A Silent Trend in Canadian Long‑Term Care: Antipsychotic Use Without Diagnosis

 

A recent report has revealed a troubling pattern in long‑term care (LTC) homes across Canada: one in four residents is being given antipsychotic medication despite having no diagnosis of psychosis. These drugs—intended to treat conditions involving delusions or hallucinations—are often being used instead to manage behavioural symptoms such as aggression or agitation, particularly among residents with dementia. 

This trend has been growing in recent years. National data shows that potentially inappropriate antipsychotic use in LTC reached more than 24% in 2023–2024, continuing an upward trajectory that began before the COVID‑19 pandemic. Rates vary widely across the country, with some jurisdictions approaching 35%. The pandemic intensified staffing shortages and disrupted person‑centred care practices, making it harder for facilities to rely on non‑pharmacological approaches. 

Canada’s rate of inappropriate antipsychotic use is also high by international standards—nearly two and a half times the rate reported in the United States, and significantly higher than in countries like Australia and Sweden. 

Advocates and health organizations stress that antipsychotics should not be the first line of response for dementia‑related behaviours. Instead, they call for renewed investment in staffing, training, and person‑centred care strategies that address the root causes of agitation without relying on powerful medications.

As Canada continues to grapple with an aging population, the findings highlight an urgent need to strengthen oversight, support caregivers, and ensure that seniors receive safe, appropriate, and dignified care.