Dementia Sleep Medications & unnecessary fixations

Clinic dementia care: sleep medications and unnecessary fixations

08/30/2014

The largest survey to date has been conducted in care for the care of people with dementia in hospital. It turned out that almost every 4th patient in German clinics suffers from dementia. Many patients receive sleep medications and are unnecessarily tied to the bed.

Almost one in four clinic patients has dementia
With the Pflege-Thermometer 2014, the German Institute for Applied Nursing Research e.V. (dip) in Cologne has published the largest survey to date in care for the care of people with dementia in the hospital. For this purpose, more than 1,800 ward and departmental hospitals were interviewed from hospitals throughout Germany. The results of the study sponsored by the B. Braun Foundation show that the topic is of outstanding importance for health care. According to the study almost one in four patients suffered from dementia at the interviewed wards (23%). „People with dementia are no longer marginal in the hospital“, the researchers write. In addition, a further increase must be expected in the future. In 2000, the proportion of over 75-year-old inpatients treated in the year was still 18 percent, in 2012 there were already 25 percent.

Exact number of patients difficult to identify
However, the exact number of affected patients in the approximately 2,000 German clinics is difficult to determine. Dementia is often just an unrecognized secondary diagnosis when seniors are admitted to a ward for instance because of a fracture or heart disease. The German Alzheimer's Society analyzes: „Often, dementia is first noticed during the hospital stay.“ In the study, which can be downloaded for free (http://www.dip.de), serious implementation problems of suitable care concepts have now been revealed. The growing shortage of staff in nursing also plays a role here.

Supply of dementia patients at night and at weekends insufficiently secured
Actually, the peculiarities in the care of people with dementia in the hospital are now known. Patients often feel disoriented in the unfamiliar environment, are afraid to try to leave the clinic and can not participate in diagnosis, treatment and personal hygiene. They need more time and more supervision to be protected from danger and to be guided. But the study results show that supply bottlenecks occur at night. „Eight out of ten interviewed stations indicate that the care of people suffering from dementia is insufficiently secured, especially at night“, The head of the study, Prof. Michael Isfort, said. But also during the weekends at the weekends, problems are revealed. „This deficiency situation often leads to unnecessary administration of sleep medication and often to questionable restraints of patients, so-called fixations“, Isfort continued.

Massively sedating medications and unnecessary fixations
Respondents of the study administered approximately 7,600 sedative medications to patients with dementia over a one-week period, and proximal fixations were performed over 1,450 times. Extrapolated to all hospitals in Germany, dip's researchers estimate that around 2.6 million sedatives are administered each year and around 500,000 mostly unnecessary fixations are performed. In the past, many projects to improve dementia care in clinics have tested promising approaches, but so far these have hardly been implemented. Only at one of ten wards will concepts be used, such as day-structuring measures or the training of dementia officers in the hospital.

Take care of care in clinics seriously
Of the executives surveyed, the case-based compensation system and the high cost-effectiveness pressure are mainly responsible for the supply deficits. But even the thinned staffing plays a role. „It's time to take care of caring at the hospital seriously“, said Isfort. „While long-term care insurance has improved the financing of care for people with dementia, hospitals have so far been waiting for higher benefits and ensuring good care to be offset by good concepts. This also crucially impedes the quality of care“, so the study leader.

Psychotropic drugs in retirement homes
Not only in hospitals, people are unnecessarily often simply sedated with medication. This also happens in retirement homes. As reported two months ago, used in the care of the elderly in large quantities psychotropic drugs, not only for the treatment of the mentally ill, but to quiet home residents. So had the Munich home supervisor in a report of one „questionable handling of psychotropic drugs“, spoken. A then launched initiative of the district court of Munich, which is responsible for more than 100 nursing homes and nursing homes, should one „important step to reduce the use of psychotropic drugs“ his. District Court President Gerhard Zierl was hopeful: „I am confident that the new initiative will improve the quality of life of home residents and promote mutual trust. Respecting and protecting the individual's liberties and enabling a self-determined life as long as possible is a fundamental obligation of our society.“ (Ad)