persons with dementia are essential in order to avoid measures that restrict freedom.
Residents’ individual risk of falling must be recorded not only when they enter a facility but
on a regular basis, particularly if the condition of their health or their medication change.
Fall incidents must be carefully analysed, centrally documented and evaluated.
2.1.2.3.
Drug safety (Medication-based restrictions of freedom)
Last year, the NPM targeted the sometimes uncritical use of sedating
medication (see NPM Report 2014, pp. 33 et seq.). Polypharmacy, but
also prescribing medications that can be potentially harmful for the
elderly and medication-based restrictions of freedom without
examining alternatives, are failures that must be faced. At a press
conference, at which the Annual Report 2014 was presented to the
public, this topic and others were the focus of attention.
In subsequent emails and telephone calls, the NPM was explicitly
requested by relatives, legal guardians, doctors, as well as
professional nursing staff to continue to address this topic. On the
other side, there was some sharp criticism. The NPM was accused by
the Austrian Economic Chambers (Wirtschaftskammer Österreich) and
by professional health care associations of disparaging nursing staff,
in particular, even though prescribing such medication is done by
doctors. Among other things, it was explicitly said that homes are
responsible only for care but not for the medical treatment of
residents. The Federal Association of Austrian Residential Care Homes
for the Elderly (Bundesverband der Alten- und Pflegeheime
Österreichs) even stated in a press release that employees in
retirement and nursing homes have to live and work with the existing
framework conditions and cannot be made responsible for the results
that can be achieved with these conditions. They stated that it is up to
society and the political arena to provide more resources, because
improvements in staff structures (presence/qualification) have to be
reflected in the payments.
NPM reaps both
approval and criticism
It must again be clearly said that neither the NPM nor the
ombudspersons wish to lay the blame for the criticised conditions at
the feet of individual actors. This cannot create any progress in
connection with a topic where the focus is and must be on the wellbeing of residents. It is revealing that advocacy groups have a high
level of sensitivity with regard to this subject, but they place the
responsibility for it outside of those areas where they themselves can
intervene. In organisational sociology the term “diffusion of
responsibility” refers to the phenomenon that a task, which must be
undertaken, is not accepted or carried out by the bodies or persons
suitable for this task, even though there is an adequate number of
persons and the necessary awareness. Many seniors in nursing
homes are impacted by multi-morbidity; in other words, they suffer
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