Stricter requirements for prescribing antipsychotic drugs to aged care residents are needed, a royal commission has been told.

Recent changes by the federal government to address problems around the use of chemical restraints don’t go far enough, counsel assisting Peter Gray says.

The commission has previously identified widespread use of medications in aged care homes to deal with challenging behaviours of residents.

Following the inquiry’s interim report last October, the Commonwealth announced a tightening of prescribing criteria for antipsychotic drug risperidone.

“These measures are commendable but in our submission, they don’t go far enough to a problem that’s persisted now for decades,” Mr Gray said on Friday.

He said prescribing criteria should be even stricter.

“The system should never again be involved in … this apparent resort to antipsychotics in place of proper care of the people showing so-called challenging behaviours,” he said.

Lawyers assisting the inquiry have made 124 recommendations for reform as part of their two-day closing submissions.

They’ll be considered by commissioners ahead of their final report to be delivered in February.

Mr Gray implored the federal government to keep to its 2019 promise of having all people under 65 out of aged care by 2025.

In June, there were 4860 people under the age of 65 living in aged homes nationally.

“The government have delivered some encouraging early signs but … there have been false dawns before,” he said.

Mr Gray said the COVID-19 pandemic had revealed telehealth services had previously been underutilised by aged care providers.

“It’s a means of avoiding potential harm and distress caused by travel for frail, older people,” he said.

“At present telehealth’s underused by specialists and aged care providers and greater uptake needs to be incentivised.”

The sector needs to come out of the “dark ages” and adopt more digital technology for better record keeping, Mr Gray said.

He also recommended providers submit more frequent financial reports to the regulator in light of many rural and regional facilities struggling with their bottom line.

The inquiry heard on Thursday a suite of reforms were needed to ensure high quality care including mandatory staff ratios and new laws to protect the rights of elderly people.