Resident-Centred Dementia Care Expanding Throughout New Brunswick Nursing Homes

by Nadine Morris | May 23, 2017

Early Results Show Inappropriate Antipsychotic Use Cut by Nearly Half

Moncton, New Brunswick – May 23, 2017 – Today the Canadian Foundation for Healthcare Improvement and the New Brunswick Association of Nursing Homes announced they are delivering on the provincial scale up of a collaboration that has significantly reduced the inappropriate use of antipsychotic medication in New Brunswick, improving quality of life for residents.

Forty-three nursing home organizations across New Brunswick are joining the second phase of a province-wide effort that began in 2016 with 15 homes adopting resident-centred, non-medication approaches to manage the challenging behaviours associated with dementia. This collaboration is supported by $600,000 in funding from the Government of New Brunswick.

In their first year, the 15 homes participating in the New Brunswick Appropriate Use of Antipsychotics Collaborative have identified 272 residents on antipsychotics without a diagnosis of psychosis – roughly 15 percent of all residents inappropriately prescribed these medications in the province. Of the 204 residents still participating at the nine-month mark, 43 percent had their antipsychotics safely reduced or discontinued, and among these residents:

  • Falls have decreased by 6 percent
  • Social engagement, wakefulness and the ability to self-manage care have significantly improved
  • Aggressive behaviours and use of other psychotropic medications have not increased

Based on drug spending data, New Brunswick has among the highest provincial rates of antipsychotic use in the elderly. In 2013, the rate of antipsychotic medication use was nearly twice as high in New Brunswick as the rest of Canada. These high rates suggest that antipsychotics are being used inappropriately. The situation in New Brunswick is exacerbated by the rate at which the province’s population is aging. It is forecast that by 2020, the New Brunswick population will be five years older than the national average.

A national report has shown that programs to promote the appropriate use of antipsychotics in New Brunswick nursing homes could prevent 600,000 prescriptions in the next five years, preventing falls and hospital visits. This would save the province $4 million in direct healthcare costs over the next five years, increasing to an average of $4 million in annual savings over the next 30 years.

The New Brunswick Appropriate Use of Antipsychotics Collaborative scales up the results achieved through CFHI’s pan-Canadian Reducing Antipsychotic Medication Use in Long Term Care collaborative that concluded in October 2015. CFHI is providing tailored learning and coaching to help teams of healthcare providers – including nurses, personal care workers, physicians and pharmacists – and administrators at participating nursing homes use data to identify patients who may benefit from non-drug therapies to treat behavioural issues related to dementia. Armed with better information about each resident, front-line staff are customizing services to support not only quality of care, but also quality of life for residents. The approach involves front-line staff and clinicians working together with families to provide personalized care, such as music and recreation therapy, to replace antipsychotic drugs and improve the quality of life of residents.

Nationwide, one in four residents of long term care is taking antipsychotic medication without a diagnosis of psychosis. Non-medication interventions, such as patient-centred approaches, are often more effective than drug treatments in managing the behavioural and psychological symptoms of dementia and addressing challenging behaviours.

For more information about this work:

Backgrounder – Participating Nursing Homes

Video

Quotes

“The inappropriate use of antipsychotic medications can pose serious health risks for seniors.  By supporting better prescribing, we can provide our seniors with better care, support our families and caregivers, and reduce costs for our healthcare system.”
The Honourable Jane Philpott, Minister of Health

"The government of New Brunswick provided $600,000 in funding to the program and to see it expanding is really exciting. It’s an important example of resident-centred care, rather than one size fits all.  Reducing antipsychotic medication in nursing homes has had a dramatic, positive effect on seniors with dementia, their families and their nursing home caregivers. Fostering healthy aging and support for seniors is one of the pillars of the New Brunswick Family Plan and we can point to this collaboration as an initiative that improves seniors’ wellbeing. Thanks to the New Brunswick Aging Strategy - and other important tools – the aging experience for everyone will be better."
The Honourable Lisa Harris, Minister of Seniors and Long-Term Care

“We have seen a real improvement in my mother in law Velma thanks to this initiative that has weaned her off antipsychotics. We thought that dementia that was taking her, but it was not – the medications just were not right for her. I encourage all Canadians to ask healthcare providers about the benefits and harms of medications prescribed to their older loved ones.”
Daphne Stafford, daughter-in-law of resident of Pine Grove Nursing Home, Fredericton

“Scaling proven innovations like the appropriate use of antipsychotic medications is key to improving healthcare for Canadians. Not only is this better, safer care for people with dementia, every resident enrolled in the program saves the province $1619 in direct healthcare costs each year thanks mainly to fewer falls.”
Maureen O’Neil, O.C., CFHI President

“It means so much to everyone involved to see residents becoming more socially engaged – in particular with their families – and reclaiming some independence, such as feeding themselves and having improved mobility. Our nursing home staff are also telling us that this initiative has created a better work culture and given them the tools they need to lead improvements in partnership with residents and their families.”
Jodi Hall, Executive Director, New Brunswick Association of Nursing Homes

About CFHI
The Canadian Foundation for Healthcare Improvement identifies proven innovations and accelerates their spread across Canada, improving patient care, the health of Canadians and value-for-money. CFHI is a not-for-profit organization funded by Health Canada. Visit cfhi-fcass.ca for more information.

The views expressed herein do not necessarily represent the views of Health Canada

About NBANH
Leading excellence in long term care, the mission of the New Brunswick Association of Nursing Homes is to lead member homes through a united voice by advocating excellence in long term care and service delivery in New Brunswick.

To arrange media interviews, please contact:

Tamir Virani
Communications and Stakeholder Relations Officer
Canadian Foundation for Healthcare Improvement
Tamir.Virani@cfhi-fcass.ca
T: 613-728-2238 (232)
C:613-410-2617