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Psychotropic drug use in aged care facilities: a reflection of a systemic problem?


To the Editor: Looi and Macfarlane have raised the important matter of inappropriate psychotropic drug use in residential aged care facilities (RACFs).1 Many other problems affect care in RACFs, including:

  • lack of a comprehensive assessment of new residents, failing to address rationalisation of medications, risk assessment, advance directives and family support;

  • poor availability of medical personnel for crisis situations;

  • overdependence on locum services;

  • inappropriate transfers to acute care;

  • poor on-the-job support for staff;

  • inadequate palliative care for the many who die in RACFs.

Finding answers to these problems is increasingly urgent. We face an increasing population of dependent older citizens, many requiring residential care.

Too commonly, general practitioners are not providing the care in RACFs that is needed and is possible. We need medical practitioners prepared to specialise in this area, as happens in the Netherlands. Further training in psychogeriatrics and in palliative care will be needed, and a single comprehensive diploma program…