Jan 18, 2019

Beware “unintended consequences” of chemical and physical restraint regulation

 

The Minister for Aged Care has revealed that new regulations for the use of chemical and physical restraints in nursing homes will be announced in a matter of weeks.

The announcement came on the eve of the Aged Care Royal Commission, and also in the wake of horrifying reports on the ABC of use of restraints in nursing homes.

The 7.30 report showed residents being restrained with belts and “dosed up” on medication. The report said that, unlike the UK and the US, Australia currently has no rules on how restraints are used.

In Australia, antipsychotic medications can only be prescribed by a doctor, and the resident and their family are supposed to be involved in the decision making at all times.

But the ABC report shows consent from family “rarely happens”, and is often only discovered when it appears on the bill.

More training needed

Dementia researcher Dr Juanita Westbury told HelloCare the trouble with legislation is it can have “unintended consequences”.

“You have to be really careful how you do this,” she said. “It can’t just be instituted in two weeks.”

“I think legislation is part of the solution,” Dr Westbury said. “But there also has to be training on what you can do.”

She said the message needs to be more about properly assessing the person in each case and finding other solutions that work, whether that be taking them out for a walk, checking they’re not in pain, making sure they have plenty to do, and ensuring they aren’t lonely.

Dr Westbury also said sometimes a small amount of medication can be used, and that in some circumstances withholding medication can actually “cause harm”.

Dr Westbury also said she’s like to see more of a conversation about what is the appropriate care in these cases, and have better education for aged care staff, doctors and families.

She said staff aren’t properly informed about the current guidelines and more training is needed.

US regulations had serious unintended consequences

Dr Westbury said there were several harmful unintended consequences when heavy regulations on antipsychotics were introduced.

Use of other sedating medications, such as benzodiazepines and anticonvulsants, rose sharply. Nursing homes also stopped taking residents who they expected would be too difficult to care for. There was also a doubling of diagnoses of people with schizophrenia because the tough new rules exempted people with severe mental illnesses.

“I do have concerns about legislation,” Dr Westbury said, “especially if it’s been quickly put together.”

Better education of GPs, aged care staff, and families is the key to improved outcomes, she said.

Leave a Reply

Your email address will not be published. Required fields are marked *

Advertisement
Advertisement
Advertisement

Aged Care Residents Give Heartwarming Life Advice To Younger Generations

It should come as no great surprise that those among us who have lived the longest would also have the greatest perspective about what matters most. Elderly residents at the St Clair Nursing Centre in Missouri, US, have captured the hearts of people across the globe as a series of heartwarming photographs featuring older people... Read More

Educating aged care workers on dementia care with VR immersion

New technology inspired by Virtual Reality (VR) and gaming is being offered to aged care workers in ACT to better educate them on caring for older people with dementia.  Read More

Why Is It So Hard To Attract Men To Caring Jobs?

The majority of gender-based stereotyping has always been centered around the conceptions of masculinity and femininity. As a young man growing up in the early ’80s, there was no shortage of testosterone-laden examples of what a man could and should be, and the way my TV heroes showed they cared for others was by beating... Read More
Advertisement