Aged Care Minister Ken Wyatt has announced new regulations to prevent the excessive use of physical and chemical restraints, after the ABC’s 7.30 aired images of dementia patients being strapped to chairs.
Mr Wyatt said the announcement was not prompted by the program, but a video in it showing a dementia patient being restrained had greatly disturbed him.
In the past 18 months, three national reports have recommended the government regulate the use of restraints as is done in the US, UK and Europe.
Mr Wyatt said regulations could be in place “within weeks”.
But doctors said understaffing in aged care homes was the real problem, which would not be fixed by the proposed laws around the use of restraints and medication.
“Ideally we would prefer not to use any medications at all, but if there is no staff there, the patients are at risk and they need to be taken care of,” Dr Harry Nespolon, president of the Royal Australian College of General Practitioners, said.
Dementia Australia chief executive Maree McCabe said restraints were being overused because 70 per cent of the aged care workforce was not required to have any training in dementia.
“One of the challenges is that staff are not always clear about the things that they can do other than give medication,” Ms McCabe said.
“They definitely don’t have enough education and training, and if we look at the basic certificate three, dementia is not there as a mandatory subject, nor as an optional subject.”
Ms McCabe said more than 50 per cent of people in residential care had dementia, and that psychotropic medication was only effective in 20 per cent of cases.
The new regulations come after two cases, one from New South Wales and one in Victoria, highlighted the use of chemical and physical restraints and were called “totally unacceptable” by Mr Wyatt.
Records show 72-year-old Terry Reeves was frequently strapped to a chair at a nursing home in Sydney’s west and on one day he was restrained for a total of 14 hours.
The treatment of Mr Reeves deeply disturbed Mr Wyatt.”Those images of that father being active and then being as docile as he is raises questions in my head around the treatment he was given,” he said.
As well as Mr Reeves being physically restrained, his daughter Michelle McCulla also believes powerful antipsychotic medication was given to him on a regular basis without the family’s knowledge or consent.
“They said that he had gotten aggressive with another male nurse,” Ms McCulla said.
“By being aggressive he was yelling and they felt the need that they had to then restrain him in his chair.
“You wouldn’t tie your dog up and leave it, let alone an elderly man.”
After Mr Reeves was moved into Garden View Nursing Home at Merrylands, Ms McCulla’s mother signed a form giving permission for him to be physically restrained with a lap belt if he was “a danger to himself or others”.
But Ms McCulla said it was used too frequently and for too long.
“Every single day there was a family member there and every single day he was in a restraint,” Ms McCulla said.
The form shows that Garden View can also use belts, tables, chairs, bed rails and medication to restrain residents.
In one 24-hour period Mr Reeves was restrained from 2.30am until 10pm.
Garden View said there were regular breaks and he was repositioned, stood up and/or walked and toileted during that period.
Earlier this week, the nursing home said it was still investigating the case and that it was “taking measures to more effectively work towards a restraint-free environment for our home”.
“We regret that Mr Reeves may have been restrained more frequently than some of his family has subsequently indicated they felt was ideal,” Garden View said in a statement.
In the second case, 84-year-old Victorian woman Margaret Barton was given what a coroner described as “excessive” doses of the sedative Oxazepam.
That caused her to fall and contributed to her death after just nine weeks in care.
Ms Barton had been given increasing amounts of drugs to treat her agitation but it worsened and she was later diagnosed with delirium, partly due to the medication changes.
She fell seven times in a 10-day period and was admitted to hospital, where she later died.
Mr Wyatt said he hoped the Royal Commission into Aged Care Quality and Safety would examine exactly this kind of treatment.