Family members of a former city councillor, who is floundering in Burnaby Hospital with Alzheimer's, are still waiting for their father to be transferred to a care facility and are questioning the decision to give him antipsychotic drugs.
Douglas Evans, now 82, served on Burnaby city council for 15 years. He was admitted to hospital roughly three months ago after he became lost while out for a walk. According to his family, his health deteriorated while in hospital. He's come down with pneumonia and C. difficile, he has lost his ability to walk, and he was given three anti-psychotic drugs, including haloperidol, which is used primarily to treat schizophrenia.
"We felt the anti-psychotic drugs were doing more damage than anything," said Evans' daughter Diane.
The family was told haloperidol (also known as haldol) was the best drug for calming down a patient, but Diane said her father was overdosed twice and was drugged into a stupor.
Douglas is no longer on any of the antipsychotic medications, Diane added.
"He's been very calm since, but of course now he can't walk. We feel those drugs sped up his deterioration," she said. "We're finding so many people with Alzheimer's are being medicated with antipsychotics."
Diane said the family is not looking to cast blame, just questioning what seems to be a common practice in dealing with dementia.
"I want to be clear we're not blaming people. We're not blaming the doctors or the nurses," Diane said. "We're just saying there has to be a better way."
Gloria Gutman, president of the International Network for Prevention of Elder Abuse, said she's heard many similar stories from patients' advocates, and that the over-medication of seniors is an issue, whether at home, in a care facility or in hospital.
"The problem is sometimes people's behaviour gets disturbed, or they act out when they are frightened, especially those people who have Alzheimer's or related dementia. (They) can get somewhat agitated when they are afraid, when they are in strange environment," she said. "(For) virtually any of us, at any age, going into hospital is a stressful process. . What happens is sometimes staff will misinterpret the behaviour and prescribe tranquilizers, sedatives, anti-psychotic medication as a way of managing behaviour, rather than taking the time to talk with the person and reassure them that they are safe."
Overmedicating seniors can make them more confused, slower and incontinent, Gutman said.
"They should not be prescribing medications that are designed for people with schizophrenia or another psychosis to people with dementia," she said. "The excuse is: we're short staffed, whether your talking about a hospital or a care facility. If someone's misbehaving we don't have time to sit and talk with them and hold their hand, but it's also staff perhaps not understanding the disease. ... The easiest thing is to give a drug."
In 2011, the B.C. Health Ministry published a report on the use of antipsychotic drugs in the province's residential care facilities. According to the report, there are roughly 64,000 people in B.C. with some form of dementia, but that figure is expected to grow to 94,000 by 2026.
The report stated that antipsychotics, originally developed for schizophrenia and psychoses, are increasingly used to treat symptoms associated with advanced dementia because they help control agitation and aggression.
The report also cited provincial guidelines that recommend physicians use "extreme caution" when prescribing antipsychotics and should do so only when other therapies have failed, or there is an identifiable risk of harm to the patient of others, or the symptoms are "severe enough to cause suffering and distress."
According to Nafisa Abdulla, a public affairs consultant with Fraser Health, antipsychotic medications are only given if prescribed by a doctor and are sometimes used to treat or manage symptoms and behaviours related to Alzheimer's and dementia.
"It all depends on individual case and circumstances," she wrote in an email to the NOW. "The patient's doctor would decide, usually in discussion with family members, whether or not that was an appropriate course of treatment."
In general, antipsychotics are sometimes used as "chemical restraints," as they restrict patients' movements, but Fraser Health's policy is that any restraints - chemical, physical or environmental - are only used to protect patients from harm when other reasonable alternatives haven't worked.
In the meantime, the Evans family members are taking shifts, watching over their father, who remains isolated in Burnaby Hospital because of the C. difficile. Diane said her father needs to be re-assessed, to determine what kind of care he requires, before he can be placed in a seniors' home.
To read the entire Ministry of Health report and Fraser Health's full response, go to Jennifer Moreau's blog at www.burnabynow.com under the opinion tab.
