Anti-psychotic use in aged care is worrying and unnecessary

The ANZSGM is concerned by the high levels of unnecessary prescription of anti-psychotics in aged care residents, leading to their call to improve access to high quality medical care in residential aged care facilities.


The recent Four Corners investigation highlighted some of the problems experienced by aged care residents when medicines were inappropriately prescribed, including dementia.


Associate Professor Edward Strivens, President of the Australian and New Zealand Society for Geriatric Medicine (ANZSGM) said the general rules of medicine still apply in residential aged care facilities – medicines should only be used to treat medically diagnosed conditions in line with professional guidelines.


“There is a high level of unnecessary use of psychotropic medicines, which include anti-psychotics, to manage people with dementia,” he explained.


“These medicines are effective when used in the appropriate person but research shows that more than 80% of aged care residents with dementia receive psychotropics, even though only 20% might benefit from them.”


“Medicines should be assessed regularly by qualified healthcare professionals to help with early detection and management of potential side effects and interactions.”


Older people are also more likely to use multiple medicines, making prescribing medicines for them highly complex. Geriatricians are trained to navigate this complexity, working alongside other healthcare professionals such as nurses and GPs to weigh the benefits and risks of each medicine.


Medical conditions, including cognitive decline, are the main reasons for older people moving into aged care facilities.


“There are numerous examples where the physical and mental decline of an older person is caused by an unrecognised underlying medical condition that can be treated or even reversed, if managed well.” he added. “This means improved access to the right healthcare professional at the right time is critical to better managing the complex health needs of aged care residents.”


“Geriatricians play a crucial role in the detection, intervention and management of quality issues in aged care settings. Working alongside other healthcare professionals such as nurses, GPs and social workers, we are able to identify abuse, provide guidance on decision-making and make recommendations and/or referrals,” said A/Professor Strivens.


“All older people deserve better access to specialists who are experts in managing their specific medical problems and we are hopeful that this will be delivered by the Royal Commission,” concluded A/Professor Strivens.


12 October 2018.