Substitute consent for nursing home residents prescribed psychotropic medication.
BACKGROUND
Prescribing psychotropic medications for persons with dementia who lack capacity to give informed consent requires proxy consent under NSW Guardianship legislation.


OBJECTIVE
To survey current practice in complying with legislation and regulations in prescribing psychotropic medications for nursing home residents.


METHODS
In three Sydney nursing homes, the files of 77 residents identified as having dementia, being on a psychotropic medication and not having capacity to give informed consent, were audited.


RESULTS
In only 6.5% of cases were all regulations adhered to; a further 6.5% attempted and partially completed substitute consent requirements. The problem and the nature of the treatment were documented in 70.1% of cases. In 16.9% of files the only documentation of the prescribed medication was in the medication chart. Doses of medications prescribed were within accepted guidelines.


CONCLUSIONS
Current regulations and legislation are not being observed. Recommendations are made as to how to make them more practicable.
Rendina
Nicola
N
Mental Health Department, The Sutherland Hospital, Caringbah, Australia.
Brodaty
Henry
H
Draper
Brian
B
Peisah
Carmelle
C
Brugue
Esteve
E
D000369:Aged, 80 and over; D001315:Australia; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D008297:Male; D008485:Medical Audit; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D009735:Nursing Homes; D055553:Prescription Drugs / Q000008:administration & dosage; D019727:Proxy / Q000331:legislation & jurisprudence*; D011619:Psychotropic Drugs / Q000008:administration & dosage
D055553:Prescription Drugs; D011619:Psychotropic Drugs