HammondCare chief executive Dr Stephen Judd has called on aged care providers to “ditch their drug habit” and take responsibility for the role they play in the over-reliance on chemical restraint in the care of people with dementia.
He said attempts to pass off the use of antipsychotics in aged care as simply a doctor-patient issue were “absolute rubbish” and a cop out from the sector.
“What it fails to acknowledge is that often doctors are prescribing at the behest of aged care staff,” he told the Risky Business 2 international dementia conference on Thursday.
He said denial was not a mature response to this important issue and some industry peak associations needed to stop playing the blame game.
“There’s no use in making excuses or passing the buck,” he said.
To create sector change, Dr Judd said a new way of thinking on antipsychotics was needed, which included better monitoring and review.
“As a society, we understand that if someone has an infection and is prescribed antibiotics, it’s prescribed for a limited time and then it’s withdrawn. We need to consider antipsychotics along the same lines.
“In most cases, antipsychotics should be used as treatments for a particular intervention and not as a long-term solution. They should have a start time, a review period and a finishing date.”
Dr Judd also backed a senate committee’s recommendation for GPs to review antipsychotic medication after the first three months as a good starting point.
“It would help a great deal if we could increase the pharmacological knowledge of doctors. But, this is not all about doctors.” He said all aged care providers should take steps to provide residential care that was grounded “in a deep understanding of the individual” and by adopting psycho-social interventions.
“It’s also about the physical environment – and this is something that the Senate inquiry really cottoned onto. Noise is to someone with dementia what stairs are to someone in a wheelchair,” he said.
“Powerful medication is not the only way to care for people. While they are an appropriate treatment for some people, they are not an inevitable form of treatment for everyone.”
The androgyny of aged care
In his keynote address, titled ‘Sex, drugs and rock ‘n’ roll’, Dr Judd also argued strongly for the end to what he described as the androgyny of aged care. He said the most pressing issue in relation to sexuality and dementia in aged care today was not the sexual expression of residents but their de-sexualising by organisations that cared for them.
“The issue that affects all residents each and every day is the suppression of sexual identity and expression that so easily creeps into our aged care homes.”
Dr Judd said by dressing residents in gender-neutral clothing such as tracksuit pants and paying a lack of attention to personal grooming and appearance, aged care environments often diminished the sexuality of people with dementia in aged care.
“As well as physical sexual expression, sexuality also encompasses an affirmation of gender – recognising women as women and men as men.
“Dress, grooming, hair, appearance matter because they lie at the heart of our identity and sense of self. When you look daggy, when your appearance does not reflect your idea of who you are, it’s harder to feel good about yourself.”
He told the Sydney audience it was critical to get away from practices that were convenient-but-bad, including sitting residents in front of the TV for hours, and instead provide care that was centred on the individual.
Risky Business 2 was attended by around 1000 local and international delegates in Sydney on 26-27 June.
Related AAA coverage: