Masses of psychotropic drugs in the elderly

Initiative wants fewer psychotropic drugs in elderly care

06/29/2014

Psychotropic drugs are actually used to treat the mentally ill. But in many homes for the elderly, the drugs are used to just calm down residents. The district court Munich now says the abuse of psychotropic drugs the fight.

Every second Munich retiree is medically sedated
Psychotropic drugs are drugs that are primarily used to treat mentally ill patients. But in many homes for the elderly, medicines are often used to calm down residents. As various newspapers report, the Munich home supervisor speaks in its 2011/12 quality report of one „questionable handling of psychotropic drugs“. Accordingly, in the Bavarian metropolis 51.28 percent of the residents of nursing homes and nursing homes prescribed psychotropic drugs with sedative or sedating effect or side effect. 51 Munich institutions with a total of 6,394 residents provided the data for this survey three years ago. The district court of the state capital has now launched an initiative to reduce psychotropic drugs in nursing homes.

A custodial measure
District Court President Gerhard Zierl explained that drug gifts were far too rarely applied for a court. However, if these are used alone for sedation and not for therapy, application is actually obligatory. If people in need of care are sedated with psychotropic drugs, this is considered a deprivation of liberty, to be equated with fixation. But the problems would continue. For example, many home residents receive five to ten or even more drugs without checking that there are any interactions. In addition, the time the medicines are sold is considered problematic by home inspection. Thus, 74 percent of the actual needs are administered in the evening (8 percent) and at night (66 percent). Furthermore, the Munich Home Inspectorate criticizes that there is a lack of a basic strategy that reconciles medical, care and nursing activities.

Look for alternative measures
The new initiative of the district court of Munich, which is responsible for more than 100 nursing homes, is to become one „important step to reduce the use of psychotropic drugs“ his. It will work on several levels. So the court wants to sensitize health insurances and general practitioners, when psychotropic drugs must be approved and when they are necessary. In addition, reviewers should look at the effects of medication. Most importantly, when an application for approval is received, the orderlies will be appointed to look for alternative measures together with relatives, caregivers and doctors - so that the person affected, who is restless or becomes aggressive, can dispense with psychotropic drugs. The head of the Supervision Court, Rudolf Mayer, stated that the three goals of the Psychopharmaceutical Initiative „Sensitize, make transparent, help“ are.

Number of fixations in homes has been reduced
The initiative sees itself as a continuation of the „Werdenfelser way“, a concept from Garmisch-Partenkirchen, with which the number of fixations in homes has been lowered since 2011, for example by low-floor chains. Successes were to be recorded here: In 2001, twelve percent of Munich residents were held with bed rails or abdominal straps of dangerous movements, in 2013 there were only five percent. With the new „Munich way“ the judges hope for a similar effect. Controversial remains whether the frivolous gift of psychotropic drugs is often owed to the overwhelmed staff. A British study concluded last year that up to 90 percent of caregivers in UK state liaisons in their most recent shift need to do several important jobs.

Improve the quality of life of the residents
Even honorary visit service could help, said district court president Gerhard Zierl. But first, a consciousness must be created. „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“, so Zierl. „We are at the beginning of a long way.“ (Ad)