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Introduction of New Clinical Care Standard by ACSQHC to Address Psychotropic Medicine Use in Cognitive Disability and Impairment

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Introduction of New Clinical Care Standard by ACSQHC to Address Psychotropic Medicine Use in Cognitive Disability and Impairment

 

By Jeff Gibbs

The Australian Commission on Safety and Quality in Health Care (the Commission) has today announced the launch of a pivotal new national standard aimed at enhancing the care for individuals with cognitive disabilities or impairments. The introduction of the Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard is a critical advancement in promoting safer and more effective treatment protocols across the healthcare spectrum.

Background and Rationale for the New Standard

Recent decades have witnessed a 60% surge in the prescription of psychotropic medications across Australia. Despite a modest reduction in antipsychotic use among the elderly—prompted by heightened awareness of associated risks—the prescribing rates remain alarmingly high, particularly among vulnerable populations. Notably, older individuals and those residing in aged care facilities are disproportionately affected by the adverse effects of these medications, including cognitive decline, heightened risk of falls, strokes, and mortality. Additionally, approximately one-third of individuals with intellectual disabilities are prescribed psychotropic drugs, exposing them to potentially severe short and long-term side effects.

Scope and Impact of the Standard

The new Standard seeks to mitigate the inappropriate utilisation of psychotropic medications and emphasises patient safety. It priorities non-pharmacological interventions as the foremost approach for managing challenging behaviours such as aggression and agitation. Psychotropic medications are advised as a last-resort measure, following the ineffectiveness of alternative strategies or in situations posing significant risk to the individual or others.

The Standard advocates for tailored non-medication strategies that respect the individual’s needs and preferences, developed in consultation with their family and other authorised caregivers. This approach underscores the commitment to upholding the dignity and autonomy of individuals with cognitive impairments.

Expert Insights and Support

Key health experts have endorsed the significance of this new Standard. Conjoint Associate Professor Carolyn Hullick, Chief Medical Officer at the Commission, stresses the necessity for mindful prescribing practices given the limited benefits and substantial risks associated with psychotropic medications in this demographic. Professor Julian Trollor from the University of New South Wales and Juanita Breen from the University of Tasmania also highlight the importance of objective-driven prescribing, continuous monitoring, and the potential to reduce medication dosages in favour of non-pharmacological alternatives.

Implementation Across Settings

The Standard is applicable universally across various healthcare settings, including hospitals, aged care facilities, and community services, ensuring that individuals with cognitive disabilities receive consistent and coordinated care irrespective of the setting.

Professor Eddy Strivens emphasises the need for coordinated efforts and effective communication, particularly during care transitions, to maintain continuity and efficacy of treatment plans and to support decision-making processes that honour patient autonomy.

Collaborative Efforts for Enhanced Care

In a collective endeavour to address these issues, the Commission has collaborated with the Aged Care Quality and Safety Commission and the NDIS Quality and Safeguards Commission to issue a Joint Statement against the misuse of psychotropics in managing behaviours in disabled and elderly populations.

Conclusion

The introduction of the Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard marks a significant step forward in improving the quality of care and safety for Australians with cognitive disabilities or impairments. It aligns with ongoing efforts to reform health care, aged care, and disability support systems across the nation.

The complete Standard and accompanying resources are available on the Commission’s website here.

 

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Alarming Data Reveals Widespread Fears of Discrimination Among Australians Facing Cancer Treatment

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Alarming Data Reveals Widespread Fears of Discrimination Among Australians Facing Cancer Treatment

 

A significant number of Australians are deeply concerned that factors such as their location, age, gender, sexual orientation, income, or the language they speak at home could adversely affect their cancer treatment and survival chances. This is according to new research commissioned by the Leukaemia Foundation, which highlights the pervasive fear of discrimination in the healthcare system.

The YouGov survey revealed that seven in ten Australians worry that these personal characteristics may impact their ability to receive effective cancer treatment. Millennials emerged as the most concerned, with 71% expressing fears, followed by Baby Boomers at 63% and Generation X at 62%.

With one in twelve Australians expected to be diagnosed with blood cancer—such as leukaemia, myeloma, or lymphoma—in their lifetime, the Leukaemia Foundation’s CEO, Chris Tanti, described the findings as deeply troubling. He emphasised that these fears are rooted in the broader issue of health inequity, which disproportionately affects marginalised communities.

“These latest results underscore the urgent need for greater awareness and action to create a healthcare environment that is safe, welcoming, and inclusive for everyone,” Tanti said. “We know there is a persistent and troubling cancer health divide across Australia, particularly impacting those living in regional areas, First Nations peoples, culturally and linguistically diverse (CALD) communities, and LGBTQIA+ individuals. These groups face significant barriers in accessing timely diagnoses and the best available treatments.”

The survey comes at a time when blood cancer remains one of Australia’s most deadly and prevalent diseases. Every day, 53 Australians are diagnosed with blood cancer—equating to one person every 27 minutes—and 17 people lose their lives to the disease.

Tanti further noted the geographical disparities in cancer outcomes, with 41% of Australians diagnosed with blood cancer living in regional, rural, or remote areas. These patients are statistically less likely to survive five years beyond their diagnosis compared to those in major cities, due in part to the challenges of accessing specialized care.

CALD communities face additional hurdles, particularly when English is not the primary language spoken at home. This can significantly hinder their ability to understand health information and navigate the healthcare system. Meanwhile, LGBTQIA+ individuals often experience social isolation and may delay seeking medical care due to fear of discrimination or distrust in the healthcare system.

“These issues are substantial, and it’s no surprise that many Australians are fearful about being diagnosed with cancer and their chances of survival,” Tanti said.

In response to these findings, the Leukaemia Foundation has launched a new campaign, A Fair Go, aimed at addressing the fear and uncertainty surrounding blood cancer. The initiative seeks to ensure that every Australian, regardless of their background, has the knowledge, resources, and support needed to confront blood cancer.

The campaign will also focus on supporting healthcare professionals by developing new resources and information tailored to priority population groups. Additionally, the Foundation will spearhead new initiatives and research programs to tackle the specific challenges these groups face.

“Where someone lives, their age, gender, sexual orientation, income, cultural background, or language spoken at home should not determine their chances of surviving cancer,” Tanti asserted. “It is unacceptable that seven in ten Australians live with this fear. We are committed to addressing the issue of inequity head-on, ensuring that every Australian with blood cancer has a fair go when it comes to treatment and care.”

As Blood Cancer Month approaches this September, the Leukaemia Foundation encourages all Australians affected by blood cancer, as well as those interested in learning more, to visit the Blood Cancer page on their website

 

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Aged Care Providers Urged to Address Unique Needs of Stolen Generations Survivors with Dementia

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Aged Care Providers Urged to Address Unique Needs of Stolen Generations Survivors with Dementia

 

As the first generation of Stolen Generations Survivors reaches old age, many now grappling with dementia, leading experts are calling on aged care providers to better understand and accommodate their unique needs. Dr. Tiffany McComsey and Harpreet Kalsi-Smith, both from the Kinchela Boys Home Aboriginal Corporation, will highlight these concerns at the upcoming International Dementia Conference in Sydney, emphasising the importance of trauma-informed care.

With approximately 17,000 Stolen Generations Survivors aged 50 and over, many are now frail and particularly vulnerable to dementia—Aboriginal and Torres Strait Islander people are three to five times more likely to develop the condition than non-Indigenous Australians. Dr. McComsey expressed concern that many aged care facilities lack an understanding of the deep trauma these individuals have experienced, which profoundly impacts their dementia journey.

One innovative approach proposed by Dr. McComsey and Ms. Kalsi-Smith is the use of life story posters. These posters, which would be created with the input of the survivors and their trusted companions, would provide a visual and narrative overview of the person’s life, including their likes, dislikes, and strategies to de-escalate potential tensions. The posters serve as a constant reminder to care staff of the individual’s background and the trauma they have endured, helping to create a more supportive and understanding environment.

Ms. Kalsi-Smith underscored the importance of these life story posters, especially for individuals with dementia who often struggle with communication and memory. “Creating a life story is a useful way to record important information about Stolen Generations Survivors and help others understand and relate to them in a supportive way,” she said.

The Kinchela Boys Home, where many of these survivors spent their childhoods, was a site of intense cultural and psychological abuse. The boys, now referred to as “uncles,” were stripped of their identities, forced to conform to an alien culture, and suffered significant trauma. Of the 600 boys who passed through Kinchela, only 50 are alive today, with seven currently living with dementia.

Aged care providers are encouraged not only to adopt the life story poster concept but also to engage in comprehensive training about the legacy of the Stolen Generations. This includes participating in truth-telling processes and ensuring all staff are equipped with trauma-informed care practices.

Ms. Kalsi-Smith highlighted the deep fear many Stolen Generations Survivors feel about entering aged care facilities, which they often associate with the restrictive environments of their childhood. This fear is illustrated by Uncle Colin Davis, a 76-year-old Kinchela Survivor recently diagnosed with dementia, who has expressed a strong desire to avoid aged care homes altogether.

Uncle Colin’s wife, Aunty Rita Davis, voiced concerns that the available aged care options near their home on the NSW South Coast would not meet her husband’s needs. “For him, it would be like the restrictions he had growing up all over again. Once you put restrictions on him, you never know what he’ll do,” she said.

Dementia Support Australia (DSA), which has provided tailored support to 50,000 people since 2016, emphasises the importance of cultural awareness and trauma-informed care training for aged care staff. DSA Head of Professional Services Marie Alford stressed that all aged care services should understand the triggers of Behavioural and Psychological Symptoms of Dementia (BPSD) in Stolen Generations Survivors and know how to safely de-escalate them.

The upcoming International Dementia Conference, hosted by The Dementia Centre, will bring these critical issues to the forefront, as aged care providers and policymakers gather to discuss the future of dementia care in Australia. As the needs of Stolen Generations Survivors become more urgent, it is clear that a tailored, culturally sensitive approach is essential for their care and well-being.

 

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Lismore Confirmed as One of Two Regional Drug Summit Forum Locations

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Lismore Confirmed as One of Two Regional Drug Summit Forum Locations

 

Robert Heyward

Regional Health Minister Ryan Park has confirmed that Lismore will host one of the NSW Government’s two Drug Summit regional forums on Monday, 4 November. These regional forums are designed to ensure that the unique experiences of communities in regional NSW are reflected in the larger discussions at the Drug Summit.

The summit will bring together a diverse range of participants, including medical experts, police, individuals with lived experience, drug user organizations, families, and service providers. These forums aim to build consensus on how NSW should address drug use and the associated harms.

Minister Park also announced that former NSW Deputy Premier Carmel Tebbutt and former NSW Leader of the Opposition John Brogden will co-chair the NSW Drug Summit. The Co-Chairs will collaborate with attendees to develop and prioritize solutions focused on improving community health, safety, justice, and integrated social support systems.

Minister for Health Ryan Park said:

  • “Bringing the summit to regional areas like Lismore is essential because drug use impacts communities in different ways.”
  • “It’s important that Lismore’s experiences with illicit drug use are reflected in the summit’s deliberations.”
  • “Janelle [Saffin] has been a strong advocate for her community, and it’s fitting that we can return to hear from Lismore in 2024.”

Member for Lismore Janelle Saffin added:

  • “I’m thrilled that Lismore will be hosting one of the two regional forums of the Drug Summit.”
  • “We have unique challenges here, and I am determined that Lismore’s voice will be heard in this statewide conversation.”
  • “In 1999, I participated in a successful Drug Summit, and I am excited to bring forward local perspectives once again in 2024.”

The Lismore forum will be an opportunity for local voices to contribute to a broader statewide effort aimed at addressing drug use and improving public health outcomes across NSW.

 

For more local Lismore news, click here.

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