Study shows antipsychotic meds in nursing homes make residents worse

Canadian nursing home residents given antipsychotic medications showed a significant worsening of their behaviours, shows a new study conducted by researchers at the University of Waterloo.For this first national longitudinal study of its kind, published in the November 2024 issue of the Journal of the American Medical Directors Association, researchers analyzed data from nearly 500,000 patients living in nursing homes across Canada between 2000 and 2002. They found some 68 per cent of residents who used antipsychotics had more problems with their behaviour during follow-up checks, and that 26 per cent were given antipsychotics in ways not recommended by the Food and Drug Administration. Read: A ‘Second Chance’ for brain injury patientsAntipsychotics are sometimes used to calm nursing home residents with aggressive or agitated behaviour, but side effects can include tremors, restlessness, rigidity, painful muscle contractions and the inability to stand and walk, which can exacerbate existing behavioural and psychological symptoms."Sometimes people may say they don't have enough staff to deal with these issues, but the reality is that these medications can make disability and cognitive impairment worse," said Dr. John Hirdes, a professor in U of W’s School of Public Health Sciences. "We need to seriously reconsider the use of antipsychotics for people who do not have conditions associated with psychosis."Read: Ontario proposes to allow nurse practitioners to oversee LTC medical careInstead of turning to these medications as a first course of action, researchers suggest focusing on person-centred care to get to the root cause of a resident's behaviour. They also suggest offering other support options, such as better pain management, clearer communication, or activities to help reduce anxiety. There are also non-drug therapies (e.g., music, art, social interaction and gentle exercise) that have shown to help manage behaviour without the need for antipsychotics.The study also outlines the inappropriate use of antipsychotics to treat behavioural and psychological symptoms of dementia (BPSD), which can include irritability, aggression, agitation, anxiety, depression, sleep or appetite changes, apathy, wandering, repetitive questioning, sexually inappropriate behaviours and refusal of care.Over the past three decades, healthcare agencies have made efforts to change prescription practices to reduce the chronic use of antipsychotics in nursing homes.The study is part of an international project called I-Care4Old, and was funded by the New Frontiers Research Fund Global Grant.

Study shows antipsychotic meds in nursing homes make residents worse

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