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Govt commits $35m to reduce chemical restraint


Prime Minister Scott Morrison at a press conference (ABC)

The Federal Government has announced new medication management and education initiatives to reduce chemical restraint in aged care as part of a $500 million-plus response to the royal commission’s interim report.

The package includes $25.5 million for aged care medication management programs including more frequent medication reviews to reduce the use of chemical restraint plus an additional $10 million to increase dementia training and support for aged care workers.

The government is also providing restrictions on repeat prescriptions of risperidone from next year, new education resources for prescribers of antipsychotics and benzodiazepines and targeted letters for high prescribers.

The report released on 31 October identified three priority areas for immediate action including reducing chemical restraints, increasing home care packages and getting younger people out of residential aged care (read our backgrounder here).

Prime Minister Scott Morrison announced the $537 million funding package for the health portfolio on Monday as an immediate response to these priority areas.

In addition to the $35.5 million to address chemical restraints, there’s $497 million for an additional 10,000 home care packages and $4.7 million to meet new targets to remove younger people with disabilities from residential aged care (read CCR’s report on those initiatives here).

“These responses together do go to those matters but I want to stress again that what we really need to establish beyond everything else is a culture of respect for older Australians,” Prime Minister Morrison told a media conference in Canberra.

“This cultural change that has once again been highlighted by the interim report of the royal commission requires a broader response than just from governments.

“It is something that goes to each and every Australian in home and family around the country,” Prime Minister Morrison said.

Funding for medication management, training

Minister for Health Greg Hunt said stronger safeguards and restrictions for the prescribing of antipsychotic risperidone were developed following recommendations from the Pharmaceutical Benefits Advisory Committee and with doctor’s groups.

“We are moving as of 1 January to ensure that the medicine risperidone is only available for a 12-week period without a subsequent approval.

“This is a very important step forward. Risperidone has been identified as an antipsychotic which has been the subject of overuse and over prescription for chemical restraint purposes,” Mr Hunt told the media conference.

Doctors will still be able to prescribe the drug but they will need to apply for additional approval if risperidone is to be prescribed beyond an initial 12 week period, the government said.

“Education resources for prescribers will also be developed to support the appropriate use of antipsychotics and benzodiazepines in residential aged care and targeted letters will be sent to high prescribers,” it said.

The $25 million is going to existing medication management programs and will provide support for pharmacists to ensure more frequent medication reviews can occur.

The government said amendments to legislation will make it clear that restraint must only be used as a last resort.

There’s also an additional $10 million over two years from 2019-20 to increase dementia training and support for aged care workers and health sector staff.

This will better equip them to manage behavioural and psychological symptoms of dementia, deliver best practice dementia care and comply with the new standards for reducing the use of physical and chemical restraints in aged care, Mr Hunt said.

Funding tool trial starts this week

Prime Minister Morrison said structural changes underway were impacting business models in response to a question about new measures to guarantee the financial viability of aged care facilities.

Aged care minister Richard Colbeck

“People when they are going into aged care now are going in for a shorter period of time … and they are requiring a much higher need of service, dementia and so on,” he said.

“A lot of facilities have been built on longer stay, lower care requirements.”

Minister for Aged Care and Senior Australians Richard Colbeck said the trial for a new funding model to replace the Aged Care Funding Instrument, which was no longer fit for purpose, was getting underway this week.

“We are working on a new methodology for remuneration of aged care facilities. That trial starts this week and will be completed by the end of the first quarter next year.

“That changes the way that we recompense aged care facilities much more on the basis of assessing the care needs of individuals and making payments to the facilities on that basis,” Mr Colbeck told the media conference.

More than 850 facilities volunteered to field test the prototype of Australian National Aged Care Classification funding assessment tool, which was developed by the University of Wollongong as part of the Resource Utilisation and Classification Study (read more here).

“We will look to progress that so that we can bundle that in with other reforms as we get close to the end of the royal commission process so that there is a larger single set of reforms going through,” Mr Colbeck said.

Senator Colbeck said the government was working on options for how to respond to other calls for viability support from parts of the sector on a single business basis.

Read also

Funding a small step in the right direction, most stakeholders say

Half a billion for home care in govt response to interim report

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2 Responses to Govt commits $35m to reduce chemical restraint

  1. Anton Hutchinson November 26, 2019 at 6:53 am #

    Once again the surplus is seen to be more important than seniors to the liberals.

    The point of the Royal Commission, and all the media sensationalism was and is around residential aged care and the new funding goes straight to Home care that is simply unsustainable and is failing society. There is no way that enough funds will ever be available to care for everyone at home.
    An example, an under 65 with Parkinsons Disease in a facility, two person assist attracts under 70k government funding for care. Take the same person out and under NDIS that cost blows out to 650k…just care, no accommodation. Do the sums people.

  2. Tony Schumacher-Jones November 27, 2019 at 2:00 pm #

    “The government is also providing restrictions on repeat prescriptions of risperidone from next year, new education resources for prescribers of antipsychotics and benzodiazepines and targeted letters for high prescribers”.

    This is dangerous territory for government to get into.

    First, clinical decision making on what drugs to prescribe and who to prescribe them to is surely a matter for medical specialists. A dangerous game to have the political/bureaucratic tail wagging the clinical dog.

    Second, why is it that there are apparently high levels of antipsychotic prescriptions? There might be a couple of answers. One might be that delusions and visual disturbances and erratic disorders of mood are a part of the dementia presentation as it worsens. So prescription use will inevitably be higher in this population. Another might be that with mostly untrained staff doing the caring then this leads to difficulties in managing behaviours and so prescribing antipsychotics might be the lesser of two evils to protect other residents and the staff themselves.

    Third, it would seem likely that, as it stands now, if you reduce antipsychotic prescriptions then you can be prepared to accept more physical aggression; so, more violence, more injuries, more angry relatives, more time off work by injured and stressed staff.

    The Royal Commission. Careful what you wish for!

    Tony Schumacher-Jones PhD

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