Training staff in alternatives to antipsychotics in dementia care
A programme shown to reduce use of antipsychotic drugs for care home residents by training staff in person-centred dementia care is being rolled out across 150 homes.
As many as 180,000 people with dementia are treated with antipsychotic medication in England every year, but only about 36,000 receive any benefit, according to the 2009 Time for action report commissioned by the Department of Health. Inappropriately prescribing these drugs can double the risk of death, treble the risk of stroke and leave people unable to walk or talk.
This has long been recognised as an issue within residential care and nursing homes which is why Alzheimer’s Society devised the Focused Intervention Training and Support programme (Fits) for care homes.
Now, with funding of £100,000 each from the Department of Health and the HC-One care home group, the programme is being rolled out in 150 care homes across the UK. The reason a programme such as FITS is so crucial is because there is no mandatory dementia training for staff in care homes or nursing homes, says Alzheimer’s Society director of research Clive Ballard:
Fits helps staff look at things from the perspective of the person with dementia.
By understanding dementia and the person behind the condition it will help them provide good quality, individually tailored care.
Often antipsychotics are used as a first line rather than a last resort and it is because of a lack of understanding about why behavioural problems occur.
The University of Worcester’s Association for Dementia Studies (ADS) has been commissioned by Alzheimer’s Society to deliver the training and also to evaluate it. ADS has recruited two dementia practice development coaches who will train 75 existing care home staff from the 150 homes to become dementia care coaches. They in turn will be able to provide training for other care staff in the homes.
Simon Evans, senior research fellow at ADS says:
The core training will be around person-centred planning and meaningful occupation. It’s about seeing the person rather than the dementia.
We want to see how the model works across a range of provider sizes. There will be different challenges depending on the resources available in each home.
While the main aim is reducing antipsychotic drug use, smaller aims include changes in staff attitudes and goal planning to meet the social and emotional needs of people with dementia.
Paul Smith, head of mental health and dementia care at HC-One said:
FITS is a two-year research programme but we are seeing beyond that by creating specific roles of ambassadors and champions so that all the learning can be rolled out.
The government figures are scary and as the third largest care home provider then we will share some of that [problem]. There are cultures to change and we recognise that.
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