Sir, – Carl O'Brien's reports on the care meted out to old people and people with an intellectual disability were shocking ("Overmedicated: the drug problem in our nursing homes", June 1st; "Chemical restraint of intellectually disabled common in residential centres, study finds", June 2nd). People with an intellectual disability are individuals with feelings and interests; some like walking, football, some like painting and other like to work. They all want a decent life and to be treated with respect, just like anyone else. But if they are subjected to boring activities all day of course they will react with bad behaviour. Wouldn't we all if treated similarly? Giving inappropriate drugs to people with no choice, whether they are old or young, is harmful and barbaric and if this is the future we can all look forward to in our old age, then I would rather walk into the sea.
Why does the system of regulation in Ireland, whether it applies to banking or healthcare, always let us down? – Yours, etc,
ANN HEELAN,
Gorey,
Co Wexford.
Sir, – The findings in Carl O’Brien’s investigative reports on the administration of tranquillising drugs to vulnerable people in nursing homes and residential centres for people with learning challenges are deeply disturbing. The principle of respect for autonomy is central to ethical understanding based on what it means to be an individual human person. And it’s particularly important for those working in medical and social care to understand the basis for the ethical principle and implement what it requires. Lack of staff should never be an acceptable reason for ignoring a cared-for person’s autonomy, no matter how difficult it may be to care for them. No one should be allowed give a tranquillising drug without first obtaining a person’s informed consent, to include especially information on its side-effects. And in caring for people who have impaired mental capacity, the principle of autonomy encompasses a requirement always to obtain their consent insofar as it is possible, and, where necessary, for others to assist them in their decision-making with the aim of preserving and developing their autonomy to the greatest extent in providing them with the care that is in their best interests. This should be an essential part of standard practice. – Yours, etc,
MANUS CHARLETON,
Sligo.
Sir, – Carl O’Brien’s investigation highlighting that thousands of older people in nursing homes are being medicated into silence is profoundly disturbing and serves to bring again to public attention a longstanding problem in residential care.
A 2013 study in Northern Ireland showed that when older people entered care homes there was a sharp increase in the administration of antipsychotics, from 8.8 per cent to 18.6 per cent.
The use of antipsychotics in patients with dementia who are unable to give informed consent to their use, experience no therapeutic benefit and are likely to suffer adverse effects – including increased risk of stroke, heart attacks and death – amounts to degrading and inhuman treatment.
We don’t stop having human rights when we reach 65 years of age. Medicating older people to keep them quiet is not a legitimate approach to care; it’s elder abuse.
Dementia-specific training, including in alternative therapies to calm patients, needs to be provided to nursing home staff.
Hiqa must also investigate the use of these drugs in nursing homes and put an end to the practice of doctors prescribing drugs at the first sign of anything they determine to be “challenging” behaviour. – Yours, etc,
JUSTIN MORAN,
Age Action Ireland,
Lower Camden Street,
Dublin 2.