Minimising inappropriate use of restraint in aged care
This package of initiatives is helping to reduce the use of physical and chemical restraint in aged care homes. There have been changes to the legislation about using physical and chemical restraint in residential aged care, and some practical measures put in place.
Initiatives to minimise inappropriate use of restraint
These initiatives aim to reduce the inappropriate use of physical and chemical restraint in residential aged care.
Minimising restraint initiatives include:
- strengthening laws that apply to residential aged care providers on restraint use
- changes to the Pharmaceutical Benefits Scheme (PBS) risperidone listing
- awareness raising activities regarding the appropriate use of antipsychotics and benzodiazepines in residential aged care
- workforce initiatives
An Aged Care Clinical Advisory Committee was also set up in January 2019 to advise on ways to reduce inappropriate use of chemical restraint in residential aged care.
Why this is important
Aged care homes are required to provide safe and quality care to residents.
Reducing the inappropriate use of physical and chemical restraint is part of providing quality care.
The goals of the initiatives
Regulatory and non-regulatory initiatives are planned or in place to reduce inappropriate use of restraint.
These initiatives aim to help people in these groups understand their responsibilities and change behaviours, where needed:
- approved providers of residential aged care
- prescribers working in residential aged care, including GPs, specialists and nurse practitioners
- nurses and personal care workers
- aged care residents’ families and decision makers
How we will meet these goals
To drive reform and minimise the inappropriate use of restraint in residential aged care, we need:
- regulatory and compliance measures
- cultural change
- effective clinical governance
A number of initiatives are working in complement to achieve change.
Laws on minimising restraint
Residential aged care providers have specific responsibilities that relate to the use of physical and chemical restraint. These responsibilities are in the Quality of Care Principles.
The Aged Care Quality and Safety Commission has more information to support providers.
Further strengthening of the legislation
The Quality of Care Amendment (Reviewing Restraints Principles) Principles 2019 came into effect on 29 November 2019. The legislation now:
- makes it clear restraint must always be used as a last resort
- refers to state and territory legislation for prescribers’ responsibilities regarding informed consent
- requires a 12-month review of the restraint regulation operations to ensure they are minimising the use of inappropriate restraint
Funding for better safety, quality and integrity
In response to the Royal Commission’s Interim Report, the Government allocated additional funding to improve safety, quality and integrity of aged care services.
The funding includes:
- $5.7 million for the Dementia Behaviour Management Advisory Service and Severe Behaviour Response Team services
- $4.3 million for the Dementia Training Program to make dementia training more available to aged care workers and health sector staff
- $25.5 million to improve medication management and safety for older Australians living in residential aged care facilities and at home
Changes to the Pharmaceutical Benefits Scheme (PBS)
Policy makers will also better understand prescribing behaviours, with unique residential aged care service identifiers to be collected in the PBS data.
Prescribing psychotropics in residential aged care
We are raising awareness and providing information on prescribing psychotropics in residential aged care.
Education and training
- nurses and personal care workers
- approved providers of residential aged care services
- families and decision makers
Workforce initiatives also include:
- professional development for doctors and nurses
- train‑the‑trainer programs for nurses and personal care workers
- nurse champions in residential aged care
Embedded pharmacists in residential aged care homes
From February 2020, a trial of embedded pharmacists will be expanded to all residential aged care services in the Australian Capital Territory (ACT).
Who we work with on the initiatives
The Commission’s Better Use of Medication in Aged Care Project is also currently focusing on psychotropic medicines used in aged care.
An Aged Care Clinical Advisory Committee advises on many of the initiatives to reduce use of restraint.
On 1 November 2019, Commonwealth, state and territory Health ministers agreed to recognise ‘quality use of medicines and medicines safety’ as a national health priority.
- the safe, quality use of medicines
- appropriate medication management in residential aged care
The Aged Care Quality and Safety Commission has:
- a range of resources for medication management, which also aim to reduce inappropriate use of restraint
- resources to support providers to minimise the use of restraint
For more information, see:
- Guiding principles for medication management in residential aged care facilities
- Six steps for safe prescribing of antipsychotics and fenzodiazepines in residential aged care
- Three simple checks to support your residents – for personal care workers in residential aged care
- Informed consent: What families need to know about antipsychotics and benzodiazepines in residential aged care
Minimising inappropriate use of restraint contact
Email us if you have questions or want more information about minimising inappropriate use of restraint in aged care.