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Care homes still using antipsychotics to quieten dementia patients, study finds

Lack of staff could be the reason why too many UK care homes are still using a ‘chemical cosh’ to quieten dementia patients, says senior nurse.
June Andrews

Staff shortages could be the reason why many UK care homes are still using antipsychotics to quieten dementia patients, despite a government-ordered review of their use, according to a senior nurse.


Dementia expert June Andrews. Picture: Nathan Clarke

Dementia expert June Andrews was reacting to a new study by five universities showing no overall reduction in the prescribing of antipsychotics between 2009 and 2012.

The research, led by Coventry University and published in the journal BMJ Open, examined prescribing data from more than 600 care homes.

The study found a fifth of residents had been prescribed at least one antipsychotic.

‘Excessive’ treatment

It also described treatment in 77% of the cases from 2012 were ‘excessive’ and lasted far longer than the recommended six weeks.

Professor Andrews, a former director of the University of Stirling's Dementia Services Development Centre, said while the study was important work, the sample period was a long time ago.

‘It would be important to understand that change takes time and awareness now is massive,' Professor Andrews told Nursing Standard.

‘However there are more recent pressures that could tempt people to use medication more; for example difficulty in affording or even finding enough of the right staff.’

Changing attitude

The study also found older antipsychotics such as haloperidol and chlorpromazine were being favoured over newer, safer types such as risperidone.

In 2009 the government’s National Dementia Strategy criticised the use of such drugs and called for a review into the side-effects, including strokes.

The in 2014, health secretary Jeremy Hunt said the attitude towards dementia must change, as he recounted reports of people ‘drugged up with a chemical cosh just so a care assistant can get a good night's sleep’.


Further information

Antipsychotic prescribing in care homes before and after launch of a national dementia strategy: an observational study in English institutions over a 4-year period

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