Rethinking Dementia: Normal Human Responses #3

There is a distinct possibility the #BanBPSD campaign may already have been misconstrued as the banning of antipsychotics completely.

It was never meant to be that; we all acknowledge many people need, and do benefit from antipsychotics, or other forms of medication, when prescribed appropriately.

It is the over dispensing of them, as a form of ‘managing’ people, and as a form of chemical restraint that are two of the issues.

The negative dehumanising labeling of people, largely due to this paradigm is also a major issue; another valid reason to BanBPSD.

We need to separate BPSD from the use of antipsychotics; it is not the same issue, even though it may be related.

This video, Human Rights Watch: Over-sedation in Nursing Homes” may explain more why we started this campaign. The actual report ‘They Want Docile’ published about nursing homes in the USA is incredibly disturbing, and clearly highlights the human rights issues too may still experience in residential care. We know it is not always a negative experience, but even ONE is one too many…

“The 110-page report, “‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia,” estimates that every week in US nursing facilities, more than 179,000 people, mostly older and living with dementia, are given antipsychotic drugs without a diagnosis for which their use is approved. Often, nursing facilities use these drugs without obtaining or even seeking informed consent. Using antipsychotic medications as a “chemical restraint”—for the convenience of staff or to discipline residents— violates federal regulations and may amount to cruel, inhuman, or degrading treatment under international human rights law.”

12 thoughts on “Rethinking Dementia: Normal Human Responses #3

  1. Excellent point Kate and it definitely required clarification as I believe our #BanBPSD campaign may have also been misconstrued in some way.

    It is so very important we are understood as standing up only for the rights of those in circumstances where the misuse of medication is considered ‘abusive’ and ‘inhumane”, nevertheless, be seen as flexible in our approaches.

    We must be mindful that for many people, their specific and individual symptom relief or treatment gets beyond a stage where nothing BUT certain medications work.

    We do tend to focus on only the destructive elements of medications and must always be aware that in some cases they are the only medications that may actually alleviate the suffering for that person.

    Medications in the right circumstances are crucial to wellbeing.

    Chemical restraint is considered elder abuse when:
    • no medically identified condition being treated
    • where the treatment is not necessary for a condition
    • used to over-treat a condition
    Chemical restraint/abuse includes use of medicines when:
    • the behaviour does not appear to have a medical cause
    • part of the intended pharmacological effect of the medicine is to sedate the person for convenience or for disciplinary purposes

    “When medicating human beings for ‘being different’, becomes an acceptable and tolerable approach, and remains unquestioned, then we truly must look inside ourselves and challenge this process for the disrespectful, degrading, inhumane process that it truly has become”. (Leah Bisiani, 2016)

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  2. Thank you Kate for clarifying. All ways of dealing with Dementia and the behaviors, human nature behaviors that occur must be carefully thought through. There is no “one size fits all” as we know in so many situations, and Dementia complicates that even more. Keep up the fight!!! Fondly, Michael

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    • I’m glad that has been helpful… I hadn’t realised until recently the possible confusion between why I and so many others believe we need to ditch the term and the labels of BPSD, but that this does not mean, ditch all medication! With love and a big hug from across the seas xxx

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  3. Kate, I also thought this was a great report by Human Rights Watch. The problem with antipsychotics in dementia care, as you well know, is they are often prescribed as the “go-to” solution rather than as a LAST RESORT, which is what they should be.

    Seeing my mom needlessly drugged into a catatonic state every day for four years was torture for me. Honestly, I don’t think I will ever get over it. #BanBPSD

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      • That said, my personal belief is that, while each case should be considered on an individual basis, the use of most antipsychotics in dementia care is unwarranted, and that abusers frequently use the excuse that “there is no other option,” which is what was repeatedly said in my mother’s case, and which was complete and utter BS. It’s a fine line that is not easily clarified.

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