A geriatric expert has told the royal commission nursing homes are ‘reaching for the script pads too early’

A geriatric expert has warned nursing homes are “reaching for the script pads too early”, prescribing sedatives and anti-depressants to elderly people and putting them at greater risk of death, stroke, disability and pneumonia.

Geriatrician Edward Strivens said the drugs were useful in about 10% of cases. But up to 80% of dementia patients are taking some form of psychotropic drug.

“The side effects will often outweigh the possible benefits,” Strivens told the aged care royal commission hearing in Adelaide on Wednesday.

He said the drugs are a last resort but too often they were used as a first resort and the medication should never be a substitute for good quality care.

“When all you have is a hammer, every problem looks like a nail,” he said.

Strivens said nursing homes should be guided by the mantra: “start low, go slow and review regularly”.

“It’s about using the smallest possible dose for the briefest possible time and making sure it works,” he said.

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In some cases people ended up on a cocktail of drugs because they are prescribed medications to counter the side effects of other pills.

“Before you know it you’ve got half a dozen different medications,” Strivens said.

He said when grappling with residents’ agitated behaviour, nursing homes should consider underlying causes and the life stories of residents. The disruption of daily routines that happens when entering a residential facility can be a major source of agitation.

He gave the example of “old bushies” in far north Queensland who were used to getting up early, including one patient he saw who had worked as a baker and would wake up at 2am everyday – a routine that was difficult to maintain in an aged care facility.

Meanwhile, the federal government has been accused of playing games with accountability for the national queue for home care packages.

The waiting list ballooned to 127,000 people last year and the commission has been told supply is not keeping up with demand.

The federal health department gave the aged care minister, Ken Wyatt, a fourth quarter data report on 10 September last year, but the government chose to release the information publicly until 28 September, on the eve of the AFL grand final.

Third quarter data was on Wyatt’s desk on 23 July last year but didn’t enter the public domain until 17 August, well after the Super Saturday by-elections held on July 28.

According to a late health department answer to an outstanding Senate estimates question released overnight, second quarter data was submitted 26 February and made public eight days later.

The department’s answer said it aimed to finalise the data report eight weeks after the end of the quarter and the timing of publication was a “matter for government”.

Labor’s aged care spokeswoman, Julie Collins, seized on the delays in releasing the data and said the government can not be trusted to fix the problem.

“This revelation clearly shows the Liberal government cared more about avoiding bad headlines than being honest with older Australians,” she told Guardian Australia.

“The least the Liberal government can do for the older Australians waiting on this list is be transparent about … wait times for home care packages.”

Older Persons Advocacy Network spokesman, Craig Gear, told the commission on Tuesday people are waiting for 18 to 24 months for home care packages and that was unacceptable. Wait times should be three months maximum, he said.

He said people were reluctant to take interim packages.

“There’s some concerns about, ‘If I take this package now, I will be stuck and this is all I will receive,’” Gear said.

The government announced a $662m funding increase on Sunday which will cover an extra 10,000 older people for subsidised care in their homes as well as a boost to residential care.