New Brunswick senior living with dementia rediscovers life’s little pleasures

A quiet revolution is gently sweeping through nursing homes in northeastern New Brunswick, and Adelbert Bertin, age 94, couldn’t be happier about it. A resident of Manoir Edith B. Pinet in Paquetville, “Bébert,”as he’s affectionately nicknamed, has been given a new lease on life, thanks to the New Brunswick Appropriate Use of Antipsychotics (NB-AUA) collaborative, aimed at reducing the inappropriate use of antipsychotics to treat symptoms related to dementia.  
 
A native of Saint-Léolin on the Acadian Peninsula, Mr. Bertin spent his entire working life as a manual labourer—first as a lumberjack, then as a heavy equipment operator—while raising three children with his wife, Amélia. As age began to take its toll, however, illness and the beginnings of dementia slowly set in.

“Dad was admitted to Edith Pinet in December 2016, after spending more than two months in hospital in Caraquet. He was suffering from multiple age-related problems, including diabetes and dementia,” recalls his daughter, Georgette Bertin, his caregiver and a nurse by training. “When he arrived at the Manoir, he was quite aggressive, which made for a difficult transition. The staff had to medicate him with several different antipsychotics just to be able to provide him with basic care.” 

Throughout it all, Georgette never left her father’s side. While she understands the reason for giving him the drugs, it was the sedative effects of the antipsychotics, which made her father lethargic and listless, that really upset her. “He started experiencing confusion, hallucinations, urinary and kidney problems, difficulty eating—he was deteriorating right in front of our eyes,” admits Georgette. “At one point, we feared the worst.” 

As it turns out, Mr. Bertin was the perfect candidate for the New Brunswick Appropriate Use of Antipsychotics (NB-AUA) collaborative. In February 2018, he was gradually weaned off all his antipsychotics according to a strict protocol, except for two, which were kept on file for use “as needed.” The staff completely switched gears, focusing on person-centred techniques, music therapy, and other non-pharmacological approaches. The changes in Mr. Bertin were almost immediate. 

“What a difference! He’s able to feed himself now, he’s better at recognizing the people around him, and he participates in the activities—sometimes he’ll even play the spoons when there’s music!” Georgette boasts. “He gets around in his wheelchair and makes jokes. Of course, the dementia hasn’t gone away, but the deprescribing [of antispychotics] has completely changed his life, not to mention the lives of his caregivers and family members.” 

“Dad seems to be enjoying life more. He’s able to do simple puzzles and keep himself busy playing cards,” Georgette continues. 
 
Sylvie Basque, Director of Care at Manoir Edith B. Pinet, remarked on the changes: “Mr. Bertin really benefited from getting off the antipsychotics in favour of an approach that’s more focused on his safety and comfort. It truly was a remarkable transformation. He’s much more pleasant now and gets along much better with the staff and the other residents. And that’s very gratifying to see.” 

“The collaborative project had good results in his case, but we’re going to keep an eye on things,” Ms. Basque continues. “We have thirty residents, and we reassess their medications every three months to see if any changes are needed. The nursing staff and attendants are also trained to deal with people who are being weaned off antipsychotics and they’re on the lookout for any changes in behaviour. But, overall, we’re very satisfied with the results.” 

Appropriate use of antipsychotics in New Brunswick

The Canadian Foundation for Healthcare Improvement (CFHI) and the New Brunswick Association of Nursing Homes (NBANH) recently announced results of the successful province-wide expansion of person-centred dementia care to all 68 nursing homes organizations.  

Since 2014, CFHI has supported 191 long term care organizations from across Canada to improve the appropriate use of antipsychotic medication and the quality of life for residents through a pan-Canadian collaboration, as well as major provincial scale collaborations in New Brunswick, Quebec, Newfoundland and Labrador, and Prince Edward Island. 

New Brunswick Appropriate Use of Antipsychotics Collaborative Adelbert Bertin

Adelbert Bertin with his wife, Amélia.

New Brunswick Appropriate Use of Antipsychotics Collaborative Adelbert Bertin

Adelbert Bertin at Manoir Edith B. Pinet nursing home in Paquetville, New Brunswick.