July 28th, 2016
SAGE, the support and advocacy service for older people, has warned that people in care situations are being increasingly prescribed potentially dangerous medication for convenience of staff rather than for therapeutic reasons.
The issue was raised by Dr Shaun O’Keefe, Consultant Geriatrician at University College Hospital, Galway at the Summer Team Meeting of SAGE, the advocacy and support service for older people, held in the Hodson Bay hotel, Athlone, July 28 - 29.
Addressing the meeting Dr O’Keefe noted that the dangers of antipsychotic medication in particular are now well established – treating those with dementia with such medications for even only 3 months will result in the death of 1 in 100 and in a stroke in 1 in 60 of those treated.These findings have resulted in changes to recommendations regarding use of these drugs that emphasize that they should be an intervention of last resort and should only be used for short periods and for treating specific problems.
Mervyn Taylor, Manager of Sage, said that in one recent case “a resident in a nursing home was given medication when he became upset on hearing of the death of his wife.
“In another case an older patient in a hospital was medicated to encourage her to adapt to continence pads - when she was still continent but needing assistance of two staff to go to the toilet.
“We have identified many cases of sedatives being given to prevent wandering during the day or night - primarily for the convenience of staff,” he said
Addressing the Conference (afternoon July 28th) Dr O’Keeffe said that medication should not be used simply to sedate people or to manage behaviour such as wandering or uncooperativeness.
“Unfortunately, we continue to see inappropriate use of medications for just these reasons’. Dr O’Keefe warned that the distinction between medication for therapeutic reasons and medication simply to ‘control’ behaviour (chemical restraint) is not understood among the general public and even by many practitioners in care facilities, including acute hospitals.
“Chemical restraint and misuse of psychoactive drugs is a violation of personal and bodily integrity and a breach of Article 3 of the European Convention on Human Rights. It is, unfortunately, being used as a first rather than a last resort in too many cases.
“The Department of Health policy document ‘Towards a Restraint Free Environment in Nursing Homes’ unequivocally states “Chemical restraint is always unacceptable”.
“HIQA’s Guidance for Designated Centres – Restraint Procedures (October 2014) also warns of ‘the use of medication... to sedate the person for convenience or disciplinary purposes.’
Sage is now seeking enforcement of legislation to address the potential for widespread abuse in this area.
“We need to ensure that any future legislation to deal with deprivation of liberty in care situations adequately addresses the issue of chemical restraint “ Dr O’Keefe said.
ENDS
For further information contact:
John Gallagher
John Gallagher Consulting
Tel. 087 9369888
