Health Minister Terry Lake addresses the concerns highlighted in a recent report released by Seniors Advocate Isobel Mackenzie

Debating senior drug use

47% of seniors in residences are on anti-depressants

Prescription drugs far outnumber a diagnosis to match the medication in B.C. residential care homes, according to a report released Tuesday.

Seniors Advocate Isobel Mackenzie’s report, Placement, Drugs and Therapy…We Can Do Better found 33 per cent of residential care home clients are prescribed anti-psychotic medication while only four per cent are diagnosed with a psychiatric disorder.

Moreover, the report says 47 per cent of clients are prescribed anti-depressants while only 24 per cent have a proven need for the drugs.

NDP Alberni-Pacific Rim MLA Scott Fraser called the findings “tragic. It’s of great concern for our seniors who have spent their lives building the health care system up,” Fraser told The NEWS from Victoria on Wednesday morning. “And now they aren’t getting the care they need.”

Parksville Qualicum Beach is a retirement Mecca with one of the oldest demographics in the country. According to Island Health, the region has six residential care facilities.

The report highlights more alarming statistics including that 15 per cent of British Columbian seniors may be “incorrectly housed,” meaning they might be better suited for assisted living or community care options.

“This is troubling on a couple of fronts,” said Mackenzie, who has worked in home care for two decades. “Most seniors would prefer to live independently than in residential care and so we want to ensure all supports and alternative living arrangements are exhausted before we move someone to residential care.”

Additionally, the report points to the scarcity of residential care beds in B.C.

Mackenzie said “if we are filling even five per cent of these scarce beds with folks who could live independently, that is 1,500 beds that could open up province-wide.”

Fraser criticized the government for what he called “bad business.”

“The government is not listening… It’s just an accounting issue for them,” he said. “It’s bad management too. It’s far more cost effective for seniors to stay in their homes longer if they can, residential care is not cheap — It’s a bad business model but more importantly it’s about quality of life and that should be the concern of government.”

Responding to the report, Health Minister Terry Lake said the ministry is aware of the problems highlighted by the Seniors Advocate and is putting more resources toward home care and community health services.

According to Lake, spending is up $1.2 billion to $2.8 billion since 2001.

Lake said B.C. has two programs underway to deal with overprescription of medications in care facilities: one is a training program for staff to more accurately determine psychiatric signs, and the other is working with doctors and pharmacists to find behavioural alternatives to anti-psychotic drugs.

Dr. Maria Chung, a geriatrician with Vancouver General Hospital, said the numbers aren’t shocking but they should be lower.

“The use of medication is too high,” Chung  said in a phone interview from Vancouver.

While she admits having zero residential care clients on medication is “unrealistic,” she said clients with psychotic behaviour need to be assessed, managed with non-pharmaceuticals if possible, and as a last resort be put on the lowest possible dosage of medication and be reassessed frequently.

She said often clients are medically assessed properly but not reassessed after they start taking medication.

“The minute they are stable they should be reassessed,” said Chung, noting education is key for both health care workers and the families of clients.

However, she also noted that there are definitely “appropriate” times to administer medication to a client.

“Sometimes it can be a quality of life drug,” said Chung. “It’s not a nice way to live your life in psychic pain.”

Mackenzie’s review is based on assessment surveys given to B.C.’s 25,000 seniors in residential care and 29,000 home care clients.

The Office of the Seniors Advocate will be addressing the above mentioned and other emerging systemic issues that affect seniors in several upcoming reports.

The Advocate’s review of seniors’ housing in the province will be released in late spring. A systemic review of home and community care is underway.

—With files from Tom Fletcher

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