Is your long-term care (LTC) home working to reduce antipsychotic use for residents without a diagnosis of psychosis? Whether you’re just getting started or building on existing work, Healthcare Excellence Canada’s (HEC) Sparking Change in the Appropriate Use of Antipsychotics (AUA) Awards Program is designed to make a meaningful impact in your home.
Why this matters
Over the past decade, LTC homes across Canada have made important progress in reducing potentially inappropriate antipsychotic use. By focusing on person-centred care strategies to address behavioural and psychological symptoms of dementia (BPSD), these efforts achieved meaningful improvements in quality of care, benefiting residents, care partners and care providers. Between 2014-2015 and 2019-2020, the rate of potentially inappropriate antipsychotic use dropped from 27.2% to 20.2%.
Unfortunately, the COVID-19 pandemic brought new challenges. Staffing shortages and high turnover made it difficult to sustain progress and rates of potentially inappropriate use have risen in many areas. Currently, 24.5% of long-term care residents in Canada are prescribed antipsychotic medication without a diagnosis of psychosis. To help renew momentum, HEC built on the Appropriate Use of Antipsychotics (AUA) approach, first identified through an improvement project in our EXTRA: Executive Training Program. The approach was then expanded through national and provincial collaboratives in partnership with long-term care homes and jurisdictions including New Brunswick, Newfoundland and Labrador, Prince Edward Island and Quebec. Together, we have supported hundreds of homes to safely deprescribe antipsychotics for people living with dementia.
Sparking Change in AUA continues this work by helping teams re-engage with person-centred care and connect with others across the country.
The AUA approach
The AUA approach focuses on person-centred care by tailoring strategies to meet the unique needs of each resident. Responsive behaviours are often a result of unmet needs, confusion or frustration due to changes residents are experiencing. By understanding the resident and their family and creating a care plan centred on their specific needs, it’s often possible to reduce or stop using unnecessary antipsychotic medications. The AUA approach is a full team approach and is most successful when all members of the resident’s care team have a common goal, share and review data and support and reinforce each other’s work. By collaborating, teams can improve residents’ quality of life, foster a positive staff culture and strengthen family involvement. As the experiences of enrolled homes show, person-centred care can lead to more connected teams, more engaged residents and more supportive environments for everyone involved.
A shared goal for safer, person-centred care
Long-term care homes across Canada have made important progress in reducing potentially inappropriate antipsychotic use, and there is an opportunity to build on this progress together. To help guide this work, an evidence-informed benchmark of 15 percent was developed by an independent panel of experts convened by Canada’s Drug Agency, in collaboration with Choosing Wisely Canada and with support from the Appropriate Use Coalition. The Coalition is a grassroots alliance of healthcare organizations and public representatives working to improve outcomes and reduce harm through appropriate prescribing.
While some homes may already be close to or below this level, others may face challenges that make this goal feel more ambitious. Every reduction, no matter the starting point, helps improve quality of care and resident safety.
Reaching this goal could mean up to 21,000 fewer residents receiving medications that may not be needed, reducing the risk of serious complications such as stroke, pneumonia and falls. It is part of a broader shift toward safer, more compassionate and individualized care in long-term care and Sparking Change in AUA is here to support each home’s journey at its own pace.
Success stories and impact
Long-term care homes enrolled in Sparking Change in AUA are already seeing meaningful change by rethinking how they respond to behaviours and centring care around each resident’s individual needs.
At Chartwell Crescent Gardens in British Columbia, the team reduced inappropriate antipsychotic use by 33 percent through individualized care plans, staff training and strong family engagement.
“This initiative has transformed our home by focusing on understanding individuals rather than just managing behaviors,” says a care team lead. “This cultural shift has led to long-term improvements in care, with residents experiencing greater engagement, better emotional well-being, and enhanced health outcomes.”
At CHSLD du Pontiac in Quebec, themed “life stations” were created throughout the home in partnership with community groups and volunteers. From art studios and book clubs to indoor cinemas and gardening corners, these spaces brought renewed energy and meaning to residents’ daily lives.
“Instead of seeing residents sitting silently in chairs in the dining room every day, it has literally brought our centre to life,” says a staff member.
“Allowing residents to transition into long-term care without having to suffer the loss of their independence, individuality, joy of hobbies, and sense of community is a gift that is not tangible.”
At Lewisporte Health Centre in Newfoundland and Labrador, two residents regained the ability to speak, eat and engage in daily life after antipsychotics were discontinued.
“The residents were then able to talk, feed themselves, and participate in activities in the home,” explains a team member.
“The initiative has helped move our focus from managing behaviors to understanding and meeting residents’ underlying needs, resulting in a notably positive impact,” shares a member of the care team.
These experiences show what’s possible when care is grounded in connection, collaboration and curiosity. Through Sparking Change in AUA, teams are creating safer environments, improving quality of life and making space for residents to thrive.
Supporting person-centred care through AUA
Sparking Change in AUA supports long-term care homes in reducing potentially inappropriate antipsychotic use while strengthening person-centred approaches to care. Designed with flexibility and minimal reporting requirements, the program is adaptable to each home’s context, whether a team is just beginning or building on past efforts.
Teams enrolled in the program are matched with a coach and gain access to practical resources, including a curated toolbox and monthly learning sessions and networking events with peers across the country. Peer-to-peer learning is a key feature of Sparking Change in AUA. The program creates space to share insights, test strategies, and stay focused on what matters most: improving the lives of residents and supporting the people who care for them.
Participation also comes with opportunities to be recognized through financial awards. Some of the awards are evaluation-based, while others are chosen through random draws. The earlier you register, the more opportunities you have to win. Once your team registers for the program, you will receive an information package with more details on each award opportunity and related scoring criteria, where applicable.
Whether your team is ready to start or looking to deepen its work, Sparking Change in AUA provides the support and structure to make meaningful improvements in care.
Are you ready to spark change?
Enrollment is now open for long-term care homes interested in joining Sparking Change in AUA. Register by October 1, 2025, to take full advantage of available supports and award opportunities.
The Progress Award is also open for submissions until August 22, 2025, offering a $5,000 prize to up to 30 long-term care homes that demonstrate meaningful progress toward their AUA goals.
Join a pan-Canadian learning community working to reimagine care with compassion and intention.
