A person-centered approach to memory care led to the reduced or discontinued use of off-label antipsychotic medications in more than half of the residents of 53 long-term care communities, including assisted living communities, who participated in a study, the results of which were announced last week.
The study was conducted in the Canadian provinces of Newfoundland and Labrador and Prince Edward Island.
The Appropriate Use of Antipsychotics, or AUA, approach works with residents living with dementia, their families and staff members to try to understand the causes of behaviors and underlying issues, such as pain, and respond to each resident’s unmet needs based on his or her personal history. The approach involves reviewing the appropriateness of the use of antipsychotics for the resident and creating individualized care plans with alternative activities — such as exercise, pet therapy or music therapy — that are meant to be meaningful and enjoyable for the resident.
In the long-term care communities that participated in the study in Newfoundland and Labrador, 52% of residents who had been prescribed antipsychotics were able to have their meds discontinued or reduced (30% discontinued, 22% reduced). In the Prince Edward Island communities, 53% of residents who had been prescribed antipsychotics were able to have their meds discontinued or reduced (25% discontinued, 28% reduced). No change was observed in physical or verbal aggressive behaviors among the residents, according to the researchers.
“We are very proud of how the long-term care homes have fully embraced this approach to care, and we congratulate them on their commitment and leadership,” said Andrew MacDougall, director of long-term care at Health PEI, an organization that announced the study results along with the Canadian Foundation for Healthcare Improvement and the government of Newfoundland and Labrador. “We will be working with private long-term care homes to expand the reach of the AUA approach,” MacDougall added.
The approach, researchers said, provides an opportunity to create supportive environments that help the resident feel calm, safe and comfortable. Reducing or discontinuing the use of unnecessary antipsychotic medications can improve resident quality of life in part by reducing the side effects caused by the medication, they said.
Forty percent of assisted living residents in the United States are living with dementia, according to the National Center for Assisted Living. Reducing the off-label use of antipsychotics is a goal of several industry organizations.