UK MPs highlight abuse of elderly with dementia

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London: An influential group of MPs is calling on the Government to stop the dangerous over-prescribing of antipsychotic drugs to people with dementia. Up to 105,000 people with dementia are given the drugs inappropriately, according to expert predictions in the new All-Party Parliamentary Group (APPG) on Dementia report, ¬ĎA Last Resort¬í, published today.

Antipsychotics continue to be a first resort for dealing with challenging behaviour in people with dementia, such as aggression or agitation, despite causing devastating side effects, doubling risk of death and costing the UK over £60 million a year.

¬ĎA Last Resort¬í identifies 5 vital steps to reduce antipsychotic use and reveals there is currently no audit or regulation of the issue. It urges the Government to use its new National Dementia Strategy to address the problem and the National Institute for Health and Clinical Excellence to conduct a thorough review.

Jeremy Wright, Chairman of the APPG on Dementia, says:
¬ĎA Last Resort shines a light on one of the darkest areas of dementia care. Antipsychotics can double risk of death and triple risk of stroke in people with dementia, heavily sedate them and accelerate cognitive decline.

¬ĎThe Government must end this needless abuse and make the 5 point plan a key element of the National Dementia Strategy. Best practice guidelines are not enough – safeguards must be put in place to ensure antipsychotics are always a last resort. We need to include families in decisions, give people with dementia regular reviews and equip care staff with specialist training.¬í

Neil Hunt, Chief Executive of the Alzheimer’s Society, says
¬ĎIt is absolutely disgraceful that widespread the abuse of people with dementia has been allowed to continue despite safety warnings on antipsychotics. Urgent action is needed.

¬ĎSafe, effective alternatives to antipsychotics are available. New Alzheimer¬ís Society research shows specialist dementia training vastly increases quality of life and could save the UK ¬£35 million a year if it was mandatory.¬í

¬ĎOver 70% of people with dementia experience challenging behavior at some point during illness. More often than not this is an expression of unmet need, not a symptom of dementia, and there is no excuse for reaching for the medicine cabinet.

Lynn Ramsey, whose husband David was prescribed antipsychotics, says
¬ĎMy husband David was given antipsychotics without my knowledge. He was unable to make the decision himself because of his dementia. At first it was extremely painful for him and the drugs impacted on his ability to eat and dress. David¬ís chin became slumped onto his chest and he could only look at the floor for the rest of his life. He died aged 63. These drugs have a major adverse affect on people¬ís lives, both patients and families.¬í

The 5-point plan recommended in the report:

1. Specialist dementia training for all care staff
2. Families must be involved in all decisions around antipsychotics.
3. More pro-active support for care home staff from GPs, community psychiatric nurses and psychiatrists.
4. Compulsory medical reviews of people with dementia every 12 weeks
5. A cost effectiveness review by The National Institute of Health and Clinical Excellence and a national audit by the Care Quality Commission

References

¬ē Up to 150,000 people with dementia in the UK in care facilities are prescribed antipsychotics according to best estimates.¬í (Prof C Ballard, APPG inquiry oral evidence). Experts in Old Age Psychiatry predict 70% of prescriptions are inappropriate, therefore up to 105,000 people with dementia are inappropriately prescribed antipsychotic drugs (A Last Resort).
¬ē Alzheimer¬ís Society funded research estimates antipsychotics cost the UK ¬£60, 792, 263 per annum and specialist dementia training would save the UK ¬£35 million a year if it was mandatory.
¬ē Antipsychotics can treble risk of stroke in people with dementia (Committee on Standards for Medicine, 2004), and double a person¬ís risk of mortality (FDA 2005).
¬ē Alzheimer¬ís Society research published in the BMJ found that specialist dementia training reduces disruptive behaviour and the use of antipsychotics by 50%.

More information
¬ē ¬ĎA Last Resort¬í collates evidence from stakeholders, experts and people with personal experience, received as part of an All Party Parliamentary Group on Dementia investigation, including the Royal College of Nursing, Royal College of Psychiatrists, Alzheimer¬ís Society and the Commission for Social Care Inspection.
¬ē 244,185 people (two thirds of care home residents) have a form of dementia.
¬ē If we live to over 65, 1 in 3 of us will end ourlives with a form of dementia
¬ē 700,000 people in the UK have a form of dementia. In less than 20 years nearly a million people will be living with dementia and by 2051 there will be 1.7 million
¬ē For support or advice contact Alzheimer¬ís Society Dementia Helpline number is 0845 300 0336 or visit www.alzheimers.org.uk

Free guide to identifying alcohol abuse

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London: A valuable guide, designed to help identify substance abuse in loved ones, is now available. ¬ĎBeginning Recovery¬í is the title of the new guide, published by Winthrop Hall – the UK¬ís only purpose built drug and alcohol treatment centre.

Coping with the stresses and strains of modern living can be a test for the toughest of resolves. Some find themselves unable to cope with work pressures, financial problems or family difficulties, and find themselves pushed over the edge, forced to seek solace in alcohol and other substances. You can get the leaflet free from Winthrop Hall

Research carried out by the Greater London Alcohol and Drug Alliance* found that 21% of adult Londoners are harmful users of alcohol, and 1% of London’s 7.5 million population are problematic drug users. According to Alcohol Concern*, between 58-60% of 11-15 year olds drink alcohol, with the mean consumption for those who drink doubling from 5 units a week in the early 1990s to 10 units in 2004. By the age of 13, the proportion of those who drink exceeds the proportion of teenagers who do not drink.

This year’s Statistics on Drug Misuse* reports that men are more likely to take illicit drugs than women Р13.7% took drugs in the last year compared with 7.4% of women. Alarmingly, during 2005/06 181,390 people were in contact with structured drug treatment services. This is a 13% increase on figures during 2004/05, where the number was 160,453 and more than twice the number in 1998/99.

For many, the problem is not obvious. However, there may be a number of noticeable changes that are out-of-character.

Symptoms to look out for:
1. Changes in behaviour or routine ¬Ė missing appointments, coming home late, going out at odd times
2. Evasiveness and vagueness
3. Mood swings – irritability, aggression, depression or euphoria
4. Taking less pride in appearance, poor skin or a weight loss problem
5. Hand tremors and regular sweats
6. Increased secretiveness or lack of openness, even lying
7. Changes in finances, running out of money or money going missing

All of these symptoms can point to a crisis. It’s not always easy for the user to admit they have a problem, and trying to help can often lead to confrontation. People sometimes think they can resolve the problem themselves without proper treatment, but if self-help with the support of friends and family has not worked, then professional help is the answer.

It¬ís important to remember that help is always at hand – but it¬ís getting the right help that counts. A copy of the ¬ĎBeginning Recovery¬í guide, offering practical advice on recognising symptoms plus information for getting treatment for substance abuse, is available by calling Winthrop Hall on + 44 (0)1580 894334.

Other support organisations include:
The National Alcohol Helpline: 0800 917 8282
Alcoholics Anonymous: 0845 769 7555
FRANK: The National Drug Helpline: 0800 776600

* source:
Greater London Alcohol and Drug Alliance ¬Ė London: The Highs and the Lows 2 (January 2007)
Alcohol Concern ¬Ė Young People¬ís Drinking, Factsheet
Statistics on Drug Misuse, England 2007 ¬Ė The Information Centre www.ic.nhs.uk

For more details on Winthrop Hall, call 01580 894334.

Half a million elderly abused in UK, says Help the Aged

London Half a million elderly people in the UK are suffering some form of abuse or neglect, according to Help the Aged.

A major survey by the charity claims they face physical, emotional, sexual or financial mistreatment.

But campaigners say that, despite the size of the problem, more than one-third of people have never heard of elder abuse.

And a quarter of those questioned admitted they would not know how to spot if an older person was suffering.

Help the Aged is launching a national campaign – Enough is Enough – to draw attention to the problem.

Supported by TV presenter Esther Rantzen, it aims to raise awareness of the warning signs and give advice on how to help.

Ms Rantzen told BBC News 24: “As a nation we’re not very good at valuing older people. They’re sort of detritus, they’re a bit of sort of rubbish.

“It’s all about younger people these days and when you start getting white hairs and wrinkles on your face you’ve had your time… why don’t you push off to a care home.

“If we treat older people with respect, if we value them and treat them as precious the way we regard children now, that would do a great deal to provide the comfort and protection that vulnerable old people need.”

Help the Aged says many people in Britain wrongly believe elder abuse is most likely to be carried out in care homes by professional staff.

In fact, it claims the largest proportion of abusers are related to their victim and that 64% of abuse occurs in the older person’s own home.

Paul Cann, director of policy at Help the Aged, said: “These figures signal a frightening ‘Not in my back yard’ public attitude, fuelling existing myths that abuse of older people is largely carried out in professional settings, or by primary carers and never close to home.

“We know this simply isn’t the case. Elder abuse can happen anywhere and by anyone, and is more likely to occur within the family home, by someone in a position of trust.

“If more people understood what elder abuse is and its impact on those affected, instead of treating it as a taboo, we’d be one step closer to tackling this national scandal.”

Elder abuse in the UK

46% of abusers are related to their victims
25% of abusers are sons and daughters
80-89 year olds are most at risk

A new booklet produced by Help the Aged lists tell-tale signs which concerned friends and relatives should look out for.

These include the person becoming withdrawn or depressed, changes to their appearance such as weight loss or an over-emphasis on insisting everything is fine.

Ms Rantzen added: “Elder abuse not only has a devastating effect on older people, it shocks and appals their loved ones and indeed the whole nation.

“What kind of country allows older people to suffer and looks away?”

Help the Aged is also calling for:

* a zero-tolerance approach to all forms of elder abuse

* compulsory training in the prevention and recognition of abuse for anyone working with the elderly

* elder abuse to be given the same priority as child abuse

* greater awareness among the legal profession to ensure abusers are brought to justice

To support the campaign, Help the Aged has also produced a moving documentary in which an actor tells the story of an abuse victim in her own words.

Story fromBBC News