Real Problems, Real Solutions

The University of Iowa’s Geriatric Education Center recently sent out a summary of studies year-to-date regarding “Management of Behavioral and Psychological Symptoms of Dementia”. Here’s a brief summary of the nine studies quoted:

(1) One study could not prove that stroke incidence was increased with antipsychotics, while another said it likely was increased. (2) Antipsychotic use has increased in recent years in nursing homes without evidence of any coherent thought process, and out-of-proportion to any increase in dependency or behavioral symptoms over the years. (3) Several studies were so “brave” as to say that “caution” should be exercised before using antipsychotic drugs in dementia, even though their data suggest that this wording is too mild.

Here’s a challenge: The REAL problem is not that these drugs are largely ineffective and dangerous when used for behavioral distress. The REAL problem is not even that we over-medicate people with dementia.

The REAL problem is that the very notion that such distress requires any pill is a flawed paradigm.

The REAL solution is not to find better pills. The REAL solution is to provide Real Care.

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