WINNIPEG – A Manitoba project is using behavioural therapy to reduce the use of antipsychotics for treating dementia patients.
The project has cut the use of antipsychotics at the Middlechurch Home of Winnipeg by 25 per cent, said Michael Haip, a manager in the long term care program at the Winnipeg Regional Health Authority.
The project uses information about a patient’s past to try to improve the quality of their life with dementia, thus alleviating stresses that can lead to problem behaviours.
“If you have someone who is perhaps mechanically inclined – working with tools for a significant portion of their life – providing them with something that gives them that similar sort of experience in their later years helps allay or resolve some of those behaviours that personal care homes sometimes find troubling to manage,” Haip said.
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For example, one former mechanic now does puzzles, because the activity uses similar skills to what he used in his work life.
The approach is much more labour intensive than medicating people, said Alison Bell, the WRHA’s long term care program pharmacy manager.
“Because of the number of drugs available on the market to treat a variety of conditions, we know that a lot of times it is the quicket thing to do,” Bell said. “Behaviour modification, whether it’s in the personal care home or even self-behaviour modification, it takes a lot of work.”
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The work includes asking a lot of questions to find out what will help a patient function as well as possible.
“What did they used to like to do? What profession did they have? Because a lot of times, with dementia, those are the kinds of activities that they will still respond to and remember,” Bell said.
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The project has helped reduce the amount of wandering, confusion, yelling and potentially aggressive behaviour that care home residents exhibit.
Bell cited the case of one patient who was transformed when a nurse practitioner reduced her use of antipsychotics.
“She went from being fully dependent, wheelchair bound, needing help for all her activities of daily living to being up and dancing.”
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