title: Substitute consent for nursing home residents prescribed psychotropic medication.
abstract: 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.
authors.affiliation: Mental Health Department, The Sutherland Hospital, Caringbah, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Rendina
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.forename: Carmelle
authors.initials: C
authors.lastname: Peisah
authors.forename: Esteve
authors.initials: E
authors.lastname: Brugue
mesh_terms: 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
chemical_list: D055553:Prescription Drugs; D011619:Psychotropic Drugs