news
Restraint laws to tighten
New restraint regulations
on the horizon.
By Dallas Bastian
T
he minister for senior Australians
and aged care, Ken Wyatt, has
said the sector can expect
changes to physical and chemical
restraint regulations following the ABC’s
7.30 coverage of reported instances of
antipsychotic and restraint misuse.
Wyatt said infractions will not be
tolerated, and added that 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 antipsychotics 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 antipsychotics and restraints,
adding the peak body’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 and Dementia and
Aged Care Services initiatives from 2014 to
2016 – the program was not continued.
Westbury 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,” she wrote.
Wyatt said knowledge and resources
from RedUSe and the HALT Project have
been used in aged care sector training by
Dementia Training Australia. ■
agedcareinsite.com.au
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