Thousands of elderly people in B.C. may have been placed in residential care when they would be better off at home, are taking too much medication, particularly antidepressants, and are not getting the rehabilitative therapy they need, B.C.'s seniors' advocate Isobel Mackenzie says in a new report.
The study "lines up with our goals and provides us with some data to work with," Health Minister Terry Lake said on Tuesday, adding that health authorities around the province are working on programs designed to help elderly people stay in their own homes as long as practical.
The report, released Tuesday, is the second major report released by Ms. Mackenzie since she was appointed last year and is the first to analyze Resident Assessment Instrument, or RAI, records for the whole province and compare them with RAI data from two other provinces, Alberta and Ontario.
In B.C., an RAI is typically done when a client enters a residential care facility and at least every three months after that, or sooner if a major change has occurred. The assessments record health-related information, including which medicines people are taking and whether they are prone to falls. The provincewide RAI analysis turned up what Ms. Mackenzie described as three systemic issues of immediate concern – including the finding that up to 15 per cent of B.C. seniors living in residential care may be incorrectly housed because assisted living or community care would have been more suitable.
The study also highlighted the overuse of medication, finding that about 47 per cent of residential-care clients are being prescribed antidepressant medications, while only 24 per cent of those clients had actually been assessed as having depression.
The third issue was the significant lack of rehabilitative therapies in B.C. The report found only 22 per cent of seniors had received any recreational therapy in the previous seven days, compared with 42 per cent in Alberta.
On the medication issue, the report said that 34 per cent of clients in B.C. residential care homes are being prescribed anti-psychotic medications while only 4 per cent have been diagnosed with a psychiatric disorder.
"One clear indicator of potentially inappropriate medication use in residential care facilities is the extent to which one particular type of psychotropic medication, anti-psychotic drugs, is prescribed to seniors," the report says. "It is well-known that these drugs are sometimes used to manage aggressive or agitated behaviours in residents who have dementia. This was not what they were intended to treat, nor are there robust clinical trials involving frail seniors to properly monitor side effects."
The use of anti-psychotic drugs in seniors' facilities is a continuing concern. A 2011 review by the B.C. government found 50.3 per cent of patients had been prescribed an anti-psychotic drug over a two-month period.
The province has taken steps to reverse that trend. In 2013, a program called CLeAR (Call for Less Antipsychotics in Residential Care) got under way, with the goal of cutting the number of seniors in residential care on anti-psychotic medications by 50 per cent across the province by the end of 2014.
Results of the initiative have not yet been released.
Violence is a leading cause of injury to B.C. care workers and results in more than 1,000 injuries each year, according to WorkSafeBC.