Sounds like a lot like a plot for a movie based on a true story based on an older movie based on a true story.
Maybe someone’s been watching “Awakenings” and getting ideas.
Whilst care in Ontario care homes increasingly looks like more and more like a “model of care ” wholly reliant on drugging seniors into stupor and submission, in Alberta drug reduction is more the order of the day – and with the results that elderly residents are “waking up”.
We call them “anti-psychotics” not based in any science science but in market research – their proper name is “neuroleptic” which means “nerve seizing”. They are part of a larger family of drugs called “major tranquilizers”, the first used in psychiatry were actually manufactured as horse tranquilisers. The newer ones are different but have similar effect on a large mammal like a human.
No wonder folks in care homes who take less of them are waking up.
Maybe it’s time we all woke up, eh?
A couple of years after a national initiative began to reduce the use of anti-psychotic medication, some people are saying the move has had an even more positive effect in Alberta than first expected.
The national initiative to reduce antipsychotic medication use in long-term care facilities began in 2014. At that time, about 30% of long-term care residents in Canada were on the drugs, with an average of 27% in Alberta.
Two years later, the national average has dropped to about 27%. And Alberta has the lowest rate in Canada with an 18% average. (Calgary averages 16%, Edmonton 15%.)
Antipsychotics (most commonly Quetiapine and Risperidone) are often prescribed when patients with dementia become agitated or aggressive, to keep them from hurting themselves or others. In an exclusive interview with Global News, Dr. Duncan Robertson, Medical Director of the Seniors Health Strategic Clinical Network, suggested the prescriptions are appropriate for short-term safety. But many patients stay on the drugs for decades, with potentially harmful side effects.
“[Side effects include] increased risk of stroke, or falling, and of actually creating more confusion in the individuals,” said Robertson, “And sedation. So [patients] can’t engage in normal activities.”
Removing the drugs for 900 residents has meant a culture change for all 170 long-term care facilities run by Alberta Health Services. Staff, including physicians, nurses, nursing aides and pharmacists, attended workshops to learn how to deal with dementia behaviours, without resorting to drugs.
At Extendicare Holyrood in Edmonton, staff pay more attention to basic needs: Does the patient need to go to the washroom? Are they hungry? Tired? In pain?
“Lots of teams said, ‘We didn’t realize how much pain [patients] might have been in, and so they were acting out, or having these responsive behaviours’,” said Mollie Cole, Manager of the Seniors Health SCN. “So when we took down the antipsychotics and gave them more Tylenol… their behaviours are way calmer.”
Other calming techniques included music therapy, exercise, afternoon naps and evening baths.
91-year-old Louis Derkach couldn’t walk, talk or even feed himself two years ago. About a month after he was taken off Quetiapine, the Holyrood resident started doing all three things again.
“That’s a long, long way from when he came in here, and it’s awesome to see,” said his daughter, Carol de Jong, as Derkach chats about what he wants for lunch.
“We can talk with him. We can visit. He has lots to tell us.”
Derkach was prescribed the antipsychotic after becoming aggressive in a hospital a number of years ago, when a nurse tried to change his shirt. Now Holyrood staff let him stay in pyjamas if he chooses, and don’t move him until he wants to move.
The unofficial motto, according to Cole: “If you don’t insist, they won’t resist.” And in her twenty years as a registered nurse, this project has been the most rewarding.
“It is the most exciting thing I’ve worked on,” said Cole with a smile. “[Patients] started waking up.”
“‘They’re waking up!’ is what we hear all over the province.”
© Shaw Media, 2016