Nursing home medications: why staffing ratios are important

Nearly two-thirds of nursing home residents are given psychiatric drugs every day. A drug use survey by the University of Tasmania has shown that 61 per cent of 11,300 residents in 150 homes were on daily doses of benzodiazepines, a type of tranquilliser drug, or antidepressants, many of which were also a sedative.

The study found that these drugs were often inappropriately prescribed with experts saying these high rates demonstrate the prevalence of chemical restraint in nursing homes.

Chemical restraint in nursing homes takes the form of the use of sedation to control the behaviour of residents, particularly those with dementia.

Existing evidence shows limited to no benefit for residents. In fact, the drugs often have adverse effects, including deaths, stroke and heart problems and are linked to increased rates of pneumonia, falls and seizures.

According to experts and peak clinical guidelines, these types of drugs should only be prescribed to people with dementia in exceptional circumstances and after psychological, or person-centred, approaches have failed.

The study found that these drugs are being used to manage even common behaviours such as wandering, agitation and calling out.

A key question is, if such high rates of chemical restraint are occurring because staff cannot manage behaviours effectively due to a lack of staff numbers or an inappropriate staff skill mix.

Mandated staff to resident ratios would help ensure that chemical restraint in nursing homes is only ever used as a last resort.