Eddie Calisto-Tavares vividly remembers making numerous phone calls to demand that her elderly father, who lived at the Maples Personal Care Home, no longer be given antipsychotic medication.
“I would phone the Maples daily,” said Calisto-Tavares on Thursday about her late father. “He was prescribed the medication when he was at Poseidon (Care Centre) by a doctor who never saw him, but that was when he was in a shared room and paranoid about the person he was with.
“When he went to the Maples, he had his own room and bathroom and we had things from his home there so he was calm. He didn’t need to be drugged up, but I had to fight with a doctor I never met. I would say he is an 87-year-old with better blood pressure than I was at that time because of this stress, so he didn’t need any drugs.”
A national report released Thursday found about 43.2 per cent of seniors who lived at Deer Lodge Centre, and 37.6 per cent at the Holy Family Home, were given antipsychotic medications in 2023 even though they hadn’t been diagnosed with a psychosis.
The two facilities had the highest rates of antipsychotic medication use in Winnipeg.
“It doesn’t surprise me to hear that others have been on these drugs when they didn’t need to be,” Calisto-Tavares said when she was told about the report, titled “Rising Rates: Antipsychotic Use in Canada’s LTC Homes.”
The report was released by the Appropriate Use Coalition, which is made up of 11 health care organizations including the Canadian Institute for Health Information, Canadian Pharmacists Association, and the College of Family Physicians of Canada.
It found one in four long-term care residents may have been given inappropriately for non-psychosis reasons. The report uses statistics provided to CIHI by provincial governments and long-term care providers across the country.
The report says antipsychotics are often the first thing care home staff reach for to manage aggression associated with dementia, but Canadian guidelines advise not using it frequently in older adults because the risks, including strokes and death, outweigh the benefits.
One of the members of the coalition, Carolyn Hoffman, CEO of the Institute for Safe Medication Practices Canada, said the statistics are “a snapshot in time.”
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The national report stated 37.6 per cent of seniors at Holy Family Home were given antipsychotic medications in 2023 even though they hadn’t been diagnosed with a psychosis.
Hoffman said until there’s more research, they don’t know whether the numbers are so high and varied at many facilities because a care home filled in a form incorrectly, has a specialized program for dementia, or some other reason.
“This is a call to action,” she said. “We need to understand why there is variation.
“We have zero cases right up to 83.6 per cent at the highest. There is a large range across the 1,500 sites which are represented. We need to know more because there is an opportunity to learn and improve.”
A spokeswoman for the Winnipeg Regional Health Authority said it regularly assesses the use of antipsychotics to manage symptoms of dementia with long-term care residents to make sure it is “safe, effective and warranted.
“The use of antipsychotic medications among residents is often initiated prior to admission to a personal care home. Once started, discontinuation of an antipsychotic medication requires a structured approach, often involving tapering of the medication in concert with non-medication-based interventions.”
As for why Deer Lodge and Holy Family have high rates of usage, the spokeswoman said both have specialty units that support residents who have complex psychological needs.
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The report found about 43.2 per cent of seniors who lived at Deer Lodge Centre were given antipsychotic medications in 2023.
“These residents require specialized environments to support their cognitive loss and which can often result in responsive behaviours,” she said, adding the residents may also have been diagnosed with depression and bipolar disorder.
Sue Vovchuk, executive director of the Long Term and Continuing Care Association of Manitoba, agreed more research has to be done to take a closer look at the statistics.
Vovchuk said because some of the sites with the highest numbers are facilities with specialized special need care, “it is important to understand the levels of care and the types of individuals at the various facilities.
“You can’t directly compare sites to sites.”
Health Minister Uzoma Asagwara, who was a psychiatric nurse before being elected, said “the decision to start these kinds of medications are hard ones for patients and their families because they often mean a loved one is in a difficult head space, whether there is a clear diagnosis or not.
“As research on aging, and the quality of care in long-term care evolves, clinical practices have to evolve with it. The findings of this report are important for that ongoing work.”
“These numbers really don’t surprise me.”–Trish Rawsthorne
Trish Rawsthorne is a retired nurse whose mother died in 2015 after receiving antipsychotic medications she didn’t need. She tried to convince long-term care homes and the province to reduce their use among seniors.
She said she is hopeful the report will spark change.
“These numbers really don’t surprise me,” said Rawsthorne. “I can only imagine that they do it because they don’t have enough staff.
“I wish them luck. I wish they could put a moratorium on it. That’s what should be done.”
kevin.rollason@freepress.mb.ca
Kevin Rollason
Reporter
Kevin Rollason is a general assignment reporter at the Free Press. He graduated from Western University with a Masters of Journalism in 1985 and worked at the Winnipeg Sun until 1988, when he joined the Free Press. He has served as the Free Press’s city hall and law courts reporter and has won several awards, including a National Newspaper Award. Read more about Kevin.
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