Our seniors deserve better
And now for yet another reason why aging boomers should be wary of Ontario nursing homes: a startling number of facilities are drugging residents with dangerous antipsychotic drugs that keep them quiet and controlled.
It has the makings of a horror show, except that for Ontario seniors this state of affairs is sadly all too real. A Star investigation by David Bruser, Jesse McLean and Andrew Bailey analyzed data on antipsychotics in nursing homes and found widespread drugging of the elderly — particularly those with dementia.
Even worse, the Star found that antipsychotic medications such as olanzapine and quetiapine come with warnings of increased death rates when given to the elderly. That’s one of the reasons why Health Canada has not approved their use among seniors with dementia.
There’s no doubt that nursing homes don’t have enough staff or the proper training to manage residents with dementia, particularly those who wander, or get easily agitated and aggressive. It’s hard work.
That’s why Ontario needs an overall strategy on dementia — with a strong focus on long-term care. After all, in six short years, some 250,000 Ontarians are expected to suffer from the debilitating cognitive disease. Ignoring the problem won’t make it go away.
Health Minister Deb Matthews could act quickly by giving new life to a bill that pushed such a strategy, tabled last year by Liberal MPP Donna Cansfield. Backed by Progressive Conservative Deputy Leader Christine Elliott, the bill received a flurry of attention last spring — and then promptly disappeared.
It was Cansfield who gathered the drug data and, after presenting it to Matthews with no followup action, provided it to Star reporters for analysis. As Cansfield says, “We have a problem; we need to deal with it. That’s our responsibility as government.” It’s an apt observation.
Adementia strategy should examine new methods of care, such as those highlighted by the Alzheimer Society of Canada.
A recent report by the society found that homes have been transformed into calmer environs by using “person-centered” care. That means staff focus on an individual’s needs and, for example, spend time talking, singing or reading to residents instead of rushing them out of bed for scheduled baths or breakfast. It helps. For those with dementia, getting hauled out of bed can incite anger and aggression. Informed consent should also be high on the government’s fix list. Considering the Star’s findings — that more than a third of residents in some 300 nursing homes are given antipsychotic drugs — staff should be following the consent rules that are already in place.
As Jane Meadus of the Advocacy Centre for the Elderly says, proper consent includes information on the side effects of antipsychotics among the elderly — including a 60-per-cent increase in death.
Most families, Meadus notes, will say “don’t do that.” As a result, homes would be forced to take better actions that don’t involve dangerous pharmaceuticals. “That would solve a big part of the problem right there,” she says.
The good news in this alarming scenario is that nursing home leaders are at least willing to discuss their struggles. Candace Chartier, CEO of the Ontario Long Term Care Association, acknowledged the problem, saying, “We know we need to do better. Seniors deserve better.”
Chartier is right, of course, but unfortunately, change won’t happen unless the government forces it.
Good leadership doesn’t ignore challenges. Matthews has made some admirable improvements in long-term care but here’s one situation where swift action is needed. Without her help, the misguided use of antipsychotics will only increase. Boomers take note — the future isn’t pretty.
Ontario needs dementia strategy that doesn’t include antipsychotic drugs