
    The other difficult scenario is a lone carer doing it tough caring for a family member with dementia. Although they have the benefit of knowing the person well the stress over time may well lead to medication use to manage very challenging behaviours
    TREBOR
    25th Jan 2018
    11:53am
    Well - when you apply subjective opinion voodoo in determining that a patient is 'psychotic', and it is somehow convenient to do so - it becomes easy to ignore the person and just give them something to quieten them down. Most doctors are highly unqualified to determine the true mental state of a patient, and making it 'easier' for the staff is not the name of the game.

    Everyone in health care, down to the lowest assistant in nursing, imagines him or her self to be a reincarnation of Sigmund Freud or the equivalent of the most highly qualified and experienced doctors, and I'm sure many of these doctors giving out these pills just take the word of staff for the condition.

    It's an appalling commentary on the way older patients, with or without dementia, are viewed by those handed the power and responsibility to care for them.
    Jennie
    25th Jan 2018
    11:59am
    Yes, good that anti psychotic drugs lead to premature death. I will put myself down if I get a diagnosis of dementia.
    A relative with dementia is taking anti psychotic drugs to stop her attacking her husband. She is now calm and he is a lot safer.
    why keep us alive past our use-by dates in an over populated world. It is cruel and unethical.
    trood
    25th Jan 2018
    11:12pm
    Totally agree Jennie. Once you get dementia unless you have heaps on money and the best of care its all downhill and the quicker you can check out the better. I have seen my friends partner in a pension only facility and the kindest thing would be for him to die because he has is no quality of life, shrivelled to half the man he used to be it is so pathetic to see what he has become.
    Old Man
    25th Jan 2018
    12:03pm
    Leaving aside the psychotic element, people (and they are above all, people, not just patients) with Alzheimers reach a stage where they are totally unaware of their surroundings and are suffering. I know from experience that doctors will increase the morphine dosage and end the unnecessary suffering. This is, of course, illegal but it cannot be detected and even if it could, it would be classified as a mistaken dosage rather than murder.

    There are many things to consider with this post and I'm sure that I will agree with most of those who want to put forward a good reason not to end someone's life. My single point with this is that the doctor's kindness ended the life of a dear person who was suffering and was probably only days away from Nature taking its course. Euthanasia is not ending a life, it is ending suffering.
    jeffr
    25th Jan 2018
    1:26pm
    In full agreement with you Old Man, having also been through having to watch,care and live through my late wife's Alzheimers and Cancer.
    TREBOR
    25th Jan 2018
    7:36pm
    Here is the horror story.... had a visit from an old school friend who was a nurse and is now retired. A lady we both know, who became matron of several hospitals before suffering a 'breakdown' and losing it all... used to steal the morphine in the drugs cabinet and replace it with water. Whether she used it or sold it for cash I don't know... but apparently she stole heaps of other stuff as well.

    Now THAT is a scary thought.
    jeffr
    25th Jan 2018
    10:50pm
    Trebor, having worked for the Health Department and as a volunteer ambo this does happen, I can say in the ambulance service and the public hospitals drugs are carefully monitored. It will never be stopped but vigilance is the answer. Hospital staff and ambo's do care and these addicts are found out.
    TREBOR
    26th Jan 2018
    2:49pm
    Apparently at one facility they turned the keys over to the supervisor upstairs - she had spares cut.
    Beelzebubbles
    25th Jan 2018
    12:17pm
    Yes, facilities DO have a DUTY OF CARE, but after spending 5 years nursing Mum through her ever more distressing dementia until her death last July, I'd want to be put out of my misery LONG before I reached the stage she was at. This article sounds more like the daughter is trying to keep her relative alive for HER sake, rather than allowing them to pass peacefully.
    OnlyDaughter
    25th Jan 2018
    12:28pm
    My Mum has a seriously diminishing cognitive ability which is difficult to deal with, but she also has selective nastiness and abusiveness which is only directed at me, whilst my 3 brothers are held up as gods, despite rarely seeing her and doing nothing. I no longer have a life of my own. I deal with my Mum and her administrative and medical matters 365 days of the year, which are accompanied her frequent vitriolic spiteful attacks to me at a personal level. My Mum is 92. If I could give her a pill that would make her nice to me, even though it might shorted her life in the long term, I would do so.
    Triss
    25th Jan 2018
    3:17pm
    That must be heartbreaking for you, OnlyDaughter.
    Rosret
    25th Jan 2018
    7:58pm
    That is so hard and I am sure she loved you dearly. Can she be put on Valium?
    sunnyOz
    25th Jan 2018
    12:39pm
    Object to the heading....more sensible to ask - 'Are Doctors ending the misery?'. I PRAY that I find a compassionate doctor if I was in that unenviable state.
    Lookfar
    25th Jan 2018
    3:01pm
    You had best join the lobby group pushing for that, Euthenasia, it is called, - as they say, God helps those who help themselves.
    Ausdigga
    25th Jan 2018
    1:17pm
    Nil by mouth is another way of emptying
    beds !!!
    Ausdigga
    25th Jan 2018
    1:17pm
    Nil by mouth is another way of emptying
    beds !!!
    Mrs Hedgehog
    25th Jan 2018
    3:35pm
    If I get Dementia the faster I die the better. I would like to be euthanised and would like to be able to make a living will while I am healthy to that effect and then be sure it would happen. Dementia is a horrible thing, having looked after my mother who was unfortunate enough to get it, I wouldn’t wish it on anyone or any family.
    sunnyOz
    25th Jan 2018
    5:50pm
    Agree...
    srs21
    25th Jan 2018
    3:56pm
    Idea of having a thorough health check on a person with dementia before being administered anti psychotics is good in theory but I have personally seen people fluff of a battery of tests only because that patient was in the dementing process.
    Knows-a-lot
    25th Jan 2018
    4:53pm
    Having been briefly in three nursing homes in 2016, and seeing dementia sufferers for myself, I can say that these poor folks have lost all their humanity (apart from external appearance). This drug which effectively euthanizes them is doing them and their relatives a favour.
    TooKool
    25th Jan 2018
    5:04pm
    What a cynical comment. You obviously know a lot about the issues.
    jeffr
    25th Jan 2018
    10:55pm
    It's obvious that you do not TooKool
    TooKool
    26th Jan 2018
    3:55pm
    jeffr, I guess three years of watching my over-medicated Dad decline in aged 'care' amounts to uninformed ignorance.
    TooKool
    25th Jan 2018
    5:02pm
    My very frail 88 year old father was put on Risperdone and remained it for almost three years. The dosage was increased when he finally went into 'care'. My father was not psychotic but he had dementia. According to his doctor, it was considered only a very small dose yet it affected him profoundly as he was frail and underweight. Already having difficulties with communication, my father had to endure over two and a half years on this hideous drug which robbed him and us of well over two years of very precious interaction. Dad began to smack his lips, his existing dementia-related dysphasia worsened considerably, he stuttered badly, his balance which was already poor became much worse and he had quite a few falls. I would visit as early as possible in the day to have what little quality time was possible with him before he received his morning meds. 40 minutes after taking it, he would become a drunk uncoordinated zombie. Risperdone was prescribed to 'make him easier to manage' for the untrained staff at his very expensive nursing home. He was labelled 'aggressive' because no one took the time to work out what was bothering him. He was labelled 'aggressive' for having the temerity to object to unnecessary attempts to spoon-feed him which offended him profoundly. He had the temerity to slap the aide's hand away with his own when she attempted to force food into his mouth. Ooops, he's being aggressive again. Let's up his dose. Dad couldn't express himself so he was unable to make his wishes known. He would become so frustrated and angry with the staff so his GP would simply 'up' the dose to make him 'compliant'. I had to fight his doctor, fight my siblings and of course the nursing home like a scalded cat to get him off it. It took just over two years for me to have it finally stopped. I was very disturbed when I started researching the drug Risperdone. It was only prescribed to 'make' him 'easy to manage' regardless of the side-effects. When I read that Risperdone side-effects included death and cognitive decline, I was horrified. It was bad enough that he had to endure dementia - the drug was stealing whatever was left and, shucks, no going back. The ultimate cruelty. The ultimate abuse. My dad has since passed away. A blessing for him. The US government took Johnson & Johnson (Jannson & Janssen in the US) to court because the pharmaceutical company mis-informed medical practitioners et al that Risperdone was safe for use with the elderly with dementia in aged care homes. A simple marketing exercise to make the drug appealing to medicos. The US government fined J&J over 2 billion dollars for that little ploy. There is evil in the world. Personally, I'm opting for Nembutal and dignity myself - I'd rather kill myself than go into aged 'care'. I just hope I don't get dementia first.
    Lookfar
    25th Jan 2018
    6:44pm
    That is so bad, Tookool, what they did and how it must have affected you, - I can feel from your words, - my mum died whilst alzheiming, from cancer, and although she was quite a long way in, every now and then a faint flicker of recognition would come in those otherwise blank eyes, and she certainly suffered badly from the untreated cancer, it was about the size of a rockmelon, - she kept trying to run away, more and more medication..
    My dad visited her every day, childhood sweethearts, she never recognised him, but she always loved Roses and Hybiscus, so he grew big plots, - every day he would have a bunch of either one or both, every day she was filled with love and delight of them, but didn't recognise him or us, he would feed her breakfast and lunch then go home, it nearly killed him, of course my brother and I, we lived in Queensland due to work, so could not visit Sydney often but could not handle it as well as him, but then, he survived the Burma Railroad as a Japanese POW, see "Merry Christmas Mr Lawrence", that was his camp, but you know, a funny thing, as mum was getting very close to death, we were all there, my brother Peter, and me and my daughter, Dad was in the next room, when suddenly my mother's eyes became clear and she sat up straight, looked in my eyes and said my name "Geoffrey" in a tone of wonder, and joy, and reached over and put her hand, gently, with fingers straight down on the top of my head, like an upside down T, then turned round and saw my brother, "Peter", again total recognition, and the hand again same, then she was gone, and left her body the next or following day.Well, I always felt she was in there somwhere, and later on I found that this breaking through the barrier of the diseased brain to connecct directly with ones loved ones, is quite typical of Alzheimers patients, and other brain destructive diseases, even to the degree that Nurses, a cynical bunch, understandably, call it the "Lawnmower syndrome", - that sudden roaring up from the engine as it runs out of petrol.
    So the evidence of all these cases indicates that the person is still there, just can't break through the blended spaghetti that their brain has become, until just before leaving altogether.
    The doctors, trapped in their religion, Materialism, deny, deny, yet feel so strongly that they can proscribe poorly reseached 'cures' without bothering to really look at the effects, and have the arrogance to get the Government take people off benefits if they won't vaccinate their children against all manner of things, despite evidence that sometimes it is harmful, or even fatal.
    If they can casually kill the occasional child, why should they bother about the older folk at the end of their trot, whether it is at the instigation of big Pharma or not, they are the soldier pulling the trigger, and had the education to know what they are doing is wrong. This system is grievously wrong, and as the generation looking down the barrel at it coming towards us, we need to question 'how did we do this to ourselves?
    And as another thought, the Australian Aborigines, the blacky's many of us disparage, very few of them are in nursing homes, being community oriented, they look after their old folk till they die.
    Rosret
    25th Jan 2018
    8:13pm
    Lookfar in reference to Aboriginals in nursing care.
    Sadly their longevity stats are very poor. Nursing care is not based on nationality. I can't claim to have researched this however the Aboriginal people have lot more welfare avenues than the rest of the community.
    Yes, they have the benefit of extended family however I am not sure what happens when a family member has dementia.

    "The concept of dementia in old age in Australian Aboriginal and Torres Strait Islander communities is intrinsically paradoxical. Firstly, few indigenous people reach old age. Secondly, from some indigenous points of view, dementia is either not recognized as a condition or as a problem, or, in the case of the more disruptive manifestations of cognitive impairment, is perceived as ‘madness’. Moreover, in the wider context of profound political, social and economic inequality experienced by most indigenous people, the western medical category of dementia may appear to be of relatively minor importance. However, government initiatives in aged care generally and dementia care in particular which are designed to address the ageing of the Australian population as a whole also include the nation's older indigenous people." THE PROBLEM OF DEMENTIA IN AUSTRALIAN ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITIES
    Author
    P. A. POLLIT
    TooKool
    26th Jan 2018
    4:22pm
    You were very fortunate, Lookfar, to have that 'connection' experience with your Mum just before she passed away. How beautiful. I was unaware that such a thing could occur. My Mum was on heavy-duty morphine for the three days it took her to pass away, and Dad had gone past any form of communication when it was his turn. They both had dementia. I would have given anything to have had that final precious experience with them.
    jeffr
    26th Jan 2018
    10:25pm
    Apologies TooKool, for being too quick in judging you. Having read what you have been through I realise I was lucky (if one can say that) that my wife after three years of Alzheimers died of Cancer and only was admitted to hospital 5 days before she passed away. It was my decision to have the morphine pump used as her spine had snapped due to the lung cancer. The pain must have been unbearable and she kept saying Ï have had enough"Yes I still feel guilty for that decision.even though I knew all the hospital staff having worked there for 16 years. I never expected to use the Palliative Care Room which my staff and I had converted from a smokers room from the old days. I am now shedding a tears by typing this and I share your feelings.
    TooKool
    27th Jan 2018
    7:06pm
    jeffr, in my books, you showed great strength in making the decision you did with respect to your wife. You listened and acted to spare her what must have been incomprehensible pain. That to me is loving kindness.
    Not Senile Yet!
    25th Jan 2018
    5:58pm
    I find this article highly factual!
    The big Pharma's should not be allowed to have rheir sweet talking Reps inside Parliament!
    Continually they spruke our Pollies behind closed doors! Totally Unethical Practice!
    Priscilla
    25th Jan 2018
    6:45pm
    I too would want to end my life if I get dementia. It would not only relieve a terrible existence but also save my family seeing me lose all quality of life. Bring it on!
    Rosret
    25th Jan 2018
    7:55pm
    mmm - I was wondering the same myself this last month as two friends with dementia went in one month.
    I think the doctors wait until they can't swallow before taking action.
    Are there any supporting stats?
    chinasue
    25th Jan 2018
    11:55pm
    I can't believe this is still happening in Australia given the hugely successful campaign in the UK (6 YEARS AGO!) by the Alzheimer's Society to reduce the use of antipsychotics (APs) in residential care homes. Following their campaign, APs were reduced by 60% in the first year. A similar campaign is clearly needed here and should be instigated by Dementia Australia! I would be the first to sign!
    Cheezil61
    26th Jan 2018
    7:01am
    Yes this article is stating the obvious but care facilities want profit & to address residents needs means hiring more staff & that is not going to happen as it will decrease profits & the residentts wellbeing is of no interest to CEO's etc. My dad is in care (Bupa) & is obviously verqy bored as there are insufficient activities or outings & we have complained via many avenues (even state & national level) for the 12 months he's been in care & get little or no change apart from medicating him more when he becomes agitated & tries to leave the safety of facility in an aggressive manner! It is the saddest thing. We are rarely able to take him on outings ourselves these days due to the moods/aggression/agitation or the other end of the scale-drowsiness associated with medicating him.

    I agree with Virginia- I would prefer euthanasia rather than put my family thru what my siblings, my mother & I & other family have been thru (& I know my dad felt the same prior to his onset of geriatrics dementia & it breaks my heart seeing what he has gone thru in last 2 or 3 years) A cure surely must be iminent!
    Kopernicus
    26th Jan 2018
    10:23am
    I strongly sympathise with your situation, it must be extremely hurtful to all involved.

    I guess the bottom line is the level of funding - inadequate, but unlikely to be increased given the huge and growing numbers in high care institutions.

    Then we have annual accreditation process which appears to be a mere audit of paperwork rather than an assessment of real care levels afforded to residents.

    There are also real differences between sites, largely based on the culture fostered by management. I was able to make a sound choice for my Mum as I was in the health system at that time and had a good idea who was who - an advantage available to few.

    The experience here is still imperfect - staff who are absent are not always replaced, for example (with the budget on the bread line). However, they are respectful and responsive to the residents and to relatives' concerns.

    Now this is a non for profit site. Imagine the added difficulty for commercial sites like Bupa where some $$ are siphoned off to shareholders.

    I've been visiting my now 94yr old parent a couple times a week for 4 years and hold a strong opinion that I would never want to become a resident. While lots of many activities are running, many residents, like Mum, choose to stay in their rooms full time and stare out the windows. Euthanasia, bring it on, for me.
    Eddy
    26th Jan 2018
    12:47pm
    Like others I would prefer euthanasia to the living death of dementia but there are too many persons in places of influence which promote their own ethical values as being the only values of worth.
    As for myself, my wife and I are caring for her 94yo mother at home. Fortunately she is not suffering dementia, her diagnosis is 'fluctuating delirium'. She has periods of lucidity, which may last days or weeks, fluctuating with what we call 'wackiness', which also can last days or weeks. From my non-medical perspective, these periods of 'wackiness' appear to be associated with blood chemistry, particularly sodium levels and thyroid.
    I often wonder how many people are written off as demented when in fact they are suffering from delirium. My Mother-in-law was and it was only the stubbornness of my wife, who was a nurse, in convincing her GP and various specialists that she did not have dementia that eventually came up with a proper diagnosis.
    Lookfar
    26th Jan 2018
    3:36pm
    Hi Rosret, My initial response to this article was to quote Dame Edna's instruction to the nursing home she sent her 'dear old dad' to, - " hose him down once of twice a day and wrap him up in carpet," - of course, like all humour, there is some truth behind it or we wouldn't laugh, then I got involved in my own situation with my Mom, and the suggestion that the human spirit is still alive and aware behind that damaged brain, and finally the information from a Black qualified Geriatric nurse in Brisbane, that there were very few Aboriginal people in Nursing homes, because, being community oriented, they look after each other.
    Unfortunately you did not answer that question, but gave the name of some "ignorant white person" who wrote a 'Thesis' whereas you should have challenged my numbers, - is the proportion of White people in Nursing homes of age X significantly greater than the proportion of Black people from Aboriginal communities of age X.
    That is the question, and seeing it is Australia day, where people are being confronted with the issue of whether to care about the black culture almost destroyed by the white culture and whether that matters, what the black culture, dominated, for better or worse, by the belief in Community, still could teach white culture, dominated by me, me, ism, is I think a worthy question.
    Hopefully you, who have made some good posts over the time I have been involved in YLC, can see the importance of this question for Australia's future.
    AlbertC
    29th Jan 2018
    12:19pm
    i think most doctors are jenuine but most specialsts are not. i have early dementure i knew iwas starting to forget things as time i was forgeting alotmore things now i have trouble rembering any thingthe specialst put me ona new drug 10 mg a was told for the first month cut the tablet in haf and take it for te next 32 days idid but it took me 3to4 hours to get over the norsiabloody aweful the te next month was worse i was fro then on to take o tab per nite yuck i woke up at my usuel time 3.30 am but igot up and straitaway igot a thumping hrad ach an tried to walk to kitchen but was all over the place i slowly walked holding on any and everything to get their idrank 3 large glases of water then laid on the couchwhilst laying down felt beterbut whrn i got up back it cameit took nearly before it woreoff i thiught that it might get better as time goes by ha ha not so the next day was worse that igot up at 2 am got wow same problem .for the next day 2 days the same i got in touch with my sister ss my brother in law was aaso sufering from dementure and parkinsons aswell she told me he was on the same stuff nd it made him very ill it too2 wweeks before he could anythig at all nd only last did he say to my sister i think i willgo ank check the vegie patch she sai he looked better and had some collor in hi cheeks i said glad to hear that it took the last 3days for me to come good after geting offit and when i see the specialist againi will tell him that stuff is poinest stuff i will not take it again and have you oeople everheard of a dease called hemochroma tosis this is apparently where the dementure comes from their 3 typs of thi trouble if one of your parents have you wil allso haveitas it pases from them to you ca be very dangerous some time ago i was told i had it so did both my sistersmy elder sister died 2 yrs ago fom it and that is yrs later she had dementure my other sister as got it and i have it 5 months ago i lost my daughter i of 8 chilrdn she was 49 yrs old another daughter has it now and she is starting to loose memory throught if life at the moment means nothing tme now i hope to live to see a cure to come on before i go still have 5 other children an i think they will all be affected by the culprit hemochromartoses it originates from vicking hords that concourds tthat ventured int ireland and later england ad possibly sotland good luck all of you and may god watch over yuo.
    Nursie
    30th Jan 2018
    11:43am
    As an RN with 60 years health care experience and seeing my Mum in an excellent aged care facility where family visited frequently the biggest problem with caring for dementia patients I believe to be:
    -under staffing
    -lack of appropriate education and training for staff
    - inappropriate equipment
    - inappropriate good design of the faciity
    - lack of Registered Nurses
    - lack of sound timely & interested medical support for residents & staff
    Good objective physical & mental assessment should be a MUST before employing appropriate medications for the RESIDENTS BENEFIT.
    Despite having respect & admiration for the staff of these facilities I have done all I can to ensure my children do not remember my end of life situation we watched with Mum. I would welcome a planned peaceful end with, for better or worse, have them remember ME
    By the way perhaps we could stop referring to Aged Care and Patients...how about Care
    Residences and Residents
    michellemartin
    6th Feb 2018
    9:14pm
    Around age 60 I noticed that my handwriting was getting smaller and I was writing faster. I also noticed a small tremor in my right hand. The doctor went over my different symptoms and he suspected I'd either had a small stroke or the beginnings of Parkinson 's disease. After finding a neurologist and some testing I was diagnosed with the beginning stages of Parkinson’s disease. That was 4 years ago. I take Sinimet four times a day to control my symptoms, which include falling, imbalance, gait problems, swallowing difficulties, and slurring of speech,December 2017 our family doctor started me on Green House Herbal Clinic Parkinson’s Disease Herbal mixture, 5 weeks into treatment I improved dramatically. At the end of the full treatment course, the disease is totally under control. No case of dementia, hallucination, weakness, muscle pain or tremors. Visit Green House Herbal Clinic official website www. greenhouseherbalclinic .com. I am strong again and able to go about daily activities.? This Herbal Formula is Incredible!! My life is back.


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