For those of us who have worked in nursing homes, we know many residents who are given drugs to help them with agitation, depression and other “behaviors”. But do we know how dangerous these drugs can be?
An article explores how the use of meds can cut short the life of a person with Alzheimers.
LONDON (AP) – Anti-psychotic drugs commonly used to treat Alzheimer’s disease may double a patient’s chance of dying within a few years, suggests a new study that adds to concerns already known about such medications.
“For the vast majority of Alzheimer’s patients, taking these drugs is probably not a worthwhile risk,” said Clive Ballard, the paper’s lead author, of the Wolfson Centre for Age-Related Diseases at King’s College London.
“Would I want to take a drug that slightly reduced my aggression but doubled my risk of dying? I’m not sure I would,” Ballard said.
I’m sure if they asked a CNA who has to deal with an agitated and acting out person with Alzheimers, the answer would be YES. Aggression takes many forms…some harmless and others not so. CNA’s get the brunt of these aggressions: We get hit, kicked, bitten, pulled, punched and so on. The violence a person with Alzheimers can produce and aim towards us is quite amazing.
Alzheimer’s disease is the most common cause of dementia and causes symptoms including aggression, delusions and hallucinations. Previous studies have shown anti-psychotic drugs, which can help control the aggression and hallucinations for a few months raise the risk of death in older patients with dementia. There are other side effects, including respiratory problems and stroke.
The violence isn’t always aimed at the aides. Other residents and families are often targets. Most of us do realize the person with AD cannot control their behaviors. We know they would not do these things in their “right” mind. The reality is clear though: An aggressive resident is a threat to all, in the nursing home setting.
Ballard and colleagues followed 165 patients aged 67 to 100 years with moderate to severe Alzheimer’s disease from 2001 to 2004 in Britain. Half continued taking their anti-psychotic drugs, which included Risperdal, Thorazine and Stelazine. The other half got placebos.
Of the 83 receiving drugs, 39 were dead after a year. Of the 82 taking fake pills, 27 were dead after a year. Most deaths in both groups were due to pneumonia.
After two years, 46 percent of Alzheimer’s patients taking the anti-psychotics were alive, versus 71 percent of those not on the drugs. After three years, only 30 percent of patients on the drugs were alive, versus 59 percent of those not taking drugs.
I wonder if they kept track of behaviors of the people who were given the placebos? THAT would be interesting data to see. It’s pretty clear that these drugs somehow hasten the death of Alzheimer victims. In the end, they all die- a sad fact. Alzheimer’s is an awful and brutal disease and one I do not wish upon anyone.
Experts aren’t sure how the anti-psychotics increase patients’ risk of dying. But they think the drugs could be damaging to the brain and their sedative effects make patients less able to exercise and more susceptible to deadly infections.
I agree. I’ve seen many a resident start taking these meds – and the meds DO work. They “calm” the resident down to a level of “safety” that works for the environment. The person is able to stay still longer, so we see less wandering and unsafe movements.
However, I’ve also seen how this turns into a mobility problem: Due to “time restraints” aides tend to push the resident around in a wheelchair vs assist them with ambulating…Legs get stiff, contractures settle in, ambulation is no longer possible. So the resident becomes wheelchair and bed bound, and totally dependent upon us for all care.
We see other outcomes every day: They no longer have control of their bladders and bowels. Skin issues become more pronounced. Sitting in one position for hours on end results in red areas, open areas and everyone knows what this means.
Residents gradually require more and more assistance with eating and drinking. Meds change the appetite, the desire to eat and drink. Meds also alter the ability to smell and taste food. Since there aren’t enough of US to do it all in a timely manner, the food goes in cold and gross; drinks are forced down (and let’s not forget how the disease process screws up the ability to swallow correctly); oral care isn’t the top priority and infection is likely present. The resident loses weight, becomes dehydrated and the vicious cycle continues.
Exactly how much of this is caused by the meds isn’t known, yet. But I think we can all say the decline starts when the meds start. Are they worth it?
The decline will happen no matter what. That’s a given. Those months, even years- of Alzheimer’s induced behaviors are a turning point. Most families will seek a nursing home admission when these things happen. They can’t manage it. Nursing homes “manage” it with drugs.
Is there a better way? Would a really good and targeted Activities Program help? I think so. There are a great many people who believe that all “behavior” is a form of communication, even coming from those whose brains are literally deteriorating. I have seen how well planned yet spontaneous activity programs work WONDERS with people with all forms of dementia. It takes everyone to make these programs work though- aides, housekeepers, the DON, the administrator…everyone. I’d like to see some research done on this. The costs savings alone should make sense: Meds are expensive! Activities are cheap in comparison.
