Always a last resort: Inquiry into the prescription of antipsychotic drugs to people with dementia living in care homes

This report published by the All-Party Parliamentary Group on Dementia (APPG) examines the problem of the over prescription of antipsychotic drugs to people with dementia living in care homes and proposes workables solutions.

Download Always a last resort: Inquiry into the prescription of antipsychotic drugs to people with dementia living in care homes

The inquiry found that over-prescribing is clearly a significant problem in many care homes. Evidence submitted to the inquiry highlights specific reasons for the use of antipsychotics. These drugs are prescribed as a response to the behavioural and psychological symptoms of dementia, experienced as a result not only of the condition, but also as a result of a wider and more complex set of problems external to the individual’s condition.

These problems include a lack of dementia care training for care home staff, which results in the staff not being able to support people with dementia, for example by providing person-centred care. Further problems include inadequate leadership in care homes, a lack of support from external services (including inadequate monitoring and review of prescriptions) and the exclusion of family and friends from decision-making.

The report makes a number of recommendations including:

  • Dementia trainings hould bemandatory for all care home staff.
  • Care homes must receive effective support from external services, including GPs, community psychiatric nurses, psychologists and psychiatrists, which should involve regular, pro-active visits to the care home.
  • The use of antipsychotics for people with dementia must be included in Mental Capacity Act training for all care home staff.
  • Protocols for the prescribing, monitoring and review of antipsychotic medication for people with dementia must be introduced.
  • There should be compulsory regulation and audit of antipsychotic drugs for people with dementia.