“We still have a problem”: One in five people in aged care treated with antipsychotics
One in five aged care residents are being given antipsychotic medication - used to treat the symptoms of psychosis - that has been linked to chemical restraint by the aged care royal commission, according to new data.
The data was mandatorily collected for the Department of Health from over 2400 aged care homes, revealing the industry’s heavy reliance on using antipsychotics on patients.
Residents are also more likely to be given the drugs if they live in rural areas.
Over half of those receiving the drugs don’t have a psychosis diagnosis, which is of particular concern as the royal commission found that “many of these medications were being used as chemical restraint”.
“I have to say it was higher than I was expecting,” pharmacy researcher Dr Juanita Breen, who appeared as an expert witness at the royal commission, told the ABC.
Dr Breen said this data suggested that much of the use of these drugs was inappropriate.
“It means that these medications are being used for other reasons,” she said.
“It would suggest that a large proportion would be used as chemical restraint … that we still have a problem.”
An earlier study from 2019 made similar findings after tracking 5825 people in residential aged care facilities over the age of 65 for three years, between 2014 and 2017.
The study also found that residents were being given the medication for significantly longer periods of time than was recommended, per the RACGP.
Despite recommendations not to extend use of the medication beyond 84 days, the study found that the mean use for men and women sat at 212 days and 216 days (or around 30 weeks) respectively.
Other experts who testified at the royal commission also indicated that a decrease in medically-trained staff at aged care facilities, combined with an increase in patients with complex needs, had contributed to the overreliance on antipsychotics.
Former aged care nurse Amanda Gorton, who left the industry in 2020, told the ABC that staff shortages had regularly left her feeling overwhelmed.
The same year, the home she worked at failed an audit from the aged care watchdog, the Quality and Safety Commission, over its use of antipsychotics.
Ms Gorton said she saw workers use the drugs to restrain residents because they didn’t have the capacity to care for them.
“I went home often in tears because I thought it can’t stay like this,” she said.
“It has to get better, it has to improve, we can’t be treating elderly people like this.”
According to an analysis of hundreds of aged care audits from the commission, Human Rights Watch said they found that the inappropriate use of antipsychotics was taking place all over the country.
“We found homes where more than 75 percent of residents were given these drugs and there was not adequate documentation of why they needed them or relevant diagnosis,” researcher Sophie McNeil said.
“We found homes where residents were so drugged up that they experienced a significant increase in falls, which resulted in injuries.”
Ms McNeill also said there was a clear link between workforce issues and using chemical restraint, after finding that staff also used antipsychotics to deal with residents asking for help or who were in pain.
“There’s not enough staff to look after people. So instead, vulnerable, older Australians are given these drugs when they don’t need them,” she said.
The data and analyses come after the Senate passed an aged care bill on its last sitting day aimed at addressing several recommendations from the royal commission.
It included an amendment to ensure every facility has a registered nurse rostered 24 hours a day.
“Putting people on drugs, restraining people, is the easy option for an aged care facility that doesn’t have the necessary staff to deal with these sorts of matters,” Senator Rex Patrick, who put forward the new amendment, said.
Having gone through the Senate without a formal division (where senators vote by sitting on the left or right of the chamber), the bill will be sent back to the House of Representatives for a vote.
However, Senator Patrick believes the government won’t want the amendment to be successful and will “park the bill and it will never be seen again”.
“The government didn’t want the optics of voting against nurses 24/7 in aged care, so they simply let it go through on the voices knowing that, tactically, they can avoid dealing with it in the house today,” he said.
Image: Getty Images