2.2. Explain the importance of advocating for an individual with dementia who may be prescribed medication

This guide will help you answer 2.2. Explain the importance of advocating for an individual with dementia who may be prescribed medication.

People with dementia can find it hard to communicate their wishes or understand what is happening to them. When it comes to medication, this can make them more vulnerable. Advocacy means standing up for someone’s rights, wishes, and best interests, especially when they may struggle to express these themselves. In this guide, we will look at why this is so significant for people with dementia who may be prescribed medication.

Dementia and Capacity

Dementia is a group of conditions that cause problems with memory, thinking, or behaviour. This affects how people make decisions or understand information, including what prescribed medication is for and any possible side effects.

Mental capacity means the ability to make decisions for oneself. The Mental Capacity Act 2005 protects those who cannot fully make decisions for themselves. The Act says any decision must be made in the person’s best interests, and people should be helped to make their own choices whenever possible. Advocates play a key role in this process.

Risks Linked to Medication in Dementia Care

People with dementia are at higher risk of medication errors. Such risks include:

• Being prescribed medication that is not needed
• Not understanding why medication is given
• Taking the wrong dose, missing doses, or overdosing
• Experiencing side effects without being able to report them
• Drug interactions if more than one medication is taken
• Stopping medication too soon or continuing when it is not beneficial

Medication can help, but it must only be used when it is the best choice. For example, antipsychotic drugs can sometimes help with severe distress, but they can have serious side effects like drowsiness, increased risk of falls, or worsening confusion. Advocating for the person helps prevent unnecessary or inappropriate medication use.

What Does Advocacy Mean in This Context?

Advocacy means:

• Supporting the person to be heard
• Making sure decisions put the person’s wishes and interests first
• Questioning prescribing decisions if they do not appear in the person’s interest
• Raising any worries the person or their family have
• Helping carers and professionals really listen to the individual
• Promoting the person’s dignity and autonomy

If someone cannot say what they want, the advocate will help find out what matters to them. This protects their rights and wellbeing.

Benefits of Advocacy for People with Dementia

Promotes Person-Centred Care

Person-centred care is about treating everyone as an individual. Advocacy follows this value. It focuses on:

• Respecting the person’s values and preferences
• Looking at personal history, culture, and beliefs
• Seeking ways for the person to participate in decision-making

Medication should match the individual’s needs rather than being used to make care easier for staff.

Protects Rights

Being prescribed medication can affect basic rights, such as consent and freedom of choice. The Human Rights Act 1998 and the Mental Capacity Act 2005 make clear that everyone has the right to make decisions about their treatment, unless unable to do so.

Advocates check that the law and codes of practice are followed. They help prevent people being given medication without proper consent or understanding.

Reduces Risk of Abuse and Neglect

Overmedication, sometimes called chemical restraint, happens when medication is used to control behaviour rather than for the person’s health needs. This is a form of abuse.

By asking questions and making sure medication is prescribed safely, advocates help prevent neglect or abuse. They alert others if there are risks or mistakes.

Supports Family and Friends

Dementia can be distressing for loved ones, especially when making decisions about treatment. Advocates can:

• Explain things clearly to families
• Bridge gaps in understanding between families and professionals
• Help families speak up if they have concerns
• Manage disagreements calmly
• Make sure the person’s voice remains central

Strong advocacy can help families feel less isolated and overwhelmed.

Promotes Safer Care

Safe practice means checking that:

• The correct medication has been prescribed
• Side effects are identified and dealt with
• Unwanted medication is stopped
• All decisions are reviewed regularly

Advocates help make sure these checks happen. They support safer care, lower the risk of harm, and improve health outcomes.

How Workers Can Advocate for a Person with Dementia

Building Trust and Respect

Forming a trusting relationship is the foundation of good advocacy. Workers should:

• Use clear language (avoid jargon)
• Take time to listen
• Notice non-verbal communication
• Look out for signs of distress or changes in mood

If the person cannot communicate through words, watching facial expressions, body language, or moods helps workers know what is right for them.

Supporting Understanding and Informed Decision-Making

Providing information in simple, everyday language can reduce confusion. Use of pictures, signs, or objects may help. Workers can show packaging and describe what the medication is for.

Allowing extra time and repeating information if needed also helps. The aim is to enable the person to take part in choices about their care as much as possible.

Challenging Unsafe or Unnecessary Prescribing

If a worker feels that medication has been prescribed inappropriately, or that the person is struggling with side effects, they should raise these concerns. This includes:

• Asking for medication reviews
• Noticing any changes in health or mood after new medication
• Recording concerns
• Speaking with doctors or the care manager about safer alternatives
• Checking the medication policy of the workplace

Sometimes, medication can be reduced or replaced with non-drug alternatives, such as music therapy, meaningful activities, or changes to the environment. An advocate encourages this whenever suitable.

Encouraging Regular Reviews

Dementia is a progressive condition, and needs can change over time. Medication that was helpful in the early stages may become less effective or even harmful later on.

Workers should remind the care team or GP to review medication at regular intervals. This stops someone being kept on medicine for too long without need.

Respecting Consent and Choice

By law, adults have the right to refuse medical treatment, even if this might cause them harm, providing they have capacity to decide. An advocate helps workers check that consent is gained lawfully. If the person cannot give informed consent, decisions should follow best interest processes. This might involve family, friends, and other professionals.

Recording and Reporting

Documentation is an important part of advocacy. Workers should:

• Record any concerns or changes
• Note discussions about medication
• Report side effects or suspected errors promptly
• Follow up to see what action has been taken

Clear records make it easier to track what has happened and protect everyone involved.

Examples of Advocacy in Action

Case Example 1: Reviewing Sedatives

Mary lives in a care home and has advanced dementia. She is given sedatives to reduce agitation, but she becomes sleepier and falls more often. A worker notices this and discusses concerns with the nurse and GP. After a medication review, the sedative dose is reduced, and Mary’s quality of life improves.

Case Example 2: Questioning Antipsychotics

Tom becomes confused and frightened, sometimes shouting at staff. An antipsychotic is suggested. A worker asks if other methods, like talking therapy or distraction, could help first. Together with Tom’s daughter, they ask the GP to try non-drug approaches. The behaviour settles, and Tom avoids potential side effects.

Case Example 3: Helping with Communication

Susan does not speak clearly but frowns and turns away when offered tablets. The worker uses body language and her care plan to find out if she is in pain or feeling unwell. The doctor is informed. After reviewing her medications, it turns out one drug is making her nauseous. Stopping this improves her mood and willingness to take other medicine.

Legal and Ethical Duties

Workers have a duty of care. This means acting always in the best interest of the person with dementia. Several laws set out the duty to advocate.

Mental Capacity Act 2005

• Requires that people must be assumed to have capacity unless shown otherwise
• Supports people to make their own decisions if possible
• Requires decisions made on behalf of someone to follow best interest principles
• Independent Mental Capacity Advocates (IMCAs) can be used if no family or friends can be consulted

Human Rights Act 1998

• States the right to private and family life, freedom from inhumane treatment, and the right to life
• Advocacy ensures rights are not ignored or breached during treatment

Health and Social Care Act 2008 (Regulated Activities)

• Organisations must focus on consent, dignity, and involvement
• Medicines must be used and reviewed safely

Overcoming Barriers to Advocacy

Organisational Issues

Some workplaces may lack a culture of advocacy or discourage staff from speaking up. Workers may need support from colleagues or managers when raising issues.

Time and Resources

Advocacy requires time, patience, and sometimes creativity to communicate well with a person with dementia.

Teams should encourage workers to spend enough time getting to know the person. Good staffing levels and ongoing training can support this.

Communication Difficulties

People with dementia can struggle with speech, memory, and understanding. Workers can overcome these barriers by:

• Using simple words and sentences
• Breaking information into chunks
• Using touch (if appropriate) or visual cues
• Working with speech and language therapists when needed

Working with Families and Carers

Family members know the person’s history, likes, and dislikes, and may notice early signs of trouble. Workers should:

• Welcome family involvement
• Share updates, with the person’s permission
• Listen to worries and suggestions

This teamwork benefits the person with dementia.

Values and Skills for Effective Advocacy

Successful advocacy relies on:

• Compassion and empathy
• Listening skills
• Assertiveness: calmly challenging unsafe or unfair practice
• Integrity: always doing what is right for the person
• Knowledge of laws and good practice
• Clear, honest communication

Regular supervision and reflective practice can help workers develop these skills.

Final Thoughts

Advocating for someone with dementia who may be prescribed medication is central to safe, person-centred care. It prevents harm, protects rights, and helps the person live as well as possible. Workers who act as advocates build trust, question unsafe practice, support informed choices, and uphold dignity at all times.

Their actions make a difference. Advocacy means looking out for the person when they need it most—when their own voice is hardest to hear.