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 38

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