The Royal Australian and New Zealand College of Psychiatrists (RANZCP) New Zealand National Committee - Tu Te Akaaka Roa has applauded the efforts of rest homes making a conscious decision to implement a more person-centred approach to dementia and aged care.
‘The time is right to have a conversation about how we manage the complex issue of prescribing anti-psychotics,’ said Dr Mark Lawrence, Chair of the New Zealand National Committee - Tu Te Akaaka Roa.
‘The RANZCP advocates for models of care where the older person is treated with dignity and lives in an environment that supports their preferences.
‘It is important that the person, and their whānau, are part of all decision-making about their care’ added Dr Mark Lawrence.
Dr Stephen Boyd, Chair of the RANZCP New Zealand Faculty of Psychiatry of Old Age Subcommittee, affirmed the need to ‘look at the evidence’.
‘The RANZCP always considers “what works” in guiding best practice.
‘It is clear that using anti–psychotics purely to sedate people with dementia is not good clinical practice and can cause significant harm.
‘We are pleased that some rest homes are reducing anti-psychotic medication in favour of person-centred care.
‘The RANZCP promotes an approach that strongly focuses on the needs of the person living with dementia, rather than simply relying on drugs.
‘There are specific cases when the use of anti-psychotics are indicated, such as when the person is experiencing distressing psychotic symptoms that can’t be controlled in other ways,’ explained Dr Boyd.
‘Unfortunately, there is a developing trend with new dementia units, where people living with dementia have limited access to outside space to walk or just enjoy their natural surroundings.
‘We are concerned this will result in higher levels of agitation and distress in those people with significant dementia, and a consequent pressure for more medications to be used.
‘We know providing care for people with dementia can sometimes be challenging but there are good alternatives to using drugs,’ said Dr Boyd.
‘For example, there is good evidence that Cognitive Stimulation Therapy can improve the quality of life of people with dementia but the workforce has to be trained in using this therapy.’
The RANZCP is also concerned that mental health services for older people are not keeping up with the increasing demand – few services and facilities are tailored for Māori, Pasifika, Asian people and younger people with dementia.
Dr Lawrence emphasised: ‘Don’t forget the 5%” - those people with enduring mental health conditions.
‘People living with dementia are some of the most vulnerable, and they must receive compassionate and integrated care.
‘We all need to work together towards improving the quality of life for people with dementia, and psychiatrists as leaders in mental health are well placed to lead this work.’
For more information, see RANZCP’s position statement Psychiatry services for older people | RANZCP
As well as the RANZCP Submission to the Office for Seniors Better Later Life and RANZCP Submission to the Mental Health and Addiction Inquiry
For all other expert mental health information visit Your Health in Mind, the RANZCP’s consumer health information website.
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