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Permalink Reply by Jill D on June 18, 2012 at 23:12

Is there any medication which can safely be used to calm a person with vascular dementia? 

 

Anti psychotics are supposed to be a no-no, as are things like Lorazepam. When a dementia attack is in full flight and managing behaviour becomes difficult, is there any sort of medication which will not worsen the condition?

 

What recommendations are in place for this sort of incident when it happens in a BUPA care home?  Medicate or what?

 

I know that this is a difficult one but we want to do our best for mum, it is all very well asking GPs/consultants but they are not in a domestic situation when these incidents are happening.

 

Thank you.

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Permalink Reply by eleine mcloughlin on June 22, 2012 at 22:06

We used Bromphenex for my son's allergies. What could we request that would be comperable to this? We have run the whole range and this was the only thing that gave him any relief. The problem is when the allergy is bad he starts with nazal drip which irritates his throat and nights are bad as he coughs ( has G-Tube ) ty

 

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Permalink Reply by Graham Stokes on June 26, 2012 at 10:20

Jill,

In all instances of agitated and distressed behaviour in dementia, antipsychotic and benzodiazepine (e.g. Lorazepam) medication must be seen as a timely resort when risks are great and distress is unacceptable (including distress felt by caring families), which is not necessarily the same as a last resort. While for most people with dementia prescribing will be a last resort, if it is known that alternative ways of caring or coping will be ineffective then the timely use of a prescribed sedative to manage the behaviour for a defined period of time is advised, rather than prolonging stress and distress in the pursuit of an alternative which it is known will offer no solution for this person in this particular instance. However, once prescribed, alternatives should be explored and the drug reviewed and reduced to a maintenance dose as soon as possible with a defined date when an attempt will be made to withdraw the drug. Any benefits beyond 12 weeks are very limited

In instances when behaviour is not extreme and hence consequences cannot be unacceptable then antipsychotics ought never be prescribed.

With the co-operation of the prescribing GPs and consultants these are the principles we follow in Bupa’s care homes when caring for someone living with dementia.

It should always be borne in mind that with the exception of Risperidone, other antipsychotic drugs prescribed for people with dementia whose behaviour is a cause for serious concern is done so 'off-licence'. This approach can only be taken if the doctor has good reason to do so and follows rules set out by the General Medical Council. Hence, caution is always advised. In all instances a doctor will need to take into account the health of the person who is to be prescribed the sedative and the likelihood of any unwanted side-effects. This would include any possible risks to a person with vascular disease.

Thank you.

Graham

Jill D said:

Is there any medication which can safely be used to calm a person with vascular dementia? 

 

Anti psychotics are supposed to be a no-no, as are things like Lorazepam. When a dementia attack is in full flight and managing behaviour becomes difficult, is there any sort of medication which will not worsen the condition?

 

What recommendations are in place for this sort of incident when it happens in a BUPA care home?  Medicate or what?

 

I know that this is a difficult one but we want to do our best for mum, it is all very well asking GPs/consultants but they are not in a domestic situation when these incidents are happening.

 

Thank you.

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