51% of Dementia Support Australia aged care referrals’ involve psychotropic polypharmacy

Psychotropic polypharmacy is highly prevalent in Australians living with dementia referred to Dementia Support Australia (DSA), according to Duncan McKellar, Acting General Manager Hammond Centre, HammondCare.

Of the 421 referrals HammondCare's DSA received between 2016 and 2020 for psychosocial interventions, over 90% been prescribed at least one psychotropic with 50.8% prescribed psychotropic polypharmacy, according to a study led by HammondCare’s Dementia Centre Research and Practice Lead Dr Mustafa Atee on the use of psychotropic polypharmacy for people referred to DSA.

The Royal Commission into Aged Care Quality and Safety recommended that restrictive practices only be used as a "last resort".

"Psychotropic medications should not be first line response for people living with dementia experiencing behaviours and psychological symptoms of dementia (BPSD)," Duncan told The SOURCE.

"While there will always be a need for psychotropics to be used appropriately, the best approach is to get to know the person living with dementia and understand the underlying causes of BPSD.

"The experience of DSA is that BPSD may be due to factors such as undiagnosed pain, hunger or thirst, discomfort, sensory disturbances or the approach of carers. 

"BPSD can also be caused by lack of meaningful activity, that is, when the person living with dementia is not receiving sufficient support or interaction to feel like their life is interesting. 

"Boredom can be an important contributor to feelings agitated. Other factors such as building design, the environment, access to outdoors and even the wall colour, floor coverings and lighting also have a role to play." 

Duncan said "formal training" was needed for care workers, nurses and GPs to gain knowledge and practice skills.

"The most important aspects are the communication and relational skills that enable the care worker to connect, interact and engage with the person with changed cognitive abilities."

Since DSA’s establishment in 2016, DSA has supported 93% of aged care homes with a 59% reduction in behavioural severity, a 64% reduction in carer distress, and 42% reduction in number of behaviours.