Are We Overmedicating People with Dementia?
There are situations where medications are necessary and can bring much needed relief, but sadly medications are often used inappropriately in dementia care. They are used to stop agitated behaviors by sedating people. It is easier to give a medication than to try to find the reason behind the behavior or accommodate a behavior.
Are Medications for the Patient or Caregiver?
My father insisted on being my mother’s sole caregiver. She had Frontotemporal Dementia and he was already 90 years old. My father really did an incredible job, but he couldn’t keep it up 24/7. We soon realized he was giving my mother more of her meds (Seroquel) to sedate her to the point that she slept much more, thus allowing my father to have more breaks during the day.
This is just one example of how meds can be misused and demonstrates how meds may be more for the caregivers than the person living with dementia. In nursing homes there may not be enough staff to take care of someone with a “difficult” behavior and giving meds to calm are many times the easiest solution.
In 2009 this report was prepared in the UK to examine the use of antipsychotic medication for people with dementia.
The Use of Antipsychotic Medication for People with Dementia - Time for Action
It definitely is time to take action! The report clearly recommended a reduction of the use of these medications.
Letter to the Minister of State
” These drugs appear to be used too often in dementia and, at their likely level of use, potential benefits are most probably outweighed by their risks overall. This is a problem across the world”
I learned about this report on the dementia podcast
Looking at the Person, Not Only the Symptom
This is one of my favorite podcasts because they include people living with dementia on their programs and they have really great info. On this podcast Professor Colm Cunningham invited an expert panel to discuss medications that are being used to treat people living with dementia. If you or your loved one is taking medications, I highly recommend you listen to this important episode. Here are a few of the points from the podcast:
Always try non-pharmacological measures first. Check if the reason for the behavior may be something else. Perhaps the person is in pain, is too hot or cold or has a bladder infection.
To prevent medicating, try to accommodate the behavior rather than try to have the person living with dementia try to fit into our routine. For example, if the facility can accommodate a person who wanders, they won’t have to be medicated for their behavior.
In many cases as the disease progresses, the behaviors may diminish. Should check if medications can be reduced.
Sleeping pills – cause a 40% increase in falls! Only use for 7-10 days.
Agitation is a behavior that is listed to be treated with medications, but no one can define agitation. There is no anti-wandering or anti-hand wringing medication. People are simply sedated to the point where they aren’t doing these behaviors anymore.
Find the Reason Behind the Behavior
In Validation, a way of communicating with people living with dementia, we believe that there is a reason behind a behavior:
An older man who is screaming or pounding may simply want to be heard and acknowledged.
An older woman who keeps blaming others may be trying to not admit that she is losing control of herself.
The man who keeps repeating the same story, may want to be respected
The older woman who lashes out at a caregiver, may think she is the woman who had an affair with her husband.
A person who keeps asking to go home, may be seeking to be loved
Many times by allowing an older person with dementia to express themselves or by understanding their needs, the behavior may lessen.
In Austria, there is a law in nursing homes that a person with dementia may not be given medications or restraints until they have had psychosocial intervention including being validated by a certified Validation Worker.
Let’s hope that one day this type of law will be found worldwide and protect those living with dementia from being overmedicated, just because it is the easiest solution. ---- Oran Aviv has been a reflexologist for 25 years and is also a Certified Validation teacher. She combines both the principles of hand reflexology and Validation to teach ©Hands-on Dementia to caregivers and senior facility staff around the world.
You can follow Oran on:
Facebook: Reflexology – Oran Aviv and see notifications of her future blogs
Youtube – Oran Aviv Reflex and More and learn how you can use hand reflexology for self care
Oran is also the author of Hands-on Dementia for Caregivers, a Step by Step Guide to Learn 3 Reflex Points to Help your Loved One and Yourself
To learn more: Hands-on Dementia eBook for caregivers