Eighteenth Report of Session 2006-07
HL Paper 156-I HC 378-I Published on 14 August 2007 by authority of the House of Commons London:
The Human Rights of Older People in Healthcare 3 Summary In addition to its scrutiny of parliamentary Bills and policy documents for human rights implications, the Committee examines areas where human rights concerns arise, such as the treatment of older persons in health care. In this Report the Committee examines how human rights principles can be applied toensure that older people in hospitals and care homes are treated with greater dignity andrespect (paragraphs 1 - 8).The Committee heard that, while some older people receive excellent care, there are concerns about poor treatment, neglect, abuse, discrimination and ill-considered discharge.It considers that an entire culture change is needed. It also recommends legislative changesand a role for the new Commission for Equality and Human Rights (paragraphs 9 - 65).In the Committee’s view there is a significant distinction between a “duty to provide” undercare standards legislation and a “right to receive” under human rights legislation. It recommends that the Government and other public bodies should champion understandingof how human rights principles can help transform health and social care services (paragraphs 66 - 95).While welcoming the recent acceptance at senior levels in the Department of Health of theimportance of human rights in healthcare, the Committee recommends adoption of astrategy to make the Human Rights Act integral to policy-making and social care across the Department (paragraphs 96 - 124)
26. A number of witnesses expressed concern about the inappropriate use of medication
on older people, including the over or under-use of medication and the use of medication
as a means of controlling patients and residents. Action on Elder Abuse cited the misuse of
medication as one type of abuse which frequently comes to its attention.47 This is a
particular issue in care homes.
27. Again, witnesses accepted that there was good practice in this area,48 but that this was
not universally implemented. Witnesses raised a particular issue of medication being
inappropriately used to keep residents docile.49 As the Alzheimer’s Society’s said:
The response to aggression in dementia is often to prescribe powerful sedative
neuroleptic drugs that can help to calm the person However, these treatments have
very damaging side effects. Medications such Haliperidol, Risperidone and
Olanzipine are being routinely prescribed to people with dementia in hospitals and
care homes. A recent study found that 40% of people with dementia in care homes
are being prescribed neuroleptic drugs.50 Neuroleptics are not licensed for use in
dementia care but have become a convenient staple as part of routine treatment,
despite known evidence on the risks which such ‘treatments’ pose to quality of life
and the increased risk of death.51
28. The concerns of witnesses accord with the findings of the Health Committee that
medication was “in many cases, being used simply as a tool for the easier management of
residents”.52 The National Service Framework for Older People requires that all people over
75 years should normally have their medicines reviewed at least annually and those taking
four or more medicines should have a review every six months.53 In 2006, Living Well in
Later Life noted that “the management of medicines needs to be addressed, as many older
people taking more than four medications are still not receiving a review every six
months”.54 CSCI found that, in 2005-06, only 59% of care homes met the National
Minimum Standard (Standard 9) for medication.55 The Alzheimer’s Society agreed that
there is a very poor record of medication in care homes.56
Toronto journalist Judy Steed has been writing about social issues for 30 years. Last fall, she embarked on a one-year project to document the most pressing policy implications of our aging society as part of the 2008 Atkinson Fellowship in Public Policy.
She has visited dozens of nursing homes and interviewed hundreds of health-care workers, policy-makers and seniors to present this weeklong portrait.
Day 4 of an eight-day Atkinson Fellowship series
Drugged-out seniors a prescription for disaster
November 11, 2008
SPECIAL TO THE STAR
They are the drugged-out generation, and they're not who you think they are.
They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.
The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs.
"You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.
Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects. Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.
Article on drugging of seniors from the Toronto STAR