BSO helping Riverview keep antipsychotic administration low

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Psychotropic medication usage 20% below provincial LTC home average

Tuesday, April 22, 2014 — Deron Hamel

PETERBOROUGH, Ont. – When front-line staff members approach a Riverview Manor resident who has advanced dementia to provide her care needs, the resident often prefers to be left alone. So that’s just what staff members do.

They will approach the resident later, and if the women still does not want her care needs implemented, staff will again leave her. Only when the resident says it’s OK will staff members provide her care needs.

This is one example of how the Peterborough long-term care home’s number of residents on antipsychotic medications is only 12.28 per cent, well below the provincial average of 31.5 per cent.

While the resident does exhibit behaviours, this simple approach of giving her the space she needs ensures that medication doesn’t need to be administered.

Riverview Manor is involved with the province’s Behavioural Supports Ontario (BSO) initiative. BSO is a $40-million provincial initiative to enhance quality of life for seniors affected by dementia and other conditions causing agitation.

Through funding allocated through the Central East Local Health Integration Network, Riverview Manor staff members have accessed education and training in BSO interventions. The home has a “BSO team” of staff members trained in these interventions, which include Montessori techniques and gentle persuasive approaches (GPA). The team is called in to help personal support workers when they are caring for this resident, should the need arise.

Staff members have even taken time to learn simple phrases in the resident’s native language to make her feel more at ease.

With interventions like these, the resident doesn’t exhibit behaviours, eliminating the need for psychotropic medications, explains administrator Mary Anne Greco.

“At Riverview, our philosophy of the utilization of medication, especially for any antipsychotic medications, is that it’s used very wisely and very judiciously,” she says. “We try that really as a last resort.

“We monitor (residents on antipsychotic medications) to make sure they’re not having any adverse side effects to the medication, we liaise with the family to see how they are doing and we’re always incorporating our Behavioural Supports Ontario team to assist with that so that all the staff are aware of the (best) approaches for residents so we don’t have to be looking at medication as a first line of care.”

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