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Become your own expert

Judith Covell – OPAN National Older Persons Reference Group Member

Almost half of the people currently on antipsychotic medication in residential aged care have not been diagnosed with psychosis.* 

‘There is absolutely a place for psychotropic medications, such as antidepressants and antipsychotics, in the treatment of someone who has a diagnosed mental health condition,’ says OPAN National Older Persons Reference Group member Judith Covell, who worked in mental health for 15 years.  

‘But these medications are being overused – or misused – for people living with dementia. There is little evidence they are effective in managing behaviours of concern. And if they are used to control or sedate an older person, this amounts to a restrictive practice.’ 

Ms Covell cared for her husband, who lived with dementia, at home for 8 years. She was one of 4 panellists on OPAN’s recent webinar: Medication: it’s your choice update

The best way to reduce the inappropriate use of antipsychotic medication, the expert panellists agreed, was behaviour support for older people and adequate training for aged care staff. 

Risks versus benefits 

Regular medication reviews also played an important role, they said. As did rigorous processes around informed consent – older people and their families need to know exactly what they are signing up for, the risks and benefits involved, as well as non-pharmacological alternatives.  

‘You get better outcomes if you involve people in their own care,’ Ms Covell says. 

‘Informing people about their medication and what it’s for enables them to partner with clinicians in managing their conditions.’ 

Her advice to older people and their families or other representatives? 

‘Start practicing now! 
‘Become your own expert: ask questions about your medical condition(s) and the medications you are being prescribed – find out what they are for and possible side effects.’ 

Use your pharmacist 

‘Be persistent: if you are uncertain about the medication you have been prescribed, book another appointment. Don’t have your prescription filled until you are sure the medication is right for you. 

‘Another good option is to use your pharmacist; they can provide a full medication review.  

‘And while some of the discussions might be difficult, talk to your family about what’s happening to your body, what sort of treatment you’re under.’ 

*Australian Institute of Health and Welfare Residential Aged Care quality indicators quarterly report July to September 2023.

Helpful resources 

Read and download our Medication checklist: 6 questions to ask your clinician for a list of questions that will enable you to make an informed decision about the medication you are being prescribed. Explore more resources on our Self-advocacy toolkit.

The Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard: view here.