In Germany the pharma industry has a strong influence on politics, health-care organisations, and decision-makers and the prices of medical drugs are amongst the highest in the world. The industry commonly offers the high cost of research as justification for these high prices. However, a mounting quantity of evidence devaluates this argument: a non negligible number of new medical drugs have been shown to represent no significant medical improvement over existing standard drugs. Quite often the marketing budget outstrips the research budget. I.e. the high prices generally do not appear to be the results of correspondingly high efforts in research. In reality, the public has no insight into the calculations behind the drug prices.
TV documentation - BR series Stationen VideoX, 29.01.2014: "Destiny dementia: without rights and at the mercy of the system?" [Schicksal Demenz: Rechtlos und ausgeliefert? - CARE HOMES FOR THE ELDERLY AND THE DEMENT]
X) This video was already DEPUBLISHED BEFORE 03.02.2014 i.e. is no longer available online! There are other documentations on this subject with a similar conclusion.
* In Germany the situation of dementia patients in care homes is often catastrophic. The situation of the personnel is a bit better.
* Most (all?) care homes are generally non-state, are operated purely for profit, frequently by large investment groups.
* Care personnel is reduced to an absolute minumum to save costs.
* Lack of time allows care personnel the execution of only the absolutely necessary care-technical tasks (with allocation of so many minutes per task** as is typical in most care organizations), no time is available for human attention to patients.
* One means of reducing personnel to a minimum is giving patients neuroleptica for insufficient reasons, very often as permanent tranquilizer. Their existence then resembles that of "zombies". Their right to exist is reduced to the role of milk cow for investors.
* Neuroleptica are generally prescribed fairly thoughtlessly - without sufficient medicinal indication. Not only in care homes.
* Relatives of patients are often not informed of the medicines given, or brazenly lied to.
* The individual relative is not taken seriously by the stakeholders of the system: care home, home carriers, medical associations, health funds. When it comes to obtaining justice relatives are habitually on the losing side. The system has nothing to fear from the relatives.
* The lobby of the large care home operators has a firm grip on the law makers, the politicians.
* Care home operators can disregard laws without legal consequences. Care homes are closed establishments without neutral supervision or control. Should a home be checked, then the aspects important to the patients are left aside, only the observance of certain formal regulations is verified.
* Assisted living communities are a humane alternative to care homes - a difference like day and night. Assisted living communities are still a rarity in Germany and most other countries because the political will is absent. The only country in which they have become commonplace to date is Denmark.
**) Cf. Charles Chaplin in "Modern Times".
TV Documentation - ARD/Monitor Video, 30.01.2014: "Dying second class in care homes" [Tod zweiter Klasse: Sterben im Pflegeheim]
* The chronical understaffing in care homes is far too great to stand by and provide for someone during the last hours before his death. Dying frequently takes place in an empty room.
* Also, the quality of medicinal aid in care homes for the terminally ill is often very bad in contrast with that of the palliative-specialized hospices: correctly chosen and applied medicines and nutrition that are in line with the patients wishes. Care homes often lack the skills required.
* Since 2007 everyone in Germany has a legal right to a palliative medical care, theoretically. In practice, the transfer of a patient from a care home to a hospice in which the conditions for the dying are incomparably better, is blocked by the health funds - the costs per patient in a hospice are on average €5000, far higher than the costs in a care home.