4th Apr 2014
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Dementia patients restrained
Dementia patients restrained

A new study published by Alzheimer’s Australia shows that 80 per cent of dementia patients living in aged care are restrained with psychotropic drugs.

The report suggests that the use of drugs in nursing homes is excessive, as only one in five of the dementia patients being given psychotropic drugs, such as anti-depressants and anti-anxiety medications, receive any benefit from it.

Glenn Rees, CEO of Alzheimer’s Australia, has told the ABC, “For people with dementia in residential care - and remember that people with dementia account for 50 per cent of residents - about 80 per cent will be on restraint at some time or another.”

It is not, however, up to aged care facilities to  prescribe medication. Aged care facilities rely on doctors to diagnose conditions and prescribe drugs, the facility simply administers the prescribed dose.

Mr Rees has suggested that there are alternatives to medication, many of which would reduce any need for these drugs in the first place. Aged care facilities could “adapt the physical environment so that it’s less confusing and less noisy,” or “give a person activities and a sense of purpose in life, whether it’s rehabilitation, social activities [or] physical recreation.”

You can find out more by reading the Alzheimer's Australia report.

What do you think? Is this high rate of drug prescription to be expected in an aged care facility? Or could it possibly indicate a laziness, or unwillingness to connect with patients, on the part of the facilities and their employees? Have your say in the comments below.





    COMMENTS

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    justjanet
    10th Apr 2014
    10:22am
    While I worked in aged care some of the problems I thought where NO follow up by the gp to find out how the residents changed also some of the residents had had the same gp for years and did not like changing . like the article stated carers nurses etc only dispense the meds then they have no say in what happens next
    Kristo
    10th Apr 2014
    10:27am
    The worst part is the number of elderly patients both in some hospitals as well as ACF's that are fed the ones like Seroquel that don't even have dementia. Many enquiries by all sorts of organisations in Australia, many deaths in the 1000's PA according to some reputable investigations. Made it onto late line the year before last but all just gets swept over.
    In other parts of the world the drugs when used off-label IE not for the intended use, they have been described as a chemical cosh.
    Keeps the patients quiet you see and very major law suits by Governments against the manufacturers for suggesting that they are OK have been undertaken in the USA and Britain plus some others.
    Most carry a black label warning in the USA.
    And in Australia?
    The PBS system is supposed to control the prescription of these. It doesn't work.
    There enough scripts issued for the stuff to treat us all if it was used as its supposed to be.
    No one in authority cares less.
    So if you are not a regular visitor to a relative or friend in an ACF and when you do visit they seem a bit 'changed' don't merely think they may be showing the effects of galloping old age; they may well be zonked out by indiscriminate and probably illegal use of such drugs if they were obtained at a PBS rate for the elderly (which we all pay for).
    Big Pharma continues to make the dollars.
    Disco3
    10th Apr 2014
    1:32pm
    Some patients with dementia can be a danger to themselves or others. For example, attempting to climb onto a window ledge or investigating power sockets or being combative. How this is managed depends upon (1) appropriate structural safety of the venue, (2) care philosophy (3) numbers of staff available with appropriate advanced training in the care of people with dementia (4) the availability of material resources to encourage creative and occupational activities. Unfortunately, all the above requirements lead to increased costs.
    We all know this. So, more appropriate methods of patient 'supervision' are required. Using mechanical restraint is abhorrent but may, at times, be necessary for short periods. Chemical restraint is equally abhorrent. Do you have another options? Let's hear them. The only way to provide the kind of care we want for our seniors is to prepare appropriately designed and resourced residential care facilities. And by resourced, I mean skilled /qualified specialists in aged care - including a multi-disciplinary team and team management. Hurry; I'm not too far away from needing that kind of care.
    Tom Tank
    10th Apr 2014
    3:44pm
    Well stated Disco3. Aged Care facilities that are dementia specific are few and far between and there is a large range of residents in each facility. A troublesome resident. for whatever the reason, can seriously impinge on the other residents and so some form of restraint may well be necessary, perhaps for the safety of the troubled one.
    Aged Care facilities in Australia are actually very good, at least the ones in Victoria are, and are away ahead of most overseas countries such as the UK and USA.
    Funding is always an issue with the majority of the staff being at the lower level of the wage scale but despite that they do, by and large, a great job.
    Some owners and doctors do have something to answer for in ripping off the system.
    buby
    14th Apr 2014
    10:51am
    Not all aged Care facilities are that good in Victoria Tom, i hear of problems everyday from a friend who has he husband in one, and she sees him everyday, and the things she talks about, leaves me wondering if this one in particular know what they hell they are doing!!!! (werribee) and there are a couple here with a bad reputation! and there are plenty of nurses out there and care workers, but the facilities don't want to hire them. Coss then they wouldn't be making a profit, again its all about the money!!!! It really makes you sick!!!
    buby
    1st Jun 2014
    10:20am
    i just found out from a friend who worked in age care/and she tells me there is no care/ there is no proper care of each patient, which is very sad indeed.If they can't comb their hair, do some things, themselves, thats just a bit of bad luck eh! SO TRAGIC i wouldn't send none of my relatives to live there. Its just another way of collecting their money!
    rahar53
    10th Apr 2014
    3:02pm
    I wholeheartedly agree with Disco3. However let us remember that we are not just talking about elderly patients here. Many more people are being diagnosed with dementia at a much earlier age. We have one such family member and the management of this already complex disease becomes even more fraught. We are very lucky to have found a very caring nursing home whose staff are constantly working with us to provide the best care with out compromising the care given to the other residents within the confines of a traditional nursing home. Not an easy task!
    unicorn
    10th Apr 2014
    3:44pm
    As far as I am concerned it is not only dimentia patients who are fed unneeded and unwanted pills they like to make it easy for the nurses and other staff for their work. This is not necessarily the idea of the nurses, it is just the "Big Pharm'as" usual deal with the government & the doctors.
    Hasbeen
    10th Apr 2014
    4:16pm
    My mother lived in a granny flat adjacent to my home, until approaching her 99Th birthday. She did not have dementia, but had memory problems, & had real difficulty learning anything new.

    Her personal hygiene, cleaning washing & meals were provided, but she was independent in her unit.

    She was a bit of a worry, like many dementia sufferers, wandering around the place. It was a relief when she required a walker. As her unit was surrounded by lawn & shrubs, & she could not push the walker through it, that was one worry eliminated.

    I still had the difficulty of her memory. I would often find she had turned a heater on early in the morning, then turned the air conditioning on, rather than the heater off, when the day warmed. Our power bills could be enormous, but what the hell, she only lived once.

    It was hugely difficult to get her old cordless phone repaired, when it started to play up, but essential, as she could never master the three different new ones we tried with her, thank god for amateur radio people.

    It was much fun, but also fairly difficult caring for a little old lady in her nineties, I am just so thankful I did not have dementia to deal with as well.

    If I had, I would have used what ever was available to keep her safe. If that had to be a bucket full of pills a day, then so be it.
    buby
    10th Apr 2014
    5:31pm
    well i'm just stunned at reading this, and scared cause i too will end up in some home i'm sure as my family couldn't give a bugger about me! AND I'M sure i will be experimented on by doctors as it suits them!!!! cause once you get old you don't have a say. What you think doens't matter any more. YOU get no respect(yes scary)
    Lynda
    10th Apr 2014
    7:48pm
    As a nurse I have looked after many Dementia patients, usually they are easy to look after in the morning and afternoon. In the evening the Sundown syndrome can begin. At this time patients can becomes confused, agitated, yell become aggressive, wander, and be generally unpredictable. Ideally it would be perfect if there could be one to one nursing, in a facility this is not possible, though in hospital one to one is provided.
    If a medication can settle the resident and provide relief of their symptoms why not use it?
    I have seen the best care provided in a facility when family members involve themselves in the care of their loved one. Not leaving it all to staff, who often have a patients load of 24-40 to look after. With only a visiting doctor once a week.. Staff burn out in age care is huge.
    musicveg
    10th Apr 2014
    11:10pm
    With aged care workers over worked it is hard for them to keep up with it all,medications need more monitoring. I believe they often over dose and give them way too much which makes them worse in a lot of cases. I hope the future sees better care for dementia patients because at the moment they are still inexperienced in a lot of areas so resort to pills to keep them calm. Very sad to watch my dad go through this 6 years ago before he died.
    Alaskan Princess
    12th Apr 2014
    5:33pm
    My Mum was on NO tablets - at 94 - early stage mild onset dementia only. One night, after I left the nursing home after telling her earlier in the day that my nephew had passed away (she was alright when I left - almost asleep), the sister on duty rang my brother & he agreed - over the phone - that she be put on medication - 2 sleeping tablets & 1 tamasapam. I was there 2 days later & found out. Spoke & met with the doctor twice & he couldn't even get her to wake up, even after I had her weaned off the tablets. They had shut her system down. She STARVED to death & DIED on my birthday 3 months later. I approached the home & spoke & wrote to them but nothing came of it. The sister? then moved to Canada. I wonder how many other deaths she caused. I was there till late the night before Mum passed, went home to get clothes & she passed away during the night. They never even rang me. I was the first contact on Mum's list but that sister? never contacted me - ever. Complaints & changes went unheeded. I now have no brothers!
    buby
    14th Apr 2014
    10:37am
    hugS TO YOU Alaskan, what a dreadful injustice. Yes i too would have said "i have no more brothers!
    How the hell do they think they are! That is the most dreadful thing to have done ever. and you will never forget.Nothing more to say just that my heart goes out to you.
    Abby
    3rd May 2014
    5:51pm
    You should sue the home or the doctor that prescribed that sort of medication for a lady of 94

    I think all patients are routinely over medicated so they can cut back on staff.
    Blossom
    13th Apr 2014
    8:25pm
    There is definitely not enough staff in general in aged care facilities. From my understanding when my now late Mother was in a nusing home in high care, the Govt. sets the ratio of staff to residents (that is what some nursing homes call them). When the ratio is 1 staff member to 6 patients and 2 staff are needed to handle the needs of one patient, that to me equals 2 to 6, not 1. There just isn't enough staff. I know a nurse worked for an agency and worked at a large nursing home when 2 staff were away sick. By the time she finished one medication run, it was almost time to start the next one. If she took her scheduled break it meant patients waited longer for attention. One day she took no breaks at all not even lunch but finished 15 minutes earlier than normal. A complaint was lodged against her.
    Some nursing homes don't use bed rails during the day but do at night to prevent them falling out of bed. One nursing home has a special mat it puts next to beds which sends a signal to the Nurses Station so they can go and check if the patient needs assistance to go to the toilet or whether a fall has occurred. Another problem is that they put all Ahlzeimers patients in together instead of putting various stages together. Patients gwho enter a Nursing Home before diagnosed with the early stages miss seeing their friends and sometimes deteriorate quicker than they might otherwise have done because they aren't getting the stimulation they are used to. I know of a nursing home group who merged their facilities into one big new one. A lot of patients told their hairdresser that they hated not seeing their friends. Alhzeimer patients are virtually "locked" in a separate section. Admittedly some do wander. They also pretend they are visitors of patients and try to get past internal security doors with genuine visitors in some facilities. Yes, it happened at one nursing home that I visited. I almost let a dementia patient escape. On another occasion a lady walked up to me in the street and asked for directions to a bus stop. I noticed she had a badge on and ran to the nursing home a few metres and called the staff to go an collect her. Meanwhile my friend was watching ready to follow her so she knew which way she went. Some Alhezeimers patients who live at home do wander if not supervised constantly. One lady I know of who wasn't very tall managed to reach the door key at the top of the frame, go out and try to climb a high fence in the middle of the night. That was why the key was put up high after previous attempted wanderings, always at night. The Police were called a few times simply to help search for her especially as they lived near a major road. My Mother insisted on starting thec evening meal before I got home. The 1st place I headed to was the stove because if the saucepan boiled there was a likelihood she had turned the jet up not down. Fortunately we never had a fire. Because I have a few medical conditions myself and have since retired I advised by social workers and my GP not to retire early because my health would suffer too and I would be no help to her at all. One of my problems with her was I couldn't go out after work for 2 hours after having been home, reminded her and made sure she had her evening meal. The neighbours found her at our front gate on the 3 occasions I go out, panicking that I hadn't come home at all. I always got a phone call from one of the neighbours and they looked after her until I got home. I declined all invitations after that. I decided it wasn't fair that she got so distressed. I was exremely lucky that my Mother was never violent which can be a huge problem. I have seen staff assaulted on several occasions. Last week I saw a phsyciatric?? patient (I don't know her medical problem) lash out at a nurse on more than one occasion. Once she caught the nurse off-guard and punched her on her arm. The patient was confined to a wheelchair because she is unable to walk.
    When the Neurologist came out to call the patient in the OH&S Manager spoke to her.
    The inside of the cover has now been marked with a warning. (I saw it being done).
    THe neurologist's comment was "you don't get too close to her" It was scary to think that so many patients including those with Alhzeimers or Dementia also can be so violent.
    The fact that nursing homes are so under-staffed and they have such difficult cases to cope with it is no wonder staff leave to "recharge the batteries" as one said to me.
    buby
    14th Apr 2014
    11:03am
    just because you seen one patient stick it to a nurse, don't be blaming that patient, cause you never know there might have been a problem with that nurse why is it they always blame the patient. Its the patient that always get needles or more pills pushed into them. I have seen many cold angry nurses, they are all that sweet, perhaps to your face!!! It can be a cruel and angry world out there!!! AT times
    naturgoddess
    13th Apr 2014
    10:34pm
    It is a very sad fact that many of the drugs prescribed do not work, or they can exacerbate the symptoms. Pharmaceutical companies are laughing all the way to the bank, and it is sickening. They have no compassion, no empathy and seem to have lost touch with peoples individuality and sensitivies.
    My mum has Dementia,the circulatory type, and her doctor has been pro-active in attending Alzheimers seminars that have been very informative. He has prescribed Mum with Diabex( a diabetic drug) and Vitamen E. Although Mum is not diabetic, the combination of Diabex and Vit E together seem to be working for her.
    There are other possibilites to consider, in the form of more natural alternatives -
    Phosphatidylserine (PS) is an amino acid derivative compound that is fat-soluble and found in high amounts in the brain, where it contributes to cognitive functioning. Found in high amounts in fish, it may improve memory in the elderly and lowers Cortisol.
    Phosphatidylserine, or PS, is a compound similar to a dietary fat which is highly prevalent in human neural tissue. It can be synthesized as well as consumed through the diet , but further benefits can be gained through supplementation.

    It is vital for cognitive function, but is not necessarily needed as the body synthesizes it. However, Phosphatidylserine (PS) supplementation in older individuals seems to improve memory and cognitive capacity.
    A standard dose of phosphatidylserine (PS) is 100mg, taken 3 times a day to total 300mg daily. This dose seems to be effective as a daily preventative against cognitive decline, and 100mg once daily may provide some degree of benefit (but may be lesser than 300mg).
    Also, L-Theanine is a unique amino acid found almost exclusively in the tea plant (Camellia sinensis) and is the primary ingredient contributing to the unusual taste of green tea. Animal studies have shown that L-theanine crosses the blood brain barrier, increases dopamine and GABA levels in the brain, and inhibits the stimulatory properties of caffeine. Human studies have shown that taking L-theanine results in the emission of brain waves associated with a state of relaxation.
    There have been studies examining the use of L-Theanine as a relaxing agent, for the improvement of learning ability, for cancer prevention and also the prevention of vascular and blood vessel diseases. However, it’s interesting to note that many of the doses used in studies have been in the vicinity of 50-200mg, equivalent to 3-15 cups of green tea per day. Most beverage companies have looked at Theanine’s positive effects on cognition and brain processes and have touted it to be a key ingredient in helping with mental focus and concentration due to its unique ability to cross the blood-brain barrier.
    L-Theanine increases the level of dopamine (the pleasure and reward neurotransmitter) and serotonin (the main inhibiting neurotransmitter) in the brain, which are both decreased in a dramatic way in stress and overwork situations. L-Theanine easily crosses the blood-brain barrier and produces a tranquilizing effect on the brain.
    Only 30 to 40 minutes are needed to feel an increase in awakening and alertness, and improved mental and emotional states. L-Theanine:
    I hope this helps others to make, higher welfare choices for themselves, or for their loved ones.
    Blessings
    buby
    1st Jun 2014
    10:16am
    THANKS naturegoddess, but all the to the normal person leaves us wondering what is it that we should be taking???
    i take omega3 and get it from flaxseed and eat it in my porridge, when i took fish oil,it did take some joint pain away, but not much. brain alertness, well that be another story. but when taking fish oil, my skin went greasy, and my hair, and not sure it helped the brain at all?
    but this says it all, yeh what the hell have they done to our foods, and we won't be living to the age of 90 odd like they say/yet they want the population to work till 70.sheeeezzzzz they are funny?
    Alaskan Princess
    15th Apr 2014
    5:01pm
    Thank you so much for your thoughts buby. I am still very upset about what happened. At the time I blamed myself because I was going to give up work & bring my Mum here to look after her, but I let myself be talked into the home situation as she was nearer all other relatives. One of the brothers visited her twice in 18 months. During this time I found out that they had also been ransacking the family home. When my daughter & I went there one day to meet my sister-in-law (who never turned up) we found piles of rubbish where they had just emptied out cupboards, boxes, etc, & taken what they had wanted & left the rest. I used to drive 100klm to visit Mum twice a week (Wed evening & weekends) but didn't go to the house. The contents were Mum's & they had no right to any of it until Mum passed away. It was all gone by then. We had a book in which we wrote down rates bills, etc & paid them out of the money in Mum's account. Out of this they even took the money for the flowers we placed with her on the day of her funeral service!! I got some of Mum's jewellery but most was never found?? All photos, etc - gone.
    bubyshka
    2nd May 2014
    4:52pm
    i'm so sorry to hear all that alaskan, they should be ashamed of themselves.
    you take care
    Abby
    1st May 2014
    7:53am
    The use of drugs to restrain the the elderly in hospitals and Nursing Homes is a disgrace.
    The drugs make them more confused and there is more potential for them to fall.
    Why not introduce euthanasia rather keep people torturing people as vegetable
    Supernan
    29th May 2014
    5:26pm
    Close relative works in caring for dementia, alzheimer & senile aged says lots of patients come in bright as a button. Not fully able to care for themselves but still aware & enjoying life. Within weeks they are drugged up, lethargic & listless. She hates it.
    Abby
    2nd Jun 2014
    12:59pm
    Beside the drugs turning the people in Nursing Homes into Zombies to the extent where they are unable to toilet themselves (they then put nappies on them)

    Also most have a heavy weight loss on going into a Nursing Home - they fall asleep over their dinner and the tray gets taken away.
    SKRAPI
    23rd Jan 2018
    8:57pm
    My husband was given those drugs when in home because I broke my arm When he came home I asked Dr, would I give that drug 2 him He said " Oh ! No ! No ~ & seemed a bit panicky I would . I didn't of course because it had just came up on Tv. that psychotic drugs shouldn't B used 4 Dementia . One day I visited @1pm . Husband was in dressing gown . Nuese a nice woman said Oh ! ...... we must give U a shave & shower Another lady confessed 2 me she didn't know Dementia patients had feeljngs quite a nice woman also . Why aren't they told the rudiments of Dementia . Husand was in 2 /nursing homes Both were understaffed Nurses who came 2 shower Hubby told me in every case that it'a always the same because the homes R where they do there training . All R understaffed with only 1 trained nurse . They R money machines .
    Big Kev
    9th Oct 2018
    8:02pm
    I worked for the Commonwealth in Aged Care for 30 years. in the 1990's we had legal advice that physical and chemical restraint constituted assault under criminal law. At that time we helped homes develop diversional therapists who were able to overcome disruptive behaviour by understanding social and cultural history. The home Glen managed was a pioneer in this field introducing music therapists to his home.
    Big Kev
    9th Oct 2018
    8:02pm
    I worked for the Commonwealth in Aged Care for 30 years. in the 1990's we had legal advice that physical and chemical restraint constituted assault under criminal law. At that time we helped homes develop diversional therapists who were able to overcome disruptive behaviour by understanding social and cultural history. The home Glen managed was a pioneer in this field introducing music therapists to his home.


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