Reducing antipsychotics helps improve lives of seniors in care: study
Published Monday, May 16, 2016 9:44AM EDT
Last Updated Monday, May 16, 2016 9:48AM EDT
More than a quarter of Canadian seniors in long-term care facilities are taking antipsychotic medications unnecessarily, in a bid to control aggressive behaviour. But now, a new report suggests there may be better and safer ways of helping these seniors.
The Canadian Foundation for Healthcare Improvement, a non-profit group that works with health-care providers to improve the system, has released results from a program it launched in 2014.
The program’s aim was to challenge nursing homes and other long-term care facilities to try out some alternative therapies to medications. And the results were surprisingly good.
More than half the seniors on antipsychotics inappropriately were able to end their use of the drugs or see their dosages significantly reduced.
CFHI’s senior director, Kaye Phillips, says about 62 per cent of seniors in long-term care have dementia, a condition that creates behaviours that staff at these facilities sometimes have trouble managing.
“Often what comes with dementia, you will see confusion, resistance to care, aggressive or disruptive behaviours,” Phillips told CTV‘s Canada AM.
To try to calm these behaviours, many seniors are prescribed antipsychotics, even if they aren’t actually suffering from psychosis.
In fact, research has shown that 27.5 per cent of seniors in long-term care facilities are taking antipsychotics without a psychosis diagnosis.
These medications are not only costly, they come with a host of potential side effects, including extreme sleepiness, dizziness, and low blood pressure upon standing, which can lead to fainting or falls.
To find alternatives to these medications, the CFHI worked with 56 long-term care homes in six Canadian provinces and territories to see which seniors could be tapered off the drugs.
They then brought in alternative, non-pharmacological therapies for the residents to prevent and better manage challenging behaviours.
The residents’ families met with the facility’s nurses, physicians and personal support workers, Phillips said, “to help identify some of the reasons why they might be experiencing some of the challenging behaviours.”
They looked at which of the residents’ social, intellectual and cultural needs were not being met and engaged them in new activities.
“So we brought on new recreational therapies – pet therapy, music therapy, gardening – trying to get people back into the simple aspects of life that bring that sparkle back into their eye,” Phillips said.
During that time, the residents were taken off the drugs or saw their dosages reduced.
“And we’ve have nothing but fantastic results,” she said.
A total of 54 per cent of the residents having their antipsychotic prescriptions changed -- including 18 per cent who saw their dosages reduced, and 36 per cent who stopped the drugs altogether.
Instead of there being an increase in aggressive behaviour, there was a notable decrease. Verbally abusive behaviour decreased by 33 per cent; resistance to care incidents decreased by 22 per cent; while falls decreased by 20 per cent.
“And not only that, we heard from families that they got their loved ones back,” Phillips said. “That’s what it’s all about.”
The CFHI says, if all Canadian long-term care facility residents were given more psychological and social supports, there could be 25 million antipsychotic prescriptions avoided over the next five years, 91,000 fewer falls, and 19,000 fewer ER visits
The group is now calling on long-term care homes and provincial and territorial governments to step up efforts to change the culture of over-medicating seniors with dementia, and increase access to these alternate programs.