The aging population of the UK means that the care of people with dementia is a subject that will affect an increasing number of us. About 700,000 in the UK currently have dementia and this is likely to increase to 1.7 million by 2051.
What is dementia?
Dementia is a collection of signs and symptoms such as memory and communication problems, changes in mood and behaviour, and the gradual loss of control of physical functions which, taken together, are an indication of damage to the brain as a result of the progressive degeneration of nerve cells.
Dementia: ethical issues
Frances Swaine, partner and head of the human rights department at Leigh Day & Co was asked to give evidence to the Nuffield Council on Bioethics earlier this year. The Council has just published a report,
Dementia: ethical issues which looks at the ethical problems faced by those providing support and care for people with dementia and the problems of how to decide what is in the best interests of someone with dementia. The report has produced a number of guidelines that provide an ethical framework for those working in this area. Frances was asked to give evidence to the council because of her experience in representing many clients without capacity, ie the ability to make decisions about their own care, who have received substandard, inadequate or inappropriate care from the health service, care industry, or social services.
One of the common threads that runs through many of the cases that the human rights team handles is the lack of respect and dignity that is afforded to elderly and confused people who are often totally reliant on others for their care. One of the key points stressed in Dementia: ethical issues is the importance of making people with dementia feel valued individuals. The second important point in the report is that an attitude of working with families and other carers is most conducive to the interest to the interests of the person with dementia. The report suggests that the appropriate attitude of professionals and care workers towards families should be that of partners in care. This is not always the experience of clients of Leigh Day.
The publication of Dementia: ethical issues was closely followed by a disturbing survey of nurses treating dementia patients of general hospital wards. The survey of over 650 nurses and 450 nurse managers revealed the widespread use of powerful antipsychotic drugs which are sometimes used to control ‘difficult’ patients. The inappropriate use of these drugs could increase the death risk of many long-term patients.
Neil Hunt, Chief Executive of Alzheimer's Society says,
'The massive over prescription of antipsychotics to people with dementia is an abuse of human rights, causing serious side effects and increasing risk of death. These powerful drugs should only be used in a small number of cases. The Government must take action to ensure that these drugs are only ever used as a last resort.
A report by the All Party Parliamentary Group on Dementia,
Always a Last Resort, published in 2008 found antipsychotics are inappropriately prescribed to up to 100, 000 people with dementia in care homes in the UK. A government review of antipsychotic drugs is due to be produced shortly but charities and health professionals are calling for the training of staff administering the drugs to be made an immediate priority.
If you would like to talk to one of our lawyers about any of the issues raised in this story please contact
Frances Swaine or
Alison Millar for a free initial consultation on 020 7650 1200.
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