Advocacy, Antipsychotic drugs, Toward better care

what happens when care homes stop giving antipsychotics to elderly people with dementia?

In June 2015, the Canadian Foundation for Healthcare Improvement released the results of a pan-Canadian collaborative project aimed at reducing the use of antipsychotic medication in long-term care facilities for the elderly.

The project achieved astonishing results, which I documented here. Shortly after the results were released, I interviewed Kaye Phillips, Senior Director at the CFHI, and leader of the highly successful project. During that interview I asked her a simple question; she responded with a clear evidence-based answer.

More information on antipsychotics.

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8 thoughts on “what happens when care homes stop giving antipsychotics to elderly people with dementia?”

  1. Did you replace the use of the drugs with more attention to residents, increased meaningful activity, etc?


    1. Anne-Marie, good question. This pan-Canadian collaborative project comprised an educational component prior to implementation, ongoing support for the facility teams during the project, and yes, nonpharmacological alternatives. As with everything, when you take something away, you have to replace it with something else.

      I will be posting more excerpts from this interview as well as the complete interview over the next little while. Please stay tuned and subscribe to get notification of new articles in the series. Thanks so much! Susan


  2. When you come and look after my husband 24/7 when he was throwing things, cursing and screaming constantly, then yo can talk to me about not having an anti-psychotic The difference was like night and day, it rturned my husband to the gentle laid back person he was and made it possible for me to keep him at hoe. Nursing home workers have shifts and can leave and go home to a normal life!!.


    1. Marilyn, thanks for your comment. It may well be that your husband was/is psychotic and therefore benefited from being prescribed antipsychotics. Did he ever get a diagnosis of psychosis? Does he have a diagnosis of dementia of the Alzheimer’s type? What is his diagnosis exactly? The problem is when people who are NOT Diagnosed with psychosis are prescribed antipsychotics for reasons of convenience, cost reduction or simply because people have no idea how to deal with them

      I have a couple of additional questions: When your husband first began to throw things, curse, and scream constantly, who did you go to for help? Social worker? Hospital? Doctor? And if any or all of the above, how did they respond to you initially? What did they suggest that you do to address the throwing, cursing, and screaming?


  3. I’d really like to read more about this. We were involved in delivering training to residential and nursing homes in Cornwall, UK in the reduction of the use of anti-psychotics and anecdotally (from observation) the outcomes for those with dementia were huge. The replacement of anti-psychotics with responsive, empathetic and meaningful connections made all the difference and the staff were so keen to learn, particularly after seeing such changes in the people they were caring for. Great stuff!


    1. Thanks Laura. I visited your site and your activities clubs page here:, and think it’s similar to an initiative that I recently heard more about on a brainxchange webinar you might be interested in; there’s more about it here as well is a link to the replay:

      I have more coming in this series, and invite you to subscribe to the blog if you haven’t already. Also, I’m going to send you a direct email and link you to my friend Liz in UK. Thanks again for your comment and for the great work that you’re doing for people living with dementia and UK.


  4. Susan thanks for sharing this interview. Overuse of antipsychotics in NH’s on dementia PTs. is unacceptable! Here is the US Medicare penalizes facilities for using antipsychotics. They also lose a rating star on medicare’s NH compare site. Antipsychotics are necessary for some in certain circumstances but not on a regular basis for dementia patients. Looking forward to more of the series.


  5. My LO is home (Ontario, Canada). He has been on antipsychotic drugs for over 2 years. I can tell when I miss giving his pills to him. He definitely becomes more agitated. His geriatrician has advocated keeping him on his meds. Doing so has reduced his need for Lorazepam drastically, which was bonus.
    SO if he were to go into a LTC, WHO DIRECTS HIS MEDICATIONS? If LTC home take folks off drugs ‘to see if it works’ when already a patient has gone through the ‘guinea pig’ stage to discover what works for him, it seems like someone like my LO could destroy the calm he has finally found.

    I would hate him go through the withdrawal and then have to begin to build up the reserve again. He does not feel good when agitated or aggressive, and I surely do not either. Those drugs have given me peace for those years.

    This creates questions (for me) about who decides and dispenses prescriptions and how much family has to say in LTC homes. It seems to me like Drs. a patient has had for years would know their needs and story better.



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