We read with alarm the article by Dr Margaret McCartney on two key aspects of dementia – care in hospital and the use of antipsychotic drugs. Her one-sided view misses the point in relation to improving the quality of dementia care.
The evidence is clear that the care of people in hospital with dementia needs to be improved. The national dementia CQUIN policy is not about screening for people with dementia, but about identifying people who remain undiagnosed. By incentivising the system, care of people with dementia will be transformed, as it has been in venous thromboembolism, the only other disease with a specific CQUIN. Pretending that patients with dementia are not in hospital does them a disservice.
The use of antipsychotic drugs in people with dementia needs attention – an estimated 1,800 people die prematurely and 1,600 suffer strokes as a result of prescriptions every year. Nobody is suggesting the drugs should be banned, but they should be used in the right circumstances and for the right length of time.
This is why we have a call to action from the NHS Institute and Dementia Action Alliance and why the Alzheimer's Society, with the Department of Health, have produced guidance on how to manage these symptoms (available at dementia.dh.gov.uk).
From Professor Clive Ballard, Director of research for the Alzheimer's Society and Professor Alistair Burns, National clinical director for dementia.
