DEMENTIA CARE


Antipsychotic drugs are still routinely used to manage symptoms in people with dementia despite the fact that the majority are inappropriate and potentially dangerous. Professor Alistair Burns is part of an initiative to change this


Photograph © Tyler Olson - Fotolia.com


EMENTIA is one of the greatest health and social care challenges facing the world today. An estimated 35 million people globally suffer from the disease, a figure expected to rise to over 100 million by 2050. Seven hundred and fiſty thousand people in the UK have dementia and the number affected by the disease can easily be multiplied by two, probably by three and possibly by four if one takes into account carers and family members. Te cost of caring for dementia patients is estimated at £20 billion a year, a figure dwarfing that for stroke, heart disease and cancer. Some stark statistics help to underscore the scale of the challenge facing UK health and social care services in dealing with the condition. Two-thirds of people in care homes have dementia and around 25 per cent of general hospital beds at any one time are occupied by people with the condition (around 40 per cent among older people) – a significant proportion of whom would not need to be there were it solely for their medical condition. In a 2009 publication entitled Counting the Cost, Te Alzheimer’s Society reported the results of a survey of carers


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Care, not control D


and hospital staff showing that 97 per cent of nurses claimed contact with people with dementia and 50 per cent of carers felt that admission to hospital had a detrimental effect on the mental and physical health of dementia sufferers. One issue of particular concern was the over-prescription of antipsychotic (neuroleptic) drugs for people with dementia. Nearly 80 per cent of nursing staff said that antipsychotic drugs were used always or sometimes to treat people with dementia in the hospital environment. Other studies have reported that an estimated 180,000 people with dementia are on these medications, and in nursing homes prescription rates are between 20 and 30 per cent, with just over five per cent of all people over the age of 65 on antipsychotics. Te commonest reason for the prescription of these drugs is agitation or aggression – which are really non-specific signs (akin to fever) oſten indicating the presence of an underlying (and oſten undiagnosed) physical condition or something in the environment that triggers a response from an individual. Only about 20 per cent of people with dementia suffer from symptoms of psychosis (the presence of delusions,


SUMMONS


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