The Australian Government Aged Care Quality and Safety Commission has released information on new requirements to minimise the use of both physical and chemical restraints. 

This includes the recording of psychotropic medications.

During site visits assessors will seek to understand how your service is managing consumers receiving psychotropic medications, particularly anti-psychotics and benzodiazepines, including PRN use.

What are Psychotropic Medications?

Psychotropic Medication is defined as any medication capable of affecting the mind, emotions and/or behaviour.

Psychotropic medications are a group of medications that include the following classifications:

  • Anti-Depressants 
  • Anti-Psychotics 
  • Anxiolytics or Anti-Anxiety
  • Antihistamines
  • Benzodiazepines
  • Mood stabilisers 
  • Sedatives and/or hypnotics

Potential risks and side effects 

Pharmacological intervention is clinically appropriate for some consumers.

However, psychotropic medication over use and misuse can be associated with an increased risk of:

  • Falls
  • Pneumonia
  • Stroke
  • Heart rhythm abnormalities
  • Cerebrovascular events
  • Confusion
  • Cognitive impairment
  • Sedation 
  • Altered gait
  • Urinary tract infections
  • Constipation and associated risk of bowel obstruction 

Extrapyramidal side effects or EPSE can occur.

EPSE involves abnormal movement of the face, trunk or limbs e.g. twitching, jerking, twisting and restlessness.

Parkinsonism and weakness in the face, arms or legs can also occur. 

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Managing behaviours 

Behavioural and psychological symptoms of dementia (BPSD) can seem difficult to manage. 

However, individually tailored non-pharmacological interventions can be very successful. 

This can include music, sensory and meaningful leisure activities.

The challenge in aged care is the combination of unbalanced skills mix, under staffing and limited resources. 

This has resulted in over 80% of people in residential aged care with dementia being prescribed at least one psychotropic drug.

There are other reasons as to why a psychotropic medication may be prescribed, including:

  • When their is a severe or immediate risk of harm to the consumer or others
  • When all alternatives to manage behaviours have been tried and unsuccessful
  • For consumers with mental health conditions e.g. depression, bipolar and schizophrenia 

 

What will you be asked during site visits? 

The Australian Government Aged Care Quality and Safety Commission has stated it will ask the following during site visits:

  • List all Psychotropic Medication
  • If the consumer has a diagnosis to be prescribed the psychotropic medication
  • If the consumer has relevant behaviours, such as physical aggression
  • Alternatives to the restraint
  • Opportunities to participate in things of interest to the consumer and frequency taken
  • Decision date – the date the medical practitioner decided to use the restraint (recorded in the Agreed Care and Services Plan) 
  • Consumer representative informed prior to restraint or as soon as practicable
  • Frequency of monitoring for signs of distress and/or harm
  • Date of Last Review when minimising or ceasing of psychotropic medication was considered 

It is important to note that medication that has been prescribed for the purposes of treatment of a mental disorder, physical illness or condition is not characterised as a restraint.

This is in accordance with the Royal Commission Background Paper May 2019, Restrictive Practice in Residential Aged Care in Australia. 

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Monitor Psychotropic Medications with AutumnCare

AutumnCare has designed a comprehensive Assessment, chart and medication trigger to record Psychotropic Medication Monitoring.

For more information get in touch with one of our team members or listen to our upcoming webinar.