Govt response to report into aged care and psychogeriatirc disorders

The Australian Government is calling for applications for research grants – totalling $2 million – into the care and treatment for psychogeriatric disorders. Such research was one of the main recommendations of the Report to the Minister for Ageing on Residential Care and People with Psychogeriatric Disorders by the Department of Health and Ageing’s Deputy Secretary, Mary Murnane.

The report followed the deaths of two residents in aged care in Qld and SA in March 2008.

The applications for the new research grants will be administered through the National Health and Medical Research Council.

Psychogeriatric disorders include psychiatric conditions that predate the ageing process, such as depression or schizophrenia, as well as the various forms of dementia that can result from ageing.

Currently more than 75% of people living in Australia’s 3,000 aged care homes have some form of dementia or some other form of cognitive impairment. A small minority can behave inappropriately placing themselves, other residents or staff at risk.

“As the population ages so the number of people with psychogeriatric 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,” the Minister for Ageing Justine Elliot said when announcing the research funding and government response to the Murnane Report.

This funding aims to further develop our understanding of the best treatment and management for people with these behaviours. This could occur through the development of medication and behaviour-management programs and identifying approaches between mental health and aged care sectors.

In addition to considering the recommendations in the Murnane Report, Mrs Justine Elliot announced practical evidence-based projects funded through the Encouraging Best Practice in Residential Aged Care program to respond to these conditions. These include:

• A $850,000 project to be managed by Hammond Care that aims to integrate staff education and support, family education and environmental design interventions to identify how these factors relate to behaviour-management in residential aged care;
• Establishing evidence-based best practice behaviour management techniques and an education resource to encourage their implementation. Worth more than $894,000 it will be led by the University of Technology, Sydney;
• A $1.274 million project, led by Monash University to enable aged care staff to increase their capacity to provide appropriate assessment and care for older people who have dementia living in residential aged care in rural areas.

Mrs Elliot said the research grants and the recommendations in the Murnane Report were important in improving the care and services available to older Australians in aged care homes suffering with mental health problems.

The recommendations contained in the report include:

• Maintain appropriate support to people with psychogeriatric disorders as an important issue for senior level aged care administrators and planners by establishing an expert group comprising old age psychiatrists, service providers and expert nursing staff to report to the Ministerial Conference on Ageing at its regular meetings.
• Develop principles of effective care and support including protocols for effective collaboration across the residential aged care and state mental health systems.
• Establish evidence-based guidelines on effective care and behaviour management for residential aged care services which would include strategies for maintaining networks across the broader service system.
• Nurture and establish collaborative networks across the primary, acute, mental health and aged care service sectors.
• Promote leadership in the sector by encouraging leading residential aged care providers to take a proactive role.
• Consider possibilities provided under the Aged Care Act 1997 to extend and strengthen care to this client group.
• Expand current workforce training strategies which could include, as an early target, training in managing aggressive and sexually inappropriate behaviour.
• Encourage GP training and access by engaging with the Australian General Practice Network, General Practice Education and Training, Royal Australian College of General Practitioners and Australian Medical Association to encourage more focus on the needs of people with behavioural problems and/or dementia both in terms of training for GPs and providing onsite support to clients within facilities.
• Facilitate ‘progression’ models of care through ongoing discussion with residents, relatives and staff to enable progression from, and to, specialist care in a high dependency unit as required.

The report was tabled at the November meeting of the Ministerial Conference on Ageing. The full report is available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-quality-report-psychogeriatric-disorders.htm