Dementia and psychotropic medicines – resources for GPs working in Aged Care
The AMA’s position on the use of restrictive practices is that they should always be used as a last resort – where any potential risk or harm caused by the restraint itself is less than the risk of the patient not being restrained.
The decision should always be made by the patient’s doctor on a case-by-case basis balancing the need to ensure the older person’s safety, and those around them, while respecting their right to dignity and self determination, including via previously expressed or known values or wishes (if they have lost decision-making capacity). This is a key issue in aged care with dementia patients and is the subject of Recommendation 17 from the Commission into Aged Care Quality and Safety.
To assist GPs working in aged care the AMA notes the range of resources available for GPs from NPS MedicineWise about the options available to manage changed behaviour in dementia.
The dementia and psychotropic medicines webpage outlines that non-pharmacological interventions are recommended as first-line management of changed behaviour in dementia, and should be continued even if a medicine is trialled. Antipsychotic medicines should only be used in severe cases of changed behaviour where non-pharmacological interventions have failed.
There is also CPD options available to GPs on the webpage called Educational visit: Dementia and changed behaviour: a person-centred approach.
More information and resources can be accessed on the NPS MedicineWise webpage here.
Recommendations from the Commission into Aged Care Quality and Safety are here.