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Antipsychotic Medicine Responsive Behaviours

To Venta Care Centre families,

In Alberta, many long term care centres are now working to reduce the use of antipsychotic medicines. Alberta Health Services is supporting this, through the Seniors Health Strategic Clinical Network.

Antipsychotics are medicines often given to people with dementia to manage behaviours. Although there can be good reasons for prescribing this medicine, their use should be limited due to side effects.

Possible side effects may include: sleepiness, restlessness, agitation, confusion, and an increased risk of falls, strokes and death. Research also shows that antipsychotics don’t help with most behaviours in people with dementia.

Our care team, which includes the nurse practitioner, nursing management, occupational therapist, recreation coordinator, clinical educator, dietitian, social worker and unit RN’s/LPN’s/HCA’s will review each resident taking these medicines monthly.

We will look for the reasons why the medicine was started, and if there might be better ways to respond to their behaviours using a person centred approach to care. Decreasing or stopping the antipsychotic medication will be considered after careful review.

When the time comes to review the medicines for your family member, we will contact you. Your input and feedback will be so valuable. As partners in your loved one’s care we would like to work with you to find ways to help your family member cope with their dementia – without the use of antipsychotics. If changes are made to the antipsychotic medicines, we will monitor the person closely and discuss any changes with you.

aid walking resident through the garden

Person-Centred Care Is Usually More Helpful than Medicine

Antipsychotics can make responsive behaviours worse. Only use them for a short time when other strategies haven’t worked and there’s a risk of someone being hurt. Keep looking for reasons for behaviours.

Examples of antipsychotic medicine:

  • Seroquel (quetiapine)
  • Risperdal (risperidone)
  • Zyprexa (olanzapine)
  • Haldol (haloperidol)

Responsive behaviours not helped by antipsychotic medicine:

  • Wanders or tries to go out
  • Has trouble sleeping
  • Seems unhappy, grumpy
  • Hoards or hides things
  • Calls out, screams, yells
  • Makes noises such as clapping and tapping
  • Can’t sit still, needs to walk
  • Uses wrong place as toilet
  • Takes clothes off in public
  • Eats things that aren’t food

Reasons for Behaviours

  • Unmet needs (hunger, thirst, tired, looking for toilet)
  • Surroundings (too much noise, too many people, bad smells, caregivers are rushed)
  • Social and emotional needs (lonely, bored, afraid)
  • Medical problems (medicine side effects, pain, illness)
  • Sensory problems (trouble hearing or seeing)

Strategies That Can Help

  • Work with families to learn routines, history, likes/dislikes
  • Reduce noise (e.g. from television and alarms)
  • Have a daily routine with familiar people
  • Offer choices, don’t argue
  • Use fewer words, give them time to answer
  • Use fewer medicines (ask for a medicine review)
  • Treat their pain
  • Make sure they wear their glasses and hearing aides

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