Alzheimer Scotland in dementia care ‘human rights’ call
Urgent action should be taken to protect the human rights of people with dementia in care homes, a charity says. The call from Alzheimer Scotland came as two watchdogs published a report after visiting 30 care homes and interviewing 1,335 residents.
It said drugs had been hidden in food to make patients more manageable and about half never went outside.
The Scottish Government is to launch a national dementia strategy later on Thursday.
About 65,000 people in Scotland have dementia and about 40% are in care homes or hospitals.
The issue of medication in food is really very concerning and highlights, probably for the first time, what a serious issue this is in care homes.
Not all care homes are doing it by any means, but there were sufficiently large numbers of care homes for the Care Commission and the Mental Welfare Commission to be concerned.
The second issue in the report is really just a little bit more need for understanding about the people that these care homes are looking after.
The Care Commission and Mental Welfare Commission visited a sample of homes between August and March and detailed their findings in a report, Remember I’m Still Me.
It said before the patients were admitted most had already had a good medical assessment, with input from GPs and dieticians.
But after admission, the report said very few had annual GP health checks and there was little evidence that medication was regularly reviewed.
The organisations expressed concern that medication was being misused, with some residents on a cocktail of antipsychotics, and some being prescribed drugs known to be dangerous.
In nine homes, the watchdogs said medication was being illegally disguised in food or drink, probably to make residents easier to manage.
About half of the residents never went out of the homes, the report said, and only a tiny minority could come and go even into secure internal gardens.
One of the watchdogs’ recommendations was for outdoor activities to be an integral part of patients’ lives, not “an optional extra”.
No life history
The commissions also looked at 182 personal plans to see how people’s life histories were recorded and found that less than a quarter had adequate details.
Just over a third of the personal plans recorded no life history at all.
The inclusion of the patients’ likes and dislikes in their personal plans was also examined by the watchdogs.
A total of 31% of the plans examined had information, although in most cases it was incomplete.
Just over a quarter had limited information, mainly about food, with one plan merely stating: ‘Likes cats. Likes milk.’
But 42% of people had no details at all recorded about what they preferred.
The report said of one patient: “This person has no visitors. There is nothing in her care plan to highlight her personality, her likes or dislikes or her history.”
Henry Simmons, chief executive of Alzheimer Scotland, said: “People with dementia must be afforded dignity, respect and liberty within the care home setting.
“It is appalling that almost 50% of people in this report had no opportunity to go outside of the care home at any point.
“This is as great a detriment to their quality of life as inappropriate medication or inadequately trained staff.
“These problems should not be tolerated and cannot be allowed to continue.”
‘Wake-up call’
Public Health Minister Shona Robison said the failings detailed in the the report were a “big wake-up call”.
“I certainly wouldn’t want that for myself and I wouldn’t want it for anyone in my family, and I wouldn’t want if for anyone else,” she told BBC Radio Scotland.
“It’s shone a light on some of the practice in care homes, although I would stress again that there is some good practice in the care home sector as well.”
The Scottish Government has accepted the report’s recommendation that its findings be used to help develop a national dementia strategy.
Ms Robison said it would “build on” a range of measures already in place to improve care, including staff training and support after diagnosis.
