Resident Stories

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Son Has Peace of Mind After Mom Taken Off Antipsychotic Meds

Five years ago, Barbara L. lived on her own in Kitchener, Ont., as she had for 25 years since her husband died. Raised on a farm in Croatia, she worked hard after arriving in Canada in 1971, taking a job on the line for a shoe manufacturer. At 90, she remained a social woman with many friends. Her son, Joseph, visited daily, and drove her to church Sundays. “That was very important to her,” he says.

Then she had a heart attack and stroke. Doctors said she had days to live. Instead, she was transferred to Trinity Village Care Centre, where she has been since.

Barbara's Story

Barbara’s memory faded and she began having anxiety, calling out at night. She was put on antipsychotic medication, but her behaviour didn’t improve. In the last year, however, Joseph noticed a difference. “She’s calm much more than before,” he says.

What changed? Barbara, now 95, is off antipsychotics. Trinity Village is among 56 long term care facilities to participate in a collaborative project from the Canadian Foundation for Healthcare Improvement (CFHI). The goal is to reduce or eliminate unnecessary uses of antipsychotic medication.

At one time, Barbara never took anything stronger than Aspirin. Studies show that 27.5% seniors in Canadian long term care are on antipsychotics without a diagnosis of psychosis. These drugs can lead to serious side effects, falls and hospitalizations. Often, the use of antipsychotics can mask other issues.

That was true with Barbara. “Staff felt there was more of a pain issue,” says Sharon Jackson, project lead at Trinity Village. “We tried meds to control her pain, and that was successful, so we were able to wean her off the antipsychotics.”

Before the CFHI project started, 3 in 10 Trinity Village residents were on antipsychotics without a diagnosis of psychosis. That’s down to 11-13%.

Where the antipsychotics has no value, that means one less medication. Even better, says Sharon, are cases where residents seem to “wake up” when antipsychotics are decreased. She describes one whose depression rating scale went from 11 to 3. Another who hadn’t said a word in ages suddenly spoke again.

Trinity Village has taken several steps to improve quality of life for residents. One is just to alter their approach – show more patience and simplify, e.g. don’t ask residents too many questions in a row, or ask them too quickly.

The care centre also launched programs to reduce feelings of loneliness, helplessness and boredom. Residents eat in smaller groups, so dining is more social. Through art projects, residents make more decisions. In yet another project, staff assembled music playlists for personal iPods, from AC/DC to It’s a Long Way to Tiperrary. Music that’s meaningful to residents boosts their mood – like “instant therapy”, says Sharon.

With the reduction in antipsychotic medication and other supportive strategies, Sharon says staff and residents have better connections. Families note how much “brighter” their loved ones are (“more alert, more awake”).

Joseph has more peace of mind when he thinks of his mother at Trinity Village. “I feel good about that, that they’re taking care of her very well.”