National Preventive Mechanism If unsuitable or too many medications are given concurrently and are perhaps overdosed as well, this can result in serious behavioural problems and ailments. Interactions of psychopharmacological medications are difficult to assess and high doses of some drugs can build up in the body as they are not metabolised and eliminated fast enough by the elderly. The possibilities for treatment with drugs are multi-facetted and include not only the timely use of a suitable drug, but frequently stopping use or gradually reducing the dose of unsuitable or no longer necessary drugs. Regular control of the list of medications with regard to necessity, interactions, side effects, etc. should be a matter of course. Individual needs and the respective situation of so-called “difficult patients” require a great deal of attention and sensitivity. The commissions have uncovered cases where drugs were prescribed in the case of “restlessness” without a traceable diagnosis. In almost all of the incidents monitored in detail, the documentation in the nursing homes did not contain any indication whatsoever of a medical briefing or explanation or the patient’s consent. In many cases, the staff did not even realise that giving sedatives with the purpose of tranquilising or immobilising the person affected could be a measure depriving them of their liberty, that there were drugs with fewer side effects, etc. Accordingly, there were also no reports made to the residents’ representatives. Ministry and Austrian Medical Association take measures Therefore, the NPM appealed to both the Federal Ministry of Health and the Austrian Medical Chamber in 2014. The Federal Ministry of Health intends to ask the Austrian Medical Chamber to include these topics in continuing education programmes for doctors. Additionally, this should become a focus in continuing education for public health officers. The Austrian Medical Chamber has made detailed remarks regarding this problem area and promised to re-examine the current continuing education programmes. The NPM welcomes these measures; however, it sees an even more urgent need for action and research beyond this, in order to ensure state-of-theart treatment with drugs in nursing homes, but also in the care of the very elderly at home. ¾¾ Deficits in obtaining informed consent and in the prescription of drugs. ¾¾ Restrictions of freedom by way of drugs are not recognised. ¾¾ More specific education of doctors with regard to treatment of elderly patients with drugs is necessary. ¾¾ Research is needed with regard to drug safety for the very elderly both in and outside of stationary long-term care. 84