Editor’s Note: In April 2014, CARP Action online re-published a very important investigative report by the Toronto Star.

The report exposed some shocking revelations about the rampant use of powerful antipsychotics in Ontario nursing homes. The Toronto Star’s investigation found that many seniors are being drugged and sedated with medications that are sometimes being used off-label and that have been known to occasionally kill patients with dementia.

The Advocacy Centre for the Elderly (ACE) published a response to the Star series in which they discuss the legal concepts at play and detail the ways in which the homes may be violating patient rights. ACE has considerable and unique experience advising and representing low-income and vulnerable seniors. They say that in their practice they have frequently encountered situations in which the homes used antipsychotics as a means of chemically retraining their more “difficult patients”.

Patients, however, have rights. If you or someone you know is at risk or if you are a concerned citizen, ACE’s thoughtful discussions, articles and legal opinions are always well worth reading. Here are the main points outlined in ACE’s response:

• ACE outlines the legal definitions and implications of “off-label” and surrounding “issues of informed consent”
• LTC homes may claim they need to prescribe antipsychotics to control aggressive behavior but this does not trump the requirement to obtain informed consent;
• Rather than using anti-psychotic medications unlawfully, LTC homes must seek alternative methods to manage behaviours. These may include:

1. Offering specialized programming and activities;
2. Providing resident-based care;
3. Seeking outside expertise through programmes offered by Behaviour Support Ontario, the Alzheimer Society and other expert groups;
4. Properly staff homes so that the behaviour of all residents can be monitored;
5. Train staff in managing dementia and other illnesses which may have related behaviours.

Ace concludes: “The use of antipsychotics should never be the primary method to manage difficult behaviours in long-term care residents, and should only be considered as a last result, given the warnings against their use in the elderly. Finally, even when antipsychotics are prescribed by the physician, they may never be given without first obtaining informed consent from the resident or their substituted decision-maker in accordance with Ontario law.”

To visit ACE’s website, please click here

To view the full PDF document containing ACE’s response, please click here