Human rights group seeks ban on chemical restraint

New government regulations should prohibit the use of chemical restraint in aged care facilities, a human rights group says.

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New government regulations on physical and chemical restraint don’t go far enough and should outright prohibit the practice of chemical restraint in aged care facilities, a human rights group says.

In a new report that documents the use of medical intervention to control behaviour in 35 aged care facilities across Australia, Human Rights Watch said some drugs reportedly being administered were not approved for older people with dementia.

The report published on Wednesday warned sedatives and antipsychotic medications were being used to control behaviour rather than for therapeutic reasons, and were causing older people physical and emotional harm. And they were often being administered without the informed consent of the resident or their family, it said.

“The long-term, continual use of this practice on older people with dementia in aged care facilities in Australia appears to be driven by a number of factors, including understaffing of aged care facilities and inadequate training in dementia support, leading to an inability to appropriately support the needs of people with dementia,” the report found.

“For understaffed facilities, chemical restraint can make managing people with dementia easier.”

The report was based on interviews with family members, doctors, nurses and advocates. It documented the use of various drugs used in chemical restraint across the Australian facilities, including antipsychotic drugs, benzodiazepines, and sedative-hypnotic drugs, sometimes known as “tranquillisers,” “sleeping pills,” or “sedatives”; and opioid analgesics, also known as narcotic painkillers.

“As best as Human Rights Watch can determine, staff in the aged care facilities where we conducted research did not seek or secure informed consent prior to giving these medications,” the report said.

“Many relatives said they only learned that their relatives had been given medications after they received pharmacy bills listing the medications.”

The report said new regulations introduced by the federal government from July this year were inadequate to protect aged care residents, and continued to explicitly allow the practice.

“The regulation purports to minimise the use of physical and chemical restraint, but it does not because it does not prohibit chemical restraint, guarantee the right to informed consent, or provide for a complaint mechanism when a person has been chemically restrained,” the report said.

It urged the federal government to “introduce legislation to prohibit the use of chemical restraints as a means of controlling the behaviour of older people with dementia or for the convenience of staff.”

Researcher and report author Bethany Brown said “older people with dementia need an understanding helping hand, not a pill.”

“The Australian government should prohibit chemical restraint and penalise aged care facilities it finds violating that prohibition,” Ms Brown said. “We all have the same right to be treated with dignity, which doesn’t change with age or dementia.”

The report also called for the Aged Care Quality and Safety Commission to monitor facilities for the inappropriate use of medications.

Aged Care Minister Richard Colbeck said the use of restraint must always be the last resort.

“Medical practitioners are responsible for obtaining informed consent before prescribing a medicine for chemical restraint. This obligation is set out in the codes of conduct which apply to medical practitioners and nurse practitioners, and is regulated by the professional boards.”

Sean Rooney, chief executive officer of aged care industry group Leading Aged Services Australia said LASA members “seek to minimise the use of restraint, with any such use a last resort after exhausting all other available options.”

“ Any decision to use either physical or chemical restraint must involve the resident’s or their substitute decision maker’s consent, and advice from health care professionals such as GPs, and the care homes’ staff,” Mr Rooney said.

“Following this, the use of restraint of any kind must be regularly monitored and reviewed by health professionals.”