The fear that older people have of ending their lives in a Care Home was brought into vivid relief yesterday when a government report on the use of ant-psychotic drugs for the elderly was published. Apparently as many as 144,000 people suffering from dementia are routinely being given such drugs unnecessarily. The Report claims that such excessive use causes an estimated 1,800 deaths each year, can cause strokes and create or add to behavioural problems. ‘The benefits of these drugs are relatively small’, the report says, recommending that the number prescribed should decrease by 2/3rds over the next three years, better training should be given to Care Homes staff, and stricter guidance to doctors.

The Report recognises the realities of the situation. Whilst the Chairman of the National Care Homes Association blames the doctors, there is no doubt that G.P.’s are often under pressure from the Homes to help staff deal with difficult patients, and they themselves may be inadequately trained in comprehensive care.

The Chairman of the Royal College of G.P.’s admits to ‘an awful situation’, claiming that doctors’ care is often patchy. The Alzheimer’s Association have responded by saying that the excessive use of drugs is a serious violation of peoples’ rights’.

Welcoming the Report and promising that all its recommendations will be acted on, the government’s care services minister says that the routine use of antipsychotic drugs is unacceptable and refers to the guidance of the National Institute for Health and Clinical Excellence that such drugs should only be ever used when they are really necessary.

In the course of my work I have visited many care homes, vastly improved over the years but still widely varying in their administration and practice. I recognise that it is a very difficult job indeed.

Better training, closer supervision of the statutory and voluntary homes, and increased financial resources are the obvious consequences of the report.

For many of us, as we live as actively as we can, fears of our last years remain. An old school friend and I were talking about it this week. And yet how well in this country older people are cared for. Yesterday I collected my monthly package of prescriptions. I saw a notice in the chemist which said that the cost is £7.10 for each item. I worked out that I was collecting £50 worth of medical care. Free.

Bryan