The sector can expect changes to physical and chemical restraint regulations within weeks, the Minister for Senior Australians and Aged Care says.
Speaking following ABC’s 7.30 coverage of reported instances of antipsychotic and restraint misuse, Ken Wyatt said infractions will not be tolerated and added work is already underway to manage and minimise misuse.
Dementia Australia said it was “very concerned” about the stories in the program. Chief executive Maree McCabe said they highlighted, in the most extreme way, flaws in the current aged care system.
“When it comes to anti-psychotics and physical restraints, in most cases, staff have an inherent desire to want to keep the person they care for safe,” McCabe said. “However, they may be unaware of the potential side effects of the medications, such as increased agitation, increased risk of falls, the potential masking of other symptoms or they may not understand that physically restraining someone could be a breach of their human rights.”
Work on the issue is a top priority for the chief clinical adviser at the new Aged Care Quality and Safety Commission, established at the beginning of the year.
On top of this, Wyatt said the Aged Care Quality Standards – which will come into full force on 1 July 2019 – also cover chemical and physical restraint.
“The use of antipsychotic medicines must be a clinical decision made by medical practitioners with the care recipient, and their carer or family involved at all times,” Wyatt said.
McCabe said staff education and training are also paramount to eliminating the misuse of anti-psychotics and restraints, adding the peak’s submission to the Royal Commission calls for mandatory levels of dementia-specific education and training.
“This would enable staff to consider and provide alternative treatment options such as administering pain relief, tailoring personal care practices to the individual’s preferences, treating pain or an underlying medical or psychiatric condition, correcting common problems like vision- or hearing-related challenges, or working with the family to engage the person in more meaningful and stimulating activities.”
In the meantime, Wyatt pointed to a number of tools and initiatives previously rolled out to address the issue, including the Decision-Making Tool Kit – Supporting a restraint free environment in Residential Aged Care, the University of New South Wales’ HALT Project and the University of Tasmania’s RedUSe project.
The latter saw a reduction in antipsychotics and benzodiazepines across the homes involved by 13 per cent and 21 per cent, respectively.
But in an opinion piece written for Aged Care Insite, RedUSe lead Dr Juanita Westbury said that – along with other Department of Health as a Dementia and Aged Care Service initiatives from 2014-2016 – the program was not continued. She added that the training materials have not been made available for use but noted that the team has been informed that there are plans to do so.
“Ideally, with appropriate support, the project could be delivered through federally funded community pharmacy as a series of Quality Use of Medicines (QUM) strategies, currently administered through the Pharmacy Guild,” Westbury wrote.
Wyatt said knowledge and resources from RedUSe and the HALT project have been used in aged care sector training by Dementia Training Australia.Do you have an idea for a story?
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