The use of pain medication may help decrease the anxiety, depression and loss of sleep often encountered by patients suffering from dementia, according to a new study.
British researchers followed 480 patients in specialized dementia care homes and found that with a 10% increase in a person’s pain medicine, there was a dramatic reduction in the use of anti-psychotic drugs and other medications.
The study was not peer-reviewed and was conducted by Four Seasons Health Care, which manages 56 dementia care centers in England.
“When people with dementia are showing distress reactions this may be due to them experiencing pain or discomfort, yet too often rather than trying to identify and relieve this symptom they are needlessly given anti-psychotic drugs to calm them and keep them quiet,” said Caroline Baker, head of quality and dementia care for Four Seasons Health Care.
“Reducing use of these drugs is a national priority. With a better understanding of how to care for people with dementia we can reduce the need for anti-psychotics together with a range of other medications and at the same time improve well-being.”
Over a two year period, the use of anti-psychotic medication by residents in 16 centers dropped by 48%, anti-anxiety drugs fell by 40%, anti-depressants dropped by 19%, and the need for sleeping pills fell by 44 percent. Depression scores dropped by nearly a third.
A corresponding increase in well-being was measured in nearly one out of two residents. About 42% of them gained weight, reversing a tendency for people with dementia to lose weight, and there was a 25% drop in the number of falls. Researchers attribute that to the increased alertness of residents as a result of taking fewer anti-psychotics and other medications.
A woman whose husband is a resident at one of the PEARL (Positively Enriching And enhancing Residents Lives) dementia care facilities, says she has seen a marked change in his behavior.
“My husband was in bed for 16 months. The home took him off night medication first; then daytime medication. In a matter of weeks he was up and about. On the next visit we sat in the lounge eating breakfast together and he is much more aware and alert. The only medication he is on now is blood pressure tablets. It is remarkable.”
As the use of anti-psychotic drugs decreased in the homes, the use of analgesics increased an average of 10%, suggesting that pain may be under-recognized in dementia care. Typically in nursing homes 40% of residents are taking pain relievers. By contrast, only about 10% of the residents in dementia care homes are taking analgesics.
The company says much of the PEARL program’s success can also be attributed to staff training designed to challenge the mindset that someone with dementia is disabled or dysfunctional. Staff is also encouraged to recognize that challenging behavior by a resident can be a distress reaction.
Trainees spend a day experiencing how it feels to be a resident in a care home where they may have their individuality and personality disregarded. They wear smeared glasses to impair their sight, earplugs to impair hearing, having one arm immobilized and are left wearing wet incontinence pads.
They are not addressed directly by name; are not given a choice about food or beverages; have tablets administered without explanation or warning and are ignored for long periods.
Then they are given the contrasting experience of once again being treated an individual with communication needs, emotions and preferences as well as physical needs.