Originally published April 10 2015
Researchers warn about overprescription of psych meds for dementia and recommend holistic approach
by L.J. Devon, Staff Writer
(NaturalNews) A recent report from the U.S. Government Accountability Office addresses the bombastic overuse of anti-psychotic medication for suppressing behavior problems in dementia patients. The report finds that one-third of elders with dementia who stayed in a nursing home in 2012 were prescribed an anti-psychotic medication. Of elders living at home with dementia, 14 percent were prescribed the drugs as well. It's a trend that should startle any caregiver or family member.
When the behavioral issues associated with dementia are drowned out by mind-altering drugs, the elderly patient feels liked they are not loved at all, not cared for, not understood and not listened to. Subjecting dementia patients to anticholinergic meds like antidepressants only makes their condition worse. Anticholinergic meds work by blocking a neurotransmitter called acetylcholine. In doing so, these meds stop acetylcholine from naturally binding to its receptors in the brain. This slows cognitive processing, making elderly dementia patients slower and more mentally impaired than they were before.
Doctors and nursing home staff work in a hasty manner, treating patients like numbers and drugging their symptoms while ignoring what the person truly needs. Dementia patients are most likely already conflicted with a daily regimen of pills. More of the same only pulls them closer to their grave while numbing their ability to function.
Why are medical professionals abandoning non-drug approaches? Why do caretakers follow along with the prescriptions? Health insurance plans and state medical aid don't pay doctors and caregivers for taking the time to actually listen to patients. Pharmaceutical drugs are the quickest way to drown out problems. They are systematically easier to push, but they are destroying our elders' quality of living, pulling them deeper into a culture of hopelessness.
"The evidence for non-pharmaceutical approaches to the behavior problems often seen in dementia is better than the evidence for antipsychotics, and far better than for other classes of medication," said first author Helen C. Kales, M.D., head of the U-M Program for Positive Aging at the University of Michigan Health System and investigator at the VA Center for Clinical Management Research.
"The issue and the challenge is that our health care system has not incentivized training in alternatives to drug use, and there is little to no reimbursement for caregiver-based methods."
A paper published by The BMJ says that non-drug approaches should be used first when dealing with common issues that go with dementia -- irritability, agitation, depression, anxiety, sleep problems, aggression, apathy and delusions. All of these problems can be handled using holistic methods that improve a patient's quality of life instead of dumbing them down and ignoring their root problems.
Holistic approach offers more hope, greater quality of life
To make non-drug approaches for helping dementia patients more accessible, researchers have developed a simple system for caregivers to follow. It goes by the acronym DICE -- "Describe," "Investigate," "Create" and "Evaluate."
Describe is for recognizing stressful situations and explaining where problem behavior occurs. It's the first step in understanding the patient and finding out the context of their behavior.
Investigate is for looking into the triggers that lead to behavior issues. It's for digging in and looking at the quality of food they are given and how this relates to their overall medical condition. To take it a step further, physician, patient and caregiver may need to home in on the side effects of their drugs which are pushing the patient over the edge.
Create stands for developing a plan to both prevent and respond to behavioral issues. This means improving the environment that the patient is in, the activities they engage in, and the social and spiritual aspect of their care. How might having their own music help them recollect memories? How might incorporating living plants in their space uplift their mood and provide fresh air? What if the nursing home provided nutrient-rich foods instead of run-of-the-mill junk foods that affect patients' moods in negative ways?
Finally, evaluate stands for reviewing what is working and deciding if any changes are necessary.
With this holistic approach, the quality of nursing home living in general would increase and the cries of dementia patients could be better heard.
Caregivers and doctors need to work on ways to reduce the amount of drugs being fed to dementia patients and should work in a more intuitive and patient manner to help patients reflect and work out their behavioral issues in healthy ways.
"Behavior-based strategies may take longer than prescriptions," acknowledged Kales, a member of the U-M Institute for Healthcare Policy and Innovation. "But if you teach people the principles behind DICE, the approach becomes more natural and part of one's routine. It can be very empowering for caregivers or nursing home staff."
Source:
http://www.uofmhealth.org
http://www.bmj.com
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