Drugs should be 'last resort' in long-term care, says long-term care leader
Saskatoon care centre looks to evaluate patients' physical and social influences
A new report by the Canadian Institute for Health Information says 39 per cent of residents in long-term care facilities were prescribed an antipsychotic drug at least once in 2014 to treat dementia. This is despite known health risks, says Kim Schmidt, leader of resident care services at Saskatoon's Sherbrooke Community Centre.
Do they feel we are forcing them to do things that they don't want to do?- Kim Schmidt
The new study makes the practices of Sherbrooke Community Centre all the more apparent: the long-term care facility started cutting its usage of antipsychotics 10 years ago, because of the associated health risks, and it found other creative ways to change behaviours of residents who live with dementia.
Of the 39 per cent, Schmidt said she doesn't "find it surprising at all. I think the use of drugs has been the go-to standard or method for handling behaviours for patients that are difficult for care partners."
We need to look deeper. What are the unmet needs for the person?- Kim Schmidt
"Now we're learning ways and we're doing things to change the way we operate as a care partners. [We're] seeing drugs as a last resort." She said she thinks that as more facilities adopt a similar approach, the number of prescribed antipsychotics will go down.
She noted that "about 10 years ago or even more, studies started coming out about the negative affects of these drugs physically for people," which include increased falling risks and increased confusion. "And we realized we need to do something different."
Schmidt was CBC's Saskatoon Morning to talk about alternatives to antipsychotic use.
Of the changes her care centre made, Schmidt pointed to making education packages for staff, and not viewing dementia "as a terrible, terrible disease that we need to medicate."
She also gave an example of how her staff deal with a patient who's acting aggressively.
"We need to look deeper. What are the unmet needs for the person? ... We need to look at all the physical things that could be causing distress for the resident, all of the environmental things. Is the environment confusing? Is there too much stimulation?" she explained.
Schmidt described this as a more flexible approach, where care providers also look at a patient's "social aspects. So, are people lonely, helpless and bored? We need to look at emotional aspects, like do people feel that their self esteem is effected? And often they do. Do they feel we are forcing them to do things that they don't want to do?"
"We need to look deeper beneath the surface," she said.