Above: David Stokes, clinical neuropsychologist and senior manager of professional practice, Australian Psychological Society

By Keryn Curtis

The Australian Psychological Society (APS) is calling on the Treasurer to allocate funding in the 2012/2013 budget to improve provision of psychological services in aged care.

Specifically the APS is requesting funding to establish a scheme to enable placement of postgraduate psychology students, with appropriate supervision, into residential aged care facilities (RACFS) to provide much needed services to the residential aged care sector.   

According to one of the authors of the submission, clinical neuropsychologist and senior manager of professional practice at the APS, David Stokes, a key element of the submission is the establishment of a new pilot residential aged care placement program to support such placements of psychology graduates.

Stokes says the incidence of psychological disorders exists at much higher rates in people in RACFs than in the wider community.  Currently, he says, these problems tend to be treated with medications rather than psychologically-based interventions.

“Medications are expensive, frequently have undesirable side effects and have risks, as they can interact with other medications a person is taking,” says Stokes.

“There’s lots of literature supporting increased quality of life measures when the polypharmacy that often plagues people in aged care, can be avoided; if some of the behavioural and emotional issues are treated behaviourally and not just with medications,” he says.

The pilot proposed in the Treasury submission involves 10 residential aged care facilities and ten universities involved in supporting the student placements. It has been costed at $330,000.

Supported placements

According to vision in the APS submission, as part of the university psychology course arrangements, “students with an interest in working with older adults would be offered a postgraduate placement in a RACF. These students would be fully supervised by qualified, experienced and registered psychologists to carry out assessment and treatment planning of clients. Students would be expected to work within the policies and practices of the RACF and contribute towards the overall multidisciplinary care of clients, such as participating in case conferences and educational in-services with medical, nursing and allied health staff.”

It is proposed that students would spend around 2 days per week at a specified RACF for one semester (20 weeks). Provisions for basic administrative costs for the RACFs as well as the universities have been included in the costings.

“The focus is very clinical.  It’s about support to individual residents and to staff; measuring quality of life as well as costs of care. 

“There are very few psychologists in aged care. They’re mainly on the fringes - in ACAT teams and particular intervention areas.  Currently it lands on the staff to manage disturbed moods and behaviours and they do the best way they can.  But often it ends with calling in the GP.

Mr Stokes said there were four or five universities that could immediately opt in to the pilot. “Queensland University, James Cook, Deakin, La Trobe, for example, would love this opportunity for their students who have aged care training. We’ve talked to some of the church organisations in aged care too and many are supportive of more psychology services but it’s a case of, where’s the money?” 

The APS has made a second submission to the Treasurer about the role of clinical neuropsychologists, in correct diagnosis in the aged care setting which they say would reduce many unnecessary admissions to residential care, keeping people at home longer and thus also reducing costs.

“We believe it is important that the government comes on board.  This is about increasing quality of life for people, improving aged care services and also reducing costs, especially the huge cost of psychotropic drugs.

“What isn’t appreciated is that there is a range of psychological and psychosocial techniques that can reduce anxiety and assist carers and the patient or resident themselves.  We need to be looking at better ways of managing needs,” he said.

An overview of the whole APS submission is available here.