Federal Government responds to psycho-geriatric patients

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PDF printable version of Federal Government responds to psycho-geriatric patients (PDF 21 KB)

April 1 2008
JE08/26

The Minister for Ageing, Minister Justine Elliot, said there had been a number of recent incidents that raised the appropriate care for people with significant psycho-geriatric illness.

Currently more than 75 per cent of people living in aged care homes have some form of dementia or some other form of cognitive impairment. A small minority can behave aggressively or inappropriately towards other residents or staff.

The matter has been highlighted by recent events at Makk & McLeay Nursing Home in Adelaide – where a death occurred on February 28. Another resident – who is 85 years old – has been charged with murder.

Makk & McLeay is a State government–run aged care facility in Adelaide which primarily accommodates older people with dementia, with a few compounded by other ageing diseases and psychiatric disorders.

On Friday 28 March, the Federal Minister for Ageing, Minister Justine Elliot, visited Makk & McLeay to see the facility first hand and meet with staff and residents.

On the same day, Minister Elliot also met with South Australian Minister for Mental Health, the Honourable Gail Gago, where she pledged to work with the State authorities on the matter.

Mrs Elliot has asked the relevant Deputy Secretary of the Department of Health and Ageing, Ms Mary Murnane, to consult with experts and providers of psycho-geriatric care including relevant state government providers on psycho-geriatric disorders.

Ms Murnane has been asked to report on “Residential Aged Care and People with Psycho-Geriatric disorders” by mid-May.

Minister Elliot stressed the importance of dealing with the sensitive matter around psycho-geriatric care in line with evidence-based practice.

Mrs Elliot said: “This is an issue across aged care and all States and Territories are dealing with this complex issue of responding to the needs of psycho-geriatric patients in nursing homes.”

Overall, Australia’s aged care homes are required to have care plans in place to manage challenging and aggressive behaviour and where necessary to protect other residents.

Since 20 March 2008, a new Aged Care Funding Instrument (ACFI) has been used to calculate the amount of care subsidy the Australian Government pays to aged care homes on behalf of their residents.

As part of the ACFI, a new Behaviour Supplement is made available for residents with cognitive or behavioural conditions, including dementia.

Higher levels of Behaviour Supplement are paid for residents who frequently display aggressive or inappropriate behaviour.

The 2007-08 Budget provides for an additional $102.7 million over four years for the Behaviour Supplement and the new Complex Health Care Supplement (an estimated $40 million is for the Behaviour Supplement).

BACKGROUND NOTES

Psycho-geriatric is not a single disorder, nor even a single group of disorders. It includes older people who have either an age-related illness or life long mental health problems. It also includes people who have diseases of the brain such as Alzheimer’s, which tend to affect predominantly those who are old. And it includes people who are both - that is they may have a psychiatric disorder that developed when they were young - and then have developed Alzheimer's as they got older, in addition to their pre-existing psychiatric condition. There are many different dementias with distinct characteristics but similar care needs.

The range of symptoms is highly varied according to the disorder, and can include depression, withdrawal, memory loss, confusion and in more rare cases delusions, hallucinations, agitation and aggression. People can present with complex behaviours, ranging from passive to aggressive and which are sometimes unpredictable. The main behaviour that requires careful management is violence.

Some conditions do not respond well to medication (eg Alzheimer's) others require powerful medications to treat psychiatric disorders, and others require simpler medications such as antidepressants and tranquilisers.

The age of someone receiving psycho-geriatric care can be as low as 50 but more often is over 60 or 70.

As the population ages so the number of people with psycho-geriatric disorders will increase. This is the case because diseases of old age which cause mental illness will be more prevalent as the number of older people increases.

Currently, there are 1.9 million Australians aged 70 and over, comprising 9.3 per cent of the population. Within 40 years the number of people aged over 65 will almost triple.

Unfortunately, Australia now has a small group of people who are defined as psycho-geriatric and that number is expected to grow with the overall ageing of the population.

For more information, contact Mrs Elliot's office on (02) 6277 7280