Australia’s horrific aged care drugging shame
EXCLUSIVE: Cash-strapped aged care facilities are doping residents on antipsychotic drugs for extended periods in defiance of medical guidelines, which say they should not be used for longer than three months.
And they are being denied dementia medications that could improve their ability to think, a major study of 68 facilities with over 10,000 residents in NSW and the ACT has found.
One in three aged care residents are zoned out on antipsychotics that put them at risk of stroke, falls and metabolic disorder.
The drugs are being used as a chemical constraint to control the behaviour of residents, the research, by Macquarie University's Dr Kimberley Lind, suggests.
"They have strong sedating effects so if you have agitation or are restless they can deal with those behaviours but sometimes patients are sedated too much and they can't function and are cognitively impaired," she said.
The best practice in managing aged care residents with dementia was to use behavioural and environmental interventions, reorient people to their environment and have cues that told them they were in their room, she said.
Patients with dementia should be given dementia drugs that improve their cognition.
Instead the study found they were being given powerful antipsychotics like risperidone because a GP can prescribe it.
A consultation with a specialist is required before an elderly person can get access to dementia drugs, Dr Lind said.
"Based on our data and that from other studies only 10 per cent of dementia patients are taking any dementia medications," she said.
Fewer than one in five of the aged care residents doped on antipsychotic medications had mental conditions like schizophrenia, paranoia, psychosis or bipolar disorder which would justify the need for the drugs, she said.
There are serious risks with antipsychotic medicines including stroke and falls and weight gain.
Many of the residents using the drugs in aged care facilities had been stroke victims, she said. Others were already suffering from diabetes and this condition could be exacerbated by further weight gain.
One way of controlling the overuse of the medications in aged care facilities would be to change the rules in the government medicine subsidy scheme and make it a condition that a specialist had to approve the use of the medications in these residents, she said.
The data was drawn from the electronic medication management records at the aged care homes and found on average patients were using the antipsychotics for seven months even though medical guidelines recommended use for less than three months.
Other research by Flinders University academics in South Australia found people living with dementia are nine times more likely to be prescribed with the antipsychotic drug risperidone while generally less likely to be given prescribed cardiovascular or respiratory treatments.
Geriatric doctor Craig Whitehead found about 25 per cent of residents of aged-care homes in South Australia, NSW and Western Australia receive risperidone, a drug used to manage changed behaviour.