An innovative training programme for care home staff has cut the use of inappropriate anti-psychotic drugs, which double the risk of death in people with dementia, by a third.
This is according to research commissioned by Alzheimer's Society and launched today (Thursday 3 July 2014).
Over 100 care homes were recruited to receive the Focused Intervention Training and Support (FITS) programme – which equips staff to understand complex behaviours in people with dementia and to deliver person-centred care as an alternative to harmful antipsychotics. When medication was reviewed, residents were more alert, communicative and active, with improvements in mobility, eating, sleeping and in achieving personal goals.
Around 90 per cent of people with dementia will experience behavioural and psychological symptoms at some point. Often, people in care homes experiencing these symptoms are prescribed antipsychotic drugs as a first resort. For someone with dementia, antipsychotic drugs can worsen dementia symptoms, double the risk of death, treble the risk of stroke and can leave people unable to walk and talk.
Proven effective in a clinical trial in 2006, the FITS programme has now been scaled up and completed by staff in 67 care homes across the UK, in what is one of the largest formal evaluations of a training programme ever conducted. The intensive nine-month training and supervision programme was delivered by specialist coaches and evaluated by the Association for Dementia Studies at the University of Worcester. Training courses focused on person-centred care approaches and alternative ways of managing the behavioural and psychological symptoms of dementia, which can include aggression.
Launched today at the Alzheimer's Society research conference, the study reports that prescriptions of antipsychotic drugs were reduced by 30 per cent in care homes who were part of the programme. As well as showing benefits for people with dementia, the study led by Professor Dawn Brooker at the University of Worcester found that FITS also brought positive benefits to care home staff, residents' families and to the care environment.
Almost 40 per cent of the 106 care homes who began the study were not able to complete the training programme. The research identifies major barriers that exist to delivering dementia-specific training in care homes, but offers practical solutions to overcome them. Any future dementia work to implement training for care home workers should be guided by the findings of this comprehensive study.
Professor Dawn Brooker, the lead researcher on the study said:
'We've shown that FITS training is feasible to deliver on a large scale, reduces the prescription of inappropriate antipsychotics and empowers teams to work in a person-centred way. Provided that the right facilitators are in place, it is an effective way to improve quality of life for people with dementia in care homes.'
Dr Doug Brown, Director of Research and Development at Alzheimer's Society, said:
'Antipsychotic drugs can be hugely dangerous for people with dementia. In many cases, they're inappropriately prescribed and can lead to reduced quality of life whilst doubling the risk of death. Too often they're used as a first resort but this research shows that person-centred care is an effective alternative and has positive benefits for care home residents and staff.
'We hear over and over from people affected by dementia that as well as the vital research to develop new treatments, they want to see research that helps them live well with dementia. Putting research findings into practice can be a challenge but this report is a key example of doing just that - it shows how care research can deliver real change to the lives of those living with the condition today.'
Read more about Focused Intervention Training and Support
Reducing the use of antipsychotic drugs: A guide to the treatment and care of behavioural and psychological symptoms of dementia