Residents’ right to protection from harm
The Australian Medical Association (AMA) has revised its Position Statement on Restraint in the Care of People in Residential Aged Care Facilities, recognising the need for balance between a residents’ right to self determination and protection from harm.
Australian Medical Association vice president, Dr Stephen Parnis, has released two Position Statements on restraint in aged care and palliative care.
AMA vice president, Dr Stephen Parnis, says the AMA, in its new Position Statement, includes the issue of harm to other residents and staff.
“Medical practitioners work with patients, carers, and family members to ensure that restraint is used as a last resort, and for the shortest possible period,” Dr Parnis says.
“There is a clear distinction between treating older people with diagnosed illness and using psychotropics (psychiatric medicines that alter chemical levels in the brain that impact mood and behaviour) for the sole purpose of restraint.
“Psychotropic medications are a clinically appropriate treatment for older people with medical conditions such as anxiety, depression, psychosis, and dementia. They can be very effective in assisting a person to become settled in their environment,” he claims.
“The use of restraints can be considerably minimised through proper resourcing, appropriate levels of trained staff to engage residents in meaningful activities, and facility design and infrastructure that maintains a low stress environment,” Dr Parnis says.
The AMA has also released its new Position Statement on Palliative Approach in Residential Aged Care Facilities.
Dr Parnis says the new Position Statement outlines the appropriate considerations in taking a palliative approach to the care and management of patients who reside in residential aged care facilities.
“Acute medical care settings prioritise preserving and, where possible, extending life,” Dr Parnis says.
“Transferring residents of residential aged care facilities to acute care settings when their condition deteriorates can often impose unnecessary pain and distress.
“It may also not necessarily respect the needs of patients living with life limiting illnesses, who prefer to receive palliation within the residential aged care facility.”
The AMA would like to see the introduction of templates for palliative care plans in aged care.
“Palliative care plans are an excellent way to ensure that everyone involved in the person’s care follows the same agreed approach,” he says.
According to research by the Grattan Institute, 70% of Australians wish to die in their home, which includes in their aged care facility.
At present, up to 70% of people die in acute care hospitals, and many are actively treated right up until the moment of their death.
By contrast, a palliative approach to care for residents of aged care facilities, living for extending periods of time with life limiting illnesses such as cancer, dementia, Alzheimer’s, neurodegenerative and renal diseases, aims to maximise quality of life through appropriate needs based care.
