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This is the second of a two-part series. Read the first part here.

After two years of at times excruciating evidence of systemic abuse inside the nation's aged care homes the royal commission into aged care this morning handed its final report to the governor-general, having already flagged the need for sweeping change. Countering the widespread practice of chemical restraint is likely high on the commission's priorities.

But real change will mean attacking a culture built on a decades-long reliance on antipsychotic medications which have been used to manage the symptoms of dementia. It would also mean attacking the commercial interests of the pharmaceutical and aged care industries.