Many pharmacists feel underprepared for navigating medicines management in people with dementia. AP explores where the knowledge gaps lie and how to close them during Dementia Action Week 2026 (21–27 September).
Dementia is one of Australia’s leading causes of death and disability. People living with dementia are vulnerable to medicine-related harm including delirium, falls, adverse drug interactions and cognitive impairment.
Pharmacists play an essential role in identifying high-risk medicines, weighing the benefits and limitations of treatments for behavioural and psychological symptoms, and supporting safe deprescribing across various settings.
This spans community pharmacies, hospitals and residential aged care facilities – each with varying levels of support.
‘Medication management in people living with dementia is quite complex,’ PSA Dementia Support Pharmacist Dee-Anne Hull MPS told AP.
‘So often there’s levels of multi-morbidity and polypharmacy which can make things a bit trickier to navigate, and unpacking that takes time.’
Building confidence through education
Many pharmacists feel they lack confidence in their knowledge and abilities when it comes to navigating medication management in dementia care, given the range of care settings, support options, medicines, risk factors and treatments involved.
A key concern is a limited understanding of what dementia is and how it affects the body.
‘A lot of people think dementia is just about memory, but it actually affects all of your body in different shapes and forms,’ Ms Hull said.
Hull wants to address this gap with education: ‘It’s important to unpack what is actually happening in the brain, what dementia looks like, the different lobes that are affected by dementia – and how that can affect symptom presentation.’
Then there is the aspect of reducing dementia risk before the condition takes hold.
‘Not all cases are genetic; up to 45% of dementia cases could be prevented through changing risk factors,’ Ms Hull said. ‘So there are different ways to help people to decrease their risk in different pharmacy settings.’
Risk management and tools for pharmacists
Pharmacists need practical tools to help assess and identify risk, monitor situations appropriately, and apply people-centred strategies for deprescribing.
Ms Hull said that starts with knowing which medicines are high-risk.
‘There’s a range of medicines that we know as pharmacists are high risk, but then there are others medicines that might be considered more high risk for someone living with dementia because of those changes to the brain,’ Ms Hull said.
Tools like calculators and reference lists can support medicine and risk decisions, but Ms Hull believes pharmacists need enough underlying knowledge to manage dementia medicines effectively.
This includes when liaison with a care team is required to determine the best care option.
‘Some people who are living with dementia might be non-verbal, so they’re no longer able to communicate. That means that you’re involving other people in their care team to help communicate on their behalf,’ she said.
Ms Hull said the challenge often lies in weighing a patient’s advance care directive against what their substitute decision-maker believes they want.
‘And making sure all those goals co-align,’ she added.
Deprescribing is also key
People living with dementia may need to be taken off certain medicines if they are no longer deemed necessary, don’t contribute to their quality of life or are causing harm.
Ms Hull told AP about one patient who was slowly deprescribed from a medicine, and whose outcomes improved as a result.
‘She had sworn that she had dementia and was waiting to see the geriatrician. Her cognition had been deteriorating over months,’ Ms Hull said.
‘Throughout the medication review we identified a couple of potentially inappropriate medicines, worked through the process and over time withdrew one of the medicines that we were particularly worried about – and at the next visit we had with her she didn’t need to see the geriatrician anymore. All that brain fog and confusion was actually one of her medicines all along.’
Where can I find out more about dementia care?
The PSA Foundation has partnered with Dementia Australia to offer an accredited educational webinar for pharmacists to help them identify high-risk medicines, evaluate the benefits and limitations of pharmacological treatments for behavioural and psychological symptoms of dementia, and support safe deprescribing across different care settings.
Register to attend the PSA webinar It’s time to talk about Dementia: Improving outcomes, held on Wednesday 23 September from 7.00-9.00 pm AEST.
