Prescribing psychotropic medications in residential aged care facilities

Individualised care plans that take greater account of the behavioural and psychological needs of residents are needed

The prescribing of psychotropic medication for people living in residential aged care facilities (RACFs) is of concern to the community, as reflected in evidence presented to the Royal Commission into Aged Care Quality and Safety.1 Although there is a tendency to blame the prescribers, it is increasingly recognised that many RACFs are poorly equipped for managing cognitively impaired older people with challenging behaviours, particularly ambulant residents with dementia. Not all RACFs have adequate circulation space for reducing the likelihood of aggressive incidents, or accessible outside areas for regular physical exercise. Some RACFs have insufficient natural light for maintaining normal sleep/wake cycles, and many do not have enough staff trained in managing the behavioural and psychological symptoms of their residents. In some locations, public sector mental health services can assist with the assessment and management of RACF residents with mental illness or challenging behaviour, but these services are often under‐resourced and unable to respond quickly. In addition, Dementia Support Australia (https://demen​tia.com.au) offers multidisciplinary assessment and management advice.