The Royal Commission into Aged Care Quality and Safety interim report describes Australia’s aged care system as “cruel and harmful”, saying too many doctors are using psychotropic medications as chemical restraints.

There has been heated debate in the Australian Doctor comments section, with geriatric psychiatrist Associate Professor Stephen Macfarlane saying too many doctors seem to have “great faith” in antipsychotics preventing residents wandering around at serious risk to themselves.

We speak to Professor Macfarlane, chair of RANZCP’s faculty of psychiatry of old age, about the real-world options for doctors and nurses who are too often denied the staffing to provide the care the outside world now demands.

No-one is condoning inappropriate prescribing. But the fact is doctors and particularly the staff in aged care often lack the resources and supports for managing these patients in the ways being suggested. What are the options in the real world when the system is failing?