Provincial Guideline

• Continuing Care Health Service Standards

Restraint as a Last Resort Provincial Policy

• Policy
• Procedure
• Restraint as a Last Resort Toolkit

Medication Review

• Appropriate Use of Antipsychotics (AUA) and Medication Reviews
• Pharmacologic Restraint Management Worksheet
• Appropriate Use of Antipsychotics Family Conference Tracking Record
• Audit Tool for Interprofessional Antipsychotic Medication Reviews
• Data Collection Template (excel)

Clinical Information for Prescribers and Pharmacists

• Antipsychotic (AP) Deprescribing Algorithm
• Physician Update on Appropriate Use of Antipsychotics Project
• RxFiles: Objective Comparisons for Optimal Drug Therapy
  • Dementia Overview: Cognitive & Behavioural Tx
  • Behaviour Management in Dementia: Where do Antipsychotics Fit?

Resources for Person-Centred Care Planning

• Responsive Behaviours: Descriptions and Assessment
• Person-Centred Care
• Care Planning to Prevent and Manage Responsive Behaviours
• brainxchange
• British Columbia Interior Health Authority
  • How to use Personal Information in Care-giving

Responsive Behaviour Tracking

• Responsive Behaviour Tracking and Assessment Tool
• Behaviour Mapping:
  • Behaviour Mapping Chart
  • Behaviour Mapping Guide
  • Behaviour Mapping Process
  • Behaviour Mapping Presentation
    • Notes
    • Slides
• The Bethany Group
  • The P.I.E.C.E.S. Three Question Template
  • ABCC model from PIECES- Rosehaven Provincial Program
  • Cohen-Mansfield Agitation Inventory (CMAI)
  • Behaviour tracking tool from PIECES Alberta
  • ABCC Behaviour Log

eLearning Modules - Appropriate Use of Antipsychotics (AUA)

• Pharmacological Restraints and Behaviour Tracking
• Managing Responsive Behaviours
• Sleep

Recommended Resources

• Alzheimer Society Canada
  • Person-centred care of people with dementia living in care homes
  • 10 Priorities for Dementia Research in Canada
  • Dementia Resources
  • I’m Living with Dementia
  • I’m Caring for a Person Living with Dementia
  • I Have a Friend or Family Member Who Lives with Dementia
  • I’m a Healthcare Provider
• Design and Dementia
  • Doorways
  • Lighting
  • Noise-Physical
  • Noise-Social
  • Wayfinding
• Eden Alternative: elimination of loneliness
• Dementia Care Matters
• Pioneer Network
  • Engaging Staff in Individualizing Care Starter Toolkit
    • Consistent Assignment
    • Individualizing Mornings
    • Flexible times for dining
    • Shift Hand-off Huddles video clip (7:30)
    • Promoting Mobility, Reducing Falls and Alarms
• State Government of Victoria, Australia, Department of Health
  • Dementia-Friendly Environments

Introduction

• Why Involve Families in Appropriate Use of Antipsychotics?

Discussions with Families/Alternate Decision Makers: AUA Quality Improvement Projects

• Appropriate Use of Antipsychotics Family Conference Tracking Record
• MyHealth.Alberta.ca
  • Antipsychotic Medicine
  • What is Delirium?
  • Dementia: Responsive Behaviours
• Choosing Wisely Canada
  • Treating Disruptive Behaviour in People with Dementia
• Canadian Coalition for Seniors’ Mental Health
  • Delirium Prevention and Care with Older Adults

Recommended Resources

• Alberta Caregiver College: Support for Caregivers of Older Adults
• Alzheimer Society Canada
  • Ambiguous loss and grief in dementia: brochure and webinar
• Centre for Applied Research in Dementia
  • A Different Visit: Montessory-Based Activities for People with Alzheimer/s / Dementia
• Clinical Excellence Commission:
  • Top 5: Improving the Care of Patients with Dementia: 2012 – 2013
• Help for Alzheimer’s Families
  • Capturing Memories for Someone Living with Alzheimer’s
  • Tips for Talking to Someone Living with Alzheimer’s
  • Create a Memory Box to Help Trigger Memories
  • I will remember for you Music Video

Introduction

• Finding Joy: Strategies for Meaningful Activity

Recommended Resources

• British Association of Occupational Therapists and College of Occupational Therapists
  • Living Well in Care Homes
• TimeSlips: Bringing Meaning and Purpose Into the Lives of Elders Through Creative Engagement
• Doll Therapy
  • National Center for Biotechnology Information Nursing Ethics: Ethical Considerations of Doll Therapy for People with Dementia
  • Annals of Long-Term Care More Than Child's Play: Ethics of Doll Therapy in Dementia
• EDGE Project (Electronic Dementia Guide for Excellence)
  • Interventions
• Tablet Applications for reminiscing, sharing music and memories
  • Grey Matters: Reaching Beyond Dementia
  • Aged Care Guide: “Dementia ‘My Life Story’ App Strikes Gold
• Music Resources
  • Music & Memory.org: Alive Inside video trailer (2:18)
  • Institute for Continuing Care Education and Research
    • Implementing Music Care in Continuing Care
    • Music Care Conceptual Framework
    • The Magic of Music: Creating Moments that Unveil the Person Within, CapitalCare Edmonton Area

Clinical Resources for Care Staff

• PowerPoint Presentations
  • AUA in Dementia: What is All the Fuss? Full page slides
  • AUA in Dementia: What is All the Fuss? Notes pages
  • Steps to Culture Change: Full page slides
  • Steps to Culture Change: Notes pages
• CLPNA CARE
  • Fall 2014 page 28: Alberta Long Term Care Sites Transform Dementia Care
• Posters:
  • Antipsychotic Medications: Potential Side Effects
  • Antipsychotic Medications: Possible Serious Side Effects
  • Antipsychotic Medicine: Responsive Behaviours

Clinical Resources for Prescribers and Pharmacists

• Choosing Wisely Canada
  • Five Tests and Treatments to Question

Quality Improvement Strategies and Tools

• AUA Map and Steps Overview
• Family Letter
• Staff Letter
• Physician Letter
• Strengths Analysis Tool
• Data Collection Template

Getting Started:

• Step 1. Why Address Antipsychotic use in Your Facility?
• Step 2. Five Key Interventions for Reducing Antipsychotic Use
• Step 3. Decide on a Starting Point; Gather an AUA Change Team

Build Awareness:

• Step 4. Build Awareness Within the AUA Team
• Step 5. Get the Word Out at Your Site
• Step 6. Build Awareness Within the Facility or Unit

Create Desire:

• Step 7. Create Desire Within the Care Team
• Step 8. Overcome Resistance to Change on Your Unit

Develop Knowledge and Ability:

• Step 9. Develop Knowledge Within the Care Team in the Five Key Areas
• Step 10. Enhance the Medication Review Process
• Step 11. Foster the Ability of the Care Team and Facility to Provide Person-centred Alternatives to Antipsychotics

Reinforce Change

• Step 12. Reinforce Change within your Unit, Facility and Organization

Clinical Resources for Care Staff

• PowerPoint Presentations
  • Prevention of Delirium in Dementia
    • Full Slides
    • Notes pages
• Alberta Health Services
  • Confusion Assessment Method
  • Do Bugs Need Drugs
    • Antimicrobial Stewardship in Long Term Care Facilities
  • Nutrition Guideline Seniors Health Overview (65 years and older)
• Med.Pass Long Term Care Resources
  • “Stop and Watch” Early Warning Tool
• Vancouver Island Health Authority (VIHA) Delirium Resources

Clinical Resources for Prescribers and Pharmacists

• Canadian Deprescribing Network
• American Geriatrics Society 2016 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
• Med Stopper
  • Deprescribing Resources
• RxFiles: Objective Comparisons for Optimal Drug Therapy
  • Dementia: Bringing Evidence and Experience to Drug Therapy Decision Points

Information to Share with Families

• MyHealth.Alberta.ca
  • Delirium: Information for Patients and Families (print booklet)
    • What is Delirium?
    • What Causes Delirium
    • What’s the Difference Between Delirium and Dementia?
    • What Puts Someone at Rsk for Delirium?
    • How Do You Recognize Delirium?
    • Can Delirium Be Prevented or Avoided?
    • How Can Comfort Rounds Help?
    • How Is Delirium Treated?
    • How Can I Help the Person With Delirium?
    • Will the Person Ever Be Back to How They Were Before?

Quality Improvement Strategies and Tools

• Team Action Plan for Delirium Prevention
• Letter for Families and Staff
• Letter for Prescribers and Pharmacists
• Poster: Dehydration and Dementia

Clinical Resources for Care Staff

• Responsive Behaviours and Sleep presentation
  • Full slides
  • Notes pages
• ​Brain Exchange
  • ​Resource Centre Topics A to Z: Sleep

Clinical Resources for Prescribers & Pharmacists

• College of Physicians and Surgeons of Alberta (CPSA)
• RxFiles
  • Chronic Insomnia in Older Adults
• Therapeutics Initiative: UBC
  • Is use of quetiapine for sleep evidence-based?

Information to Share with Families

• Choosing Wisely Canada
  • Insomnia and anxiety in older people: Sleeping pills are usually not the best solution

Quality Improvement Strategies and Tools

• Strategies to Support Sleep
• Sleep and Responsive Behaviours Action Plan
• Letter for families and staff
• Letter for prescribers
• Guidelines for a Good Night Sleep
• Data Collection Template with Sleep (.xlsx)
• Sleep and Responsive Behaviours tracking tool
• Behaviour Mapping Chart

For best viewing of the videos and learning modules, copy and paste the url into Google Chrome .

Interactive Learning Modules

Appropriate Use of Antipsychotics (AUA):

• Family Engagement in AUA

Videos

• Island Health Dementia Video Series
  Some of the available titles include:
  • Responsive Behaviors
  • Hallucinations or Delusions
  • Repetition
  • Personal Care
• WorkSafeBC: videos, dementia
  • 1. Introduction (2:41)
  • 2. How to approach residents (5:39)
  • 3. How to distract and redirect (2:44)
  • 4. Stop and assess(3:14)
  • 5. When all the right stuff doesn't work(4:33)
  • 6. Easing the stress (4:00)
• Teepa Snow: videos, resources, races
• Terra Nova Films, film and inservice previews :
  • Creating Moments of Joy (2:11)
  • Creating a Home in Nursing Homes (2:52)
  • Dementia with Dignity (2:52)
  • Dealing with Physical Aggression in Caregiving (2:46)
• Choose from a number of available videos. Our top picks:

Dementia Resources

• Alberta Health Services
  • Bringing Person-Centered Dementia Care to Life
  • Meeting the Needs of People Living with Dementia in Alberta's Residential Living Options: Ensuring Person-Centered Care
• Alzheimer Society Canada
  • About Dementia
• Alzheimer's Association UK
• British Columbia Interior Health Authority
• Canadian Dementia Resources and Knowledge Exchange
  • Resource Center Topics A to Z
• CareWest
  • Dementia Care Training
• Dementia Support Australia
• Registered Nurses' Association of Ontario: Long-Term Care Best Practices Toolkit, 2nd edition