Relatives’ perspectives on the use of chemical restraint for persons with dementia in residential aged care

With an ageing population, the incidence of dementia is increasing and many people with dementia become residents in aged care facilities. A person with dementia may be unable to express their needs resulting in behaviours that can lead to the unnecessary use of psychotropic medications. It is important family members are enabled to participate in decision making around care and treatments. This study aimed to explore relatives’ experiences and knowledge of behavioural and psychological symptoms of dementia (BPSD) and associated antipsychotic medication use for persons with dementia in residential aged care. A qualitative thematic analysis design was used with semi-structured interviews of six relatives of persons with dementia in residential aged care from South Australia, Victoria and Western Australia. Three major themes were identified, namely: a lack of education and information for both relatives and staff about dementia and the use of antipsychotic medication; the need for relatives to be included in any decision making in antipsychotic use; and finally, relatives expressed experiences of an aged care culture that encouraged the use of antipsychotic medication over person-centred care. To ‘be the change’, relatives need to be involved in decision-making regarding the use of antipsychotic medication and require support and education about the progression of dementia, behaviours and the risks and benefits of antipsychotic medication use. Furthermore, the education of care staff to use a person centred approach inclusive of family members may result in more appropriate care for the person with dementia and reduce the need for chemical alternatives.