Tuesday, 19 July 2011

In healthcare it’s often the small things that make a big difference.

I was heartened to read a news story yesterday about the use of painkillers for patients suffering from dementia.

Agitation is commonly associated with dementia and often treated with antipsychotic drugs which can accentuate the symptoms of the condition and cause excessive sedation. These drugs can rob Alzheimer’s or dementia patients of the last vestige of interaction with the world around them and reduce them to ‘zombie’ status.

One of the tragedies of dementia is that a patient is unable to tell his or her carers how they are feeling and bearing in mind that many elderly people experience painful arthritis or similar conditions, it is logical to assume that a high proportion of patients may be suffering undiagnosed pain. 

In a recent study, researchers the UK and Norway found that there was a 17% reduction in agitation symptoms in dementia patients given painkillers.

This is a wonderful initiative in easing the suffering of our most vulnerable patient community. My mother suffered from dementia for nearly ten years before her death but was fortunate to be cared for by an amazing team of people. During a routine discussion on her care, the matron advised me that they were giving my mother paracetamol four times a day. I asked them how they knew she needed this medication and they simply said – ‘her joints look painful so we thought it best to see if we can ease her discomfort’. The transformation was dramatic. Within a few days she was calm, and content. Her antipsychotic medication was discontinued and she became more alert and aware of her surroundings. I wrongly assumed this was standard practice so I am delighted to see that this ‘breakthrough’ is being made public.

How often we find a simple solution to a complex problem.

Andrew Lansley, please take note – to improve care and outcomes – you don’t always have to deliver complicated and expensive strategies. Keep it simple!


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