Conference hears elderly rights infringed by overmedication

A leading consultant geriatrician says older people are having their human rights infringed by the unnecessary use of potentially hazardous anti-psychotic drugs in nursing homes.

Addressing the summer team meeting of Sage, a support and advocacy service for the elderly, in Athlone on Friday, Dr Shaun O'Keefe of University Hospital Galway said the inappropriate over-prescription of such medications is a danger to those living with dementia, and must stop.

Treatment of dementia patients with anti-psychotic medications over a three-month period can lead to death in 1 in 100 cases according to Dr O’Keefe, and 1 in 60 patients will have a stroke if regularly prescribed the drugs.

Last year, The Irish Times carried a special report on the rampant use of psychotropic drugs on residents in care facilities. It found that heavy sedatives are often used to make elderly and intellectually disabled patients more manageable, and anti-psychotics are regarded as a particularly “dangerous and hazardous” class of psychotropics, Dr O’Keefe said.

He recalled examples where a nursing home resident was given sedatives when he became upset upon hearing about the death of his wife, along with an older hospital patient who was medicated to encourage her to use incontinence pads to avoid needing staff to bring her to the toilet.

“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,” Dr O’Keef told the meeting.

It was noted that in many cases staff are resorting to the medications because they are too overburdened to concentrate on residents individually.

The situation is not helped by the patchy provision of psychiatry services for older people in certain parts of the country, Dr O’Keefe said.

“We have evidence from a number of studies in Irish long-stay settings in the last number of years, including the audit of dementia care in acute hospitals, which showed that almost half of people who came to acute hospitals from nursing homes were on anti-psychotic medications,” he added.

Care experts have called on legislators to strictly enforce commitments contained within the National Dementia Strategy and Hiqa’s guidance for designated centres to move away from chemical restraints in favour of more patient-friendly methods of treatment.