The Lynn Valley Care Centre is pictured in Lynn Valley in North Vancouver on March 16, 2020.JONATHAN HAYWARD/The Canadian Press
More people in B.C.'s long-term care and assisted-living homes are being given anti-psychotic medication since COVID-19 forced these facilities to impose tight restrictions on visitors, and the province’s seniors watchdog says the uptick underscores the pain of those isolated from their loved ones.
Seniors Advocate Isobel Mackenzie released the results of a survey of more than 13,000 long-term care residents and their family members Tuesday and urged the provincial government to allow longer and more frequent visits in order to offset the long-term risks to residents increasingly hurt by these separations.
She said there has been a 7-per-cent increase in the rate of prescribing these drugs at nursing homes and assisted-living facilities since March, and respondents to the survey reported weight loss, worsening mood and signs of depression among residents. The data gleaned from the provincial PharmaNet tracking system does not show whether people with existing prescriptions have had their dosages upped over the past nine months or why new patients were given these heavy sedatives, she added.
“I can’t prove causation, but you say ‘What’s different for residents now from before?' Life is the same except for one thing: They can’t see their people,” Ms. Mackenzie told The Globe and Mail in an interview.
Roughly a third of all residents in these homes have now been dispensed anti-psychotics and this pandemic-related increase has “basically wiped out” gains the long-term care sector had made over the past four years to reduce these prescriptions, Ms. Mackenzie said.
Krista James, national director for the Vancouver-based Canadian Centre for Elder Law, said seniors with dementia may act out with aggression or other behaviours as a way of communicating that they are in physical pain or grieving the loss of contact with their loved ones. Ms. James, whose non-profit does legal research and consultation on policy issues related to aging, said these anti-psychotics are then deployed to sedate residents in emergency situations for a short period of time.
So far, 187 people living in long-term care have died from COVID-19 in the province. Another 4,500 residents have died since the pandemic hit from other causes, according to the report. Roughly half of the family members that responded to the survey stated their loved ones' physical, mental and emotional condition had worsened once they saw them after the initial lockdown was relaxed, the report stated. Historically, Ms. Mackenzie said, over a span of three months it is normal to see roughly a quarter of residents decline in these ways.
The advocate said the province’s swift ban on visits at care facilities last spring helped B.C. weather the initial destruction in the sector and the rules were relaxed in the summer, but many families found it hard to negotiate the system and more visits need to be allowed because the risks can be managed.
“Most family members were not aware of the possibility of essential visits during the first four months of visit restrictions, and almost half of the people who did apply for an essential visit were refused,” the advocate’s report stated.
Ms. Mackenzie, who reports to the provincial health ministry, recommended that the province change visitation rules to allow every person living in one of these facilities to identify an “essential” visitor who can come by frequently for care, and then a rotating cast of “social" visitors to give families more time together.
Her report also recommended that B.C. create an association for these residents and their families to have a say in decision-making.
Health Minister Adrian Dix, who was unavailable for an interview Tuesday, e-mailed a statement thanking Ms. Mackenzie’s office and those who took part in the survey, but did not commit to implementing any of her recommendations. Instead, he touted the province’s initial response of bumping the pay of care aides and restricting them to working at just one nursing home each, policies he said helped B.C. save many more lives than Quebec and Ontario, jurisdictions that took fewer precautions in the sector.
In May, a Canadian Armed Forces report into how Ontario’s long-term care sector first responded to COVID-19 found one home using narcotics to sedate residents who are “agitated and difficult” over being confined to their rooms during the pandemic lockdown.
Experts in aging and long-term care say this continuing isolation has caused immeasurable harm on seniors living in these facilities, with studies showing extended periods of loneliness can be as bad for people’s health as smoking 15 cigarettes a day and shaving off eight years of life expectancy.
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