Appropriate use of antipsychotics in Canada. Elderly male patient with his pet bird. Across Canada, 1 in 5 long term care (LTC) residents is on antipsychotic medication without a diagnosis of psychosis — yet the best health evidence says that only 5% to 15% of residents should be taking these medications.

Antipsychotics are often prescribed in a bid to reduce challenging behaviours and resistance to care, but they have a sedating effect. For many seniors, antipsychotic medication is minimally effective at best. At worst, it can cause harmful side effects and contribute to falls and hospitalization. These medications are sometimes prescribed to treat disruptive behaviours in people with dementia.


But did you know that antipsychotic medications:

  • Do not help manage most symptoms and behaviours of dementia?
  • Slow brain performance and reflexes, even at small doses?
  • Can produce negative side effects — confusion, dizziness, sleepiness, increased risk of falls?

The good news is that rates of potentially inappropriate antipsychotic use in Canada are falling thanks to the efforts of provincial health quality councils, governments, associations, providers and many others who are expanding appropriate use of antipsychotics (AUA) programs.

At CFHI, we’re doing our part to improve elder care by incubating, spreading and scaling the AUA approach across Canada.

How we started

The antipsychotics reduction collaborative had its roots in?CFHI’s EXTRA: Executive Training Program. Two managers with the Winnipeg Regional Health Authority?designed an initiative to help multidisciplinary teams of healthcare providers better use data from the Resident Assessment Instrument/Minimum Data Set. The goal was to identify patients who may benefit from non-drug therapies to treat behavioural issues associated with dementia.

At one site, staff were trained to provide non-pharmacological approaches to managing behaviours associated with dementia. As a result:

  • 27% of a cohort of residents was taken off antipsychotic medication without any increase in behavioural symptoms,
  • Quality of life was improved for patients, and
  • A $400,000 savings was achieved across in six months across the region.

Where are we spreading and scaling the AUA collaborative?  

How does it work? 

CFHI provides tailored learning and coaching to help interprofessional teams in LTC homes — nurses, personal care workers, physicians, pharmacists and administrators — to use data to identify patients who may benefit from non-drug therapies to treat behaviours related to dementia. Equipped with better information about each resident, direct care staff can then work with families to tailor services and provide personalized care, such as music and recreation therapy. 

The AUA Approach

Appropriate use of antipsychotics in Canada infographic