Health care professionals’ caretaking of persons with dementia who use dietary supplements

Abstract

Persons with dementia experience progressive loss of cognitive functioning and increasing need for help with activities of daily living, including help with administering their prescribed drugs (PD). This thesis describes the use of dietary supplements (DS) (including herbs) by persons with dementia and the risk related to their use, as DS may cause adverse effects. It further describes the awareness of this risk and the attributed responsibility by relevant health care professionals in primary health care. The study methods used were questionnaire-surveys of patients with dementia (n=151), employees in pharmacy (n=105) and home care service (HCS) (n=231), and individual interviews with general practitioners (GPs) (n=14). Forty-six percent of the persons with dementia used DS and 11% had potentially clinically relevant interactions between DS and PD. Only one-third of the patients received help with the administration of their DS. Several of the patients who did not receive help had cognitive decline, indicating a need for such help. Only one-third of the patients with dementia and half of their caretakers knew that DS may impose a health-risk. Half of the general practitioners (GPs) and the employees in home care service (HCS), but few pharmacy employees, expressed that they had been worried about patients’ DS use. One-third of the employees in HCS and two-third of the GPs had intervened because of possibly dangerous use. None of the studied health care professionals attributed the responsibility for the safety of these patients to their own profession. The main reason why the GPs did not want to take on the responsibility was the lack of available information about safety, effect and sometimes even DS-content. Conclusion: DS use are common in patients with dementia and may represent a risk to them, but no group of health care professionals wants to take the responsibility to increase their safety.