The number of seniors prescribed anti-psychotics without a diagnosis of psychosis has increased in publicly funded long-term care facilities, says B.C. seniors advocate Isobel Mackenzie, who calls it a troubling trend.
At the same time, the rate of physical, occupational and recreational therapy in the facilities continues to decline, she said.
On Wednesday, the province’s watchdog for seniors released the seventh annual Long-Term Care Facilities Directory on 297 publicly funded long-term care homes, comprising 27,931 beds in the province operated either directly by a health authority or by a contractor.
The guide offers basic information on everything from the people in the facilities — the average age is 84 and most are women — to the facilities themselves — 90 per cent of rooms have single beds — and quality-of-care indicators, such as use of medications and restraints.
The proportion of residents taking anti-psychotics without a diagnosis of psychosis increased by eight per cent over the previous 2019-2020 year, following a decreasing trend since 2015-2016.
“The use of anti-psychotics without a diagnosis of psychosis has increased and the use of antidepressant medication is slowly increasing,” the report said.
While 23 per cent of residents have depression diagnosed, 51 per cent receive antidepressant medication, which represents little change from the previous year.
Both rates continue to be “slightly higher” in health authority-owned facilities than contracted facilities.
The rate of residents with daily physical restraints — seven per cent — has remained unchanged for the past five years, the report said.
Meanwhile, a five-year trend shows a continued reduction in the rate of physical, occupational and recreational therapy — 10 per cent of residents received physical therapy, 28 per cent received recreation therapy and six per cent received occupational therapy in 2020-2021.
The latest directory includes many new quality-of-care indicators, including a tally of wait times for publicly funded long-term care facilities — ranging from zero days to a maximum of 2,096 days, or 5.7 years.
Vancouver Island Health had the highest average wait time at 171 days, followed by Northern Health at 165 days, Fraser Health at 62 and Interior Health at 59. Vancouver Coastal Health had the shortest wait time at 21 days.
Wait time is defined as the period from when a resident is accepted for service until the day they are admitted to the facility.
The seniors advocate expressed concern about a “measurable decrease” in facilities that received one or more inspections in the previous year — 73 per cent versus 83 per cent — but noted that she was told the drop is a result of the pandemic and inspections have returned to their “regular pace.”
The directory did show, however, a year-over-year increase in direct-care hours per patient, with 83 per cent now meeting the provincial benchmark of at least 3.36 hours of direct care per resident per day, up from 50 per cent in 2019-2020. This had long been a focus and complaint of the seniors advocate. Funded direct hours have since increased.
Overall, the average direct care hours in long-term care in Island Health from 2016-2017 to 2020-2021 increased from 3.19 to 3.37.
Other highlights:
• 90 per cent of the rooms in long-term care are single occupancy.
• 32 per cent of residents are totally dependent on staff for their activities of daily living, such as toileting, bathing and getting in and out of bed.
• The average length of stay in long-term care was 2.5 years (900 days), a seven per cent increase over the previous year
• The rate of falls, at 13 per cent of residents, and pressure ulcers, at two per cent of residents, remained relatively unchanged year over year.
The release of the directory from the Office of the Seniors Advocate corresponds with the launch of a new website that includes an interactive map of all publicly funded long-term care facilities in British Columbia for seniors, their family members and caregivers to navigate “to make informed decisions,” said Mackenzie.
The complete Long-Term Care Facilities Directory is available at seniorsadvocatebc.ca/long-term-care-directory.
