What is really going on in aged care?

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22 July, 2013
Alzheimer’s Australia has today called on the Government to do more to protect the legal and human rights of nursing home residents, after new research reported in the Medical Journal of Australia revealed that up to 70% of residents are being given potentially dangerous antipsychotic or sedative medication.

“Sedatives and tranquilizers are not an acceptable alternative to quality care,” said Glenn Rees, AM, CEO of Alzheimer’s Australia.

“These medications have their role as a treatment of last resort after other strategies have been tried.

“We have highlighted the problem of the inappropriate use of antipsychotic and sedative medications in some residential aged care facilities for years, and we know that there are effective alternatives to respond to behavioural and psychological disturbances among residents.

“This new research reinforces earlier studies, and adds urgency to our need to protect the oldest and most vulnerable Australians.”

The new study looked at medication records from 9,500 nursing home residents in five states. 70% of residents were prescribed psychotropic medication with 27% taking antipsychotics and 41% prescribed benzodiazepines. One in three residents was taking more than one class of psychotropic medication.

“We hear from the experts that only around a quarter of the roughly 140,000 nursing home residents being prescribed these medications are likely to derive a clinical benefit,” said Mr Rees.

“This means there could be as many as 100,000 older Australians being put at risk of a range of side-effects, including an increased risk of stroke and death, because of our failure to provide appropriate non-medical care.

The study follows a report earlier this year by the Drug Utilisation Sub-committee of the Pharmaceutical Benefits Advisory Committee that raised serious concerns about the growing use of antipsychotic medications among older Australians. The report concluded that medications designed to treat serious psychiatric disorders were being used beyond their intended purpose and without appropriate review.

“This is a complex problem that needs to be addressed using a range of strategies,” said Mr Rees.

“Already we are seeing some good initiatives from the National Prescribing Service, and the introduction last year of a dementia care supplement in residential care is also the first reflection of the special needs of those with the most difficult behavioural symptoms of dementia.

“But we need to ensure that more funding is targeted to those with complex care needs, and that it results in better trained staff and better designed facilities.”

According to Alzheimer’s Australia, antipsychotic and sedative medications are often used to reduce behavioural disturbances such as agitation or aggression among nursing home residents with dementia, but these symptoms can often be better addressed using simple strategies. For example, determining whether a person with dementia is crying out because they are in pain; or identifying if a person is hitting out at a carer because they are uncomfortable being showered by strangers or have an untreated urinary tract infection.

“We know that well-designed facilities with adequate numbers of staff trained to use psychosocial approaches such as Montessori techniques can provide personalised care to people with dementia. This can avoid many of these problems and keep people safe, Mr Rees said.

“There are 321,000 people with dementia in Australia today, and many of these people are or will be living in nursing homes in the future.

“People with dementia and their carers need to know that the Government and the Opposition are committed to ensuring residential care provide safe places for older people and that they are properly funded and regulated to deliver high quality care.”