Dementia care must wake up to sedative use

The Mental Welfare Commission for Scotland has criticised the care of a dementia patient as lacking the “dignity and respect that she deserved.”

The 80-year-old woman, identified in the report only as Mrs V, was given sedatives rectally 57 times and by injection on a further 29 occasions over an 11 day period after presenting at hospital with a chest infection.

86 sedatives over 11 days – I think these figures speak for themselves.

The report categorises the use of these sedatives as ” repeated, uncomfortable and undignified” and resulted in Mrs V losing the ability to eat. Needless to say, Mrs V’s death was hastened by the hospital’s actions and in a manner abhorrent to what we expect in 21st century Scotland.

I raise this case, clearly one of the worst, as it is counter-pointed by my own experience of dementia care in Scotland.

My father was diagnosed with vascular dementia 4 years ago and lost his battle with this terrible disease in October of last year. While the death of a parent is one of the most personally traumatic experiences someone can ever have,  my family took some comfort from the excellent care Dad received for 3 years from the staff at Alloa Community Hospital.

All the nurses who took care of Dad morning, noon and night had immense patience, enormous compassion and understood that while dementia sufferers may not outwardly be the person they once were, their memories, experiences, loves and indeed hopes are still bound up, bubbling just under the surface.

They deserve respect and dignity. My father got this, Mrs V clearly did not.

These are just two examples out of thousands across Scotland, and that number is set to grow as the population continues to get older.

So while a cure to this illness is still a hope not yet realised, care is all important – both for the comfort of patients and their families.

Too often, dementia sufferers are seen as problems – disruptive, angry and a nuisance. As a solution to this, the medicine cabinet is all too readily available but studies show that the inappropriate use of sedatives can cause the condition to deteriorate.

Don’t get me wrong, sedatives when used on a patient by patient basis can help with side effects of dementia including depression, and difficulties with perception and spatial awareness.

But they should not be used so dementia sufferers can be put in a corner and forgotten about. Sadly, this seems to be what has happened in the case of Mrs V.

In response to Mrs V’s case, the Scottish Government said: “Many of the issues the report identifies are already being addressed through the national dementia strategy published last summer… the strategy – Scotland’s first ever for dementia – was clear that general care in acute hospitals needs to get better at identifying and supporting people who have dementia.”

The National Dementia Strategy is an important step towards improving the care of dementia sufferers. It sets out plans to reduce the “inappropriate use” of sedatives and improve the training of staff.

Hopefully with this strategy in place we can get to a point where the use of sedatives is a last resort, not a first response.

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2 thoughts on “Dementia care must wake up to sedative use

  1. I went to a hustings run by SAMH during the election and people were talking about this. I was so shocked because I had no idea this sort of thing went on and I really felt for them. They were understandably really angry at seeing their relatives treated like this.

    Sadly, though, the panel just basically said it was a bad thing and had to be stopped but weren’t so specific about how to do it.

  2. […] interestingly named G’s Spot, whose author lost his father to Dementia last year, argues that inappropriate use of sedatives in […]

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