Jeremy Wright MP: The challenge of treating dementia

Jeremy Wright, MP for Rugby and Kenilworth and Chairman of the All Party Parliamentary Group on Dementia, looks at the use of anti-psychotic drugs in care homes.

I suspect that dementia is an issue that many readers will be familiar with - 1 in 3 older people will end their lives with a form of dementia, an estimated 700,000 people in the UK have a form of dementia, and this is expected to rise to a million in less than 20 years.

On Monday, in partnership with the Alzheimer’s Society, we launched A Last Resort which is a report into the use of anti-psychotic drugs in care homes. Two thirds of care home residents have a form of dementia. The report highlights expert findings that suggest that 105,000 people with dementia are given anti-psychotic drugs inappropriately. This equates to 70% of all prescriptions.

The report also identifies that:

• Over 70% of people with dementia experience challenging behavior at some point during their illness, such as aggression or restlessness.
• Specialist dementia training for care home staff reduces need for anti-psychotics by 50%.
• Alzheimer’s Society funded research estimates that anti-psychotics cost the UK £60,792,263 per annum.

It is clear to me that there is a real issue with the over-prescription of anti-psychotics to people who may not be in a position to make an informed choice. The report finds that anti-psychotics double the risk of death, triple the risk of stroke and cause devastating side effects in people with dementia, such as accelerated cognitive decline.

‘A Last Resort’ also reveals key failings in our health and social care system and identifies five vital steps that would reduce antipsychotic use:

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

Best practice guidelines are not enough - safeguards must be put in place to ensure anti-psychotics 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. We owe it to our fellow citizens who are suffering from these drugs to take action, and to do so now.

The Government is due to publish its own National Dementia Strategy in the autumn. I hope that the Department of Health will make the five point plan a key element of this strategy.  The Government should take steps to end this needless abuse of some of our most vulnerable citizens. If this Government will not, the next one must.