Tina, I don’t think anyone wants to see anyone ‘drugged up’ or over-medicated, so I’m with you there all the way. I’m with you also in the thinking you’ve done about what is best for your husband and for you, in dealing with Ken’s dementia.
Nobody is against medication for real problems that can only be dealt with by medication, and for presenting problems that need to be addressed immediately and with care. Then monitored and supervised.
Jancis, (can’t remember which thread you posted your question to) no care home can prescribe antipsychotic medications. Only a GP or a Consultant or similar can dole out a prescription. (Having said that, it is occasionally the case that care homes have been known to give to another resident medications that were never prescribed for that resident, but which were prescribed for another resident. It is hopefully rare, but it may not be rare for all I know. It may be common practice.)
If I’m wrong, I’m sure someone will let me know, but I think that the Panorama programme was trying to address the fact that in “many/some/a few/more than a few/too many” care homes – care homes that are surviving on bare minimum staffing levels, and where the staff are not sufficiently trained to deal with the demands of dementia – it is sometimes the case that they place demands on the GP or the Consultant to prescribe ‘something’ to enable the care home, the care home staff, the care home in general to handle the demands of dementia.
That’s not fair to the resident. That’s not necessarily ‘in the best interests’ of the resident.
And that’s where the GP/Consultant has the responsibility to prescribe only those medications that are seen to be required for that particular patient’s presenting problems, in the best interests of that particular resident.
Beckyjan wrote “I agreed to my husband being prescried Quetiapine. The Consultant discussed this with me and I raised questions like stroke risk and over sedation. It was all explained very thoroughly and I am happy we took that route.
Yes, he is very sleepy some of the time, but he was prior to the drugs and I believe that is part of the dementia.”
It is part of BeckyJan’s husband’s dementia. No doubt about that. But it may not be part of everybody else’s dementia. Everyone’s different; everyone’s reaction to drugs is different;
Everyone’s dementia is different.
And that’s why, IMHO, the prescribing of any single drug/medication/tablet has to considered seriously and with reference only to the needs of the individual patient.
GPs/Consultants are not allowed to be pressurised into prescribing to help the care home to ‘manage better’ a resident if there are other ways that could/should be employed. Namely, increase staffing levels, increase training, increase the interaction between resident and staff, increase the quality and content of the care given.
But there should be no system in place which increases the potentially damaging effects of a medication to the patient unless that is an an unavoidable risk.
Burstow said “We need to have a relentless focus on the quality of care.” Nobody can argue with that.
PS to Moderators: would it be possible to merge the two threads that are discussing this issue? Thank you in advance.
