• Tamara Backhouse, Anne Killett, Bridget Penhale, Diane Burns, and Richard Gray.
• a School of Rehabilitation Sciences , University of East Anglia , Norwich , United Kingdom.
• Aging Ment Health. 2014 Mar 1; 18 (2): 187-93.

ObjectivesTo determine the prevalence of antipsychotic use in care homes. To explore which behaviours care home staff can find difficult to manage and which non-pharmacological interventions are currently used within care homes to help cope with behavioural and psychological symptoms of dementia.MethodA postal survey sent to all care homes registered as specialising in the care of older people or/and older people with dementia within four counties in the East of England (n = 747).ResultsQuestionnaires were returned from 299 care home managers (40%). The vast majority (n = 200, 73%) reported having at least one resident with an antipsychotic prescription in their home. Twelve percent (n = 1027) of care home residents were reported to be prescribed antipsychotic medications. Aggression was most frequently reported, by 37% (n = 109) of care home managers, as a difficult behaviour to manage. Non-pharmacological interventions were reported to be used in 87% (n = 253) of care homes. The interventions most commonly used in care homes to manage difficult behaviours were reminiscence (75%, n = 219) and music therapy (73%, n = 213).ConclusionThis survey was a first attempt to estimate the use of antipsychotics in care homes. Despite measures to reduce antipsychotic use for all people with dementia in England, we found that 12% of care home residents were still prescribed antipsychotic medication. Around half of all care home managers reported they had experienced behaviours they found difficult. Antipsychotic medications and a variety of non-pharmacological interventions appear to be used concurrently in many care homes.

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