Ethical and effective: Approaches to residential care for people with dementia

Abstract

New knowledge underpins calls for change in approaches to the care of people with dementia. Person-centred care is considered essential, whereas purpose-built facilities and environmental design are reported to enhance safety and to have a positive effect on behaviour. Research findings have highlighted the inappropriate use of antipsychotic drugs and there is debate about their value in ‘managing’ symptoms. This paper presents the combination of approaches used to enable residents of two secure dementia units to live life within their ability and without antipsychotic drugs. Essential to the success of the change process was staff education, knowledge of the person, a varied leisure activity programme and a supportive environment. Evidence of the positive difference these strategies made includes statistics that show a decline in falls and behavioural issues, and feedback from family members. In light of the evidence, this article posits that it is ethically wrong to give people with dementia antipsychotic medications because their behaviour is deemed to be unacceptable, when there are other viable options.