Hospitals overprescribing cosh to sedate dementia patients

Hospitals overprescribing cosh to sedate dementia patients

It has been difficult for Susan to constantly run to and fro from her high profile job in New York to the quaint backwaters where Jack Strafford lives with his old German Shepherd in the ancestral house. Ever since her 60-yr-old dad, whom she lovingly called “Grizzly” because of the unruly hair, lost his wife and partner of 40 years, he had increasingly become aloof. A sense of filial love brought Susan to her home after a long drive every weekend. But this time, she noticed that he looked different, was gruff and kept forgetting important things such as taking medications. His neighbors informed that he often stays on the front porch for long, staring at nowhere. Susan was alarmed. She got him medically tested. Then came the medical report – Strafford had been diagnosed with a neurodegenerative disorder – dementia. “It will only get worse,” suggested the doctors. “Better get him into a senior’s home. He needs constant attention.”

The nursing home looked like a perfect place to provide comfort and company to the old man. The first few weeks were smooth sailing. The hospital staff seemed to like him. But slowly, things turned sour.  Susan soon discovered that her father had been put on more pills to quell his aggression. The staff were unable to manage his agitation. During one such episode, four people were called in to restrain “Grizzly.” he was administered chemical cosh, a kind of sedative to control agitation, a common complaint in those living with a neurodegenerative disease. With tears in her eyes, Susan explained that the after effects of the antipsychotic drug had turned her dad to a zombie. He looked untidy, disheveled and had trickles of drool. It looked as if he had not shaved for days and his hair badly needed combing.

Antipsychotic use to control behavioral symptoms is risky

Whether it is antipsychotics or opioids, most seniors are put on a diet of pills that could have serious consequences to their life. One study assessed mortality risks in elderly patients with dementia who were prescribed antipsychotic medication. The authors confirmed that these medications are not the best means to treat behavioral problems as they carry a significant risk of death. In another study, it was found that nearly one in five senior citizens were prescribed antipsychotics and three-fourth of prescriptions were ‘excessive” (use beyond six weeks against the government guidelines). This is despite the government ruling in 2009 that called for a drastic slash (two thirds in four years) in dementia medications for all elderly citizens. But the pills are being recklessly used to control the behavior.

Dementia is commonly associated with sundowning effect, a pattern of “disruptive behavior and complete disorientation”. It is generally apparent towards late afternoon/early evening and is associated with aggression, confusion, restlessness and verbal outbursts. One of the chief reasons cited for sundowning is a disturbance in circadian rhythms that prevents a person from sleeping properly. The symptoms could be managed through use of various therapies and medication in the right quantity.

Antipsychotic drugs – the know-how

Chemical cosh is a cocktail of antipsychotic drugs that has a tranquilizer kind of an effect. These are generally given to people suffering from psychiatric illness such as schizophrenia or Alzheimer’s where the lines between the real and the imaginary world are blurred. Their sedative effect is effective in reducing hallucinations and in preventing those with severe mental ailments from causing harm to themselves or to others. However, prescribing cosh to the elderly in an unrestrained manner is responsible for the following risks:

  • Early mortality
  • Falls
  • Heart attacks
  • Bone fractures
  • Choking
  • Infections
  • Pneumonia
  • Disorientation

Sometimes, the patients may get so addicted to these prescriptions that they find it difficult to function without them. According to George McNamara, head of policy at the Alzheimer’s Society, using antipsychotics to manage behavioral symptoms is “a step backward into the dark ages.” He suggests training programs for hospital staff and caregivers, and using more people-centric treatment approaches to curb the excess use of the harmful drugs.

Prescription drug addiction is treatable with timely intervention

Instead of prescribing medications with severe side effects, offering natural cures for stress relief is a viable alternative. For instance, using music therapy, aromatherapy and aroma-acupressure can control aggressiveness and induce relaxation. However, these should be used as additional tools along with other behavioral therapies to help the patients lead better lives.

If you or your loved one is addicted to any prescription drug, contact the Prescription Drug Abuse Helpline of California to find out about the best prescription drug addiction treatment in California. Call our 24/7 helpline (855) 738-2770 or chat online to know about state-of-the-art drug addiction treatment centers in California.