Author: ChangeLTCNow

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Thriving in a long-term care home


Sherbrooke Village in Saskatoon where the Eden Alternative was implemented

That’s exactly what residents are doing in the long-term care home at the Sherbrooke Community Centre in Saskatoon.  The home has followed the Eden Alternative for over 20 years.

“Our whole purpose is to create a community where people thrive,” Schmidt told White Coat, Black Art host Dr.  Brian Goldman. “Different from an institution where people are meant to die.”    Click here to read more 

Amongst the many programs offered is the iGen, an intergenerational classroom where students and residents exchange wisdom and knowledge with each other Monday through Friday.

This program and others at Sherbrooke work to “alleviate the plagues of the human spirit” one senior — or elder, as they are called here — at a time, said CEO Kim Schmidt. These plagues are loneliness, boredom and helplessness.

This home has 263 residents, 15 of whom are indigenous,  and over 60% of the residents have dementia.

Ontario needs more homes where residents thrive in a place that looks and feels like home, not an institution.

Please help make this transformation a reality by forwarding this post to your contacts or by sharing on your Facebook, Twitter or Instagram accounts.

 

 

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3. Did you know that………

Did you know that staff turnover is less in the Green House model of care?

For nearly two decades, The Green House Project, an emotion-based model of care, has received praise and positive media coverage for bringing the humanity back to eldercare. But while the model itself is a major departure from the status quo, the math behind it is quite straightforward: Operators that adopt Green House principles find themselves with fuller communities, a more engaged and satisfied workforce, substantially lower risk of COVID outbreaks, and costs that are either in line with or lower than traditional facilities, which typically operate with much greater overhead.

Green House’s unique staffing structure results in greater workplace satisfaction and lower levels of stress for frontline caregivers. Staff turnover is substantially lower than traditional nursing facilities: In 2021, Green House homes had a CNA (Certified Nursing Assistants), much like our PSWs, turnover rate of 33.5%, compared to nearly 130% among traditional nursing facilities prior to the pandemic. Read more here

 

Emotion-based model of care is one which has smaller environments, 8-16 residents/unit; communal dining room and kitchen; where full-time staff actually know their residents and where residents, staff and families are all valued as a part of the team sharing times of laughter, joy and meaningful activities.

What is most important is that your family member has quality of life in the years remaining. Learn more about emotion-based models of care at www.changeltcnow.ca and contact your MPP now to advocate for emotion-based models of care in all our long-term care homes!

Please help us as champions of emotion-based care for Ontario’s long-term care homes by forwarding this post to your contacts or by sharing on your Facebook, Twitter or Instagram accounts.

 

 

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1. Did you know that……

Did you know that the use of antipsychotic medications is lower in emotion-based models of care?

Queen’s University IRC (Industrial Relations Centre), published a paper in 2019, “Dementia Care Innovation in the Region of Peel” by Francoise Morrisette, which showed that one year after implementing the Butterfly model in long-term care homes, the use of antipsychotic medications was lower and aggressive events were less.

The same result was achieved in the Green House model. George Heckman, a Geriatrician and the Schlegel Research Chair of Geriatric Medicine at the University of Waterloo, said any long-term care homes that want to further reduce the number of antipsychotic drugs prescribed ‘potentially inappropriately’ can adopt the Green House model, which has been studied by his team. “The Green House model data shows antipsychotic use being much lower. They also have fewer hospitalizations. They have a better quality of life. The staff who work there have a better quality of work.” Read more here

Emotion-based model of care is one which has smaller environments, 8-16 residents/unit; communal dining room and kitchen; where full-time staff actually know their residents and where residents, staff and families are all valued as a part of the team sharing times of laughter, joy and meaningful activities.

What is most important is that your family member has quality of life in the years remaining. Learn more about emotion-based models of care at www.changeltcnow.ca and contact your MPP now to advocate for emotion-based models of care in all our long-term care homes!

 

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Guess who is having success reducing the use of antipsychotic drugs!

The headline of CBC’s Matthew Pierce’s recent article is “More than 1 in 5 residents in long-term care given antipsychotics without a diagnosis, data shows”.  Click here to read more 

Without the need to reinvent the wheel, long-term care homes that implemented an innovative model of emotion-based care  (e.g., Hogewey, Green House, Butterfly and Eden) demonstrated success in reducing the use of antipsychotic drugs resulting in fewer aggressive incidents and cost savings from fewer drugs.  For example, as of 2020, in their units where the Butterly model was implemented, Malton Village saw a reduction of antipsychotic drug use from 40% to 8% and  Henley House from 57.9% to 8%.

If this is the kind of care you would like for yourself or a family member, please share this information with as many of your friends and contacts as possible – even your MPP, city councillor or your local newspaper.

 

 

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Bravo to Quebec: a re-imaging of long-term care homes

 

A Green House Dining Room (copied with permission)

A recent article in the Globe and Mail (Ontario edition) noted that “Quebec aims to eliminate the indignities of institutional living with the Green House model, a re-imagining of long-term care homes”.  Click here to read more

The Green House model is one of several innovative models of care that feature a safe home-like environment and where relationships matter.  Other innovative models include the Eden Alternative, the Butterfly Home, and the Hogewey Village.

Consistently both before and during the pandemic, long-term care homes where an innovative model was implemented have fared better in so many ways: decrease in staff sick days, decrease in antipsychotic medications, decrease in falls causing injury, fewer Covid cases and fewer deaths caused by Covid, to mention just a few.

While there has been some progress with innovative models in several provinces in Canada, Quebec is the first to show leadership with a provincial strategy that has what it takes to significantly and positively change the face of long-term care homes as we know it.

Ontario missed an excellent opportunity to lead the way when its Independent Long-term care Covid-19 Commission recommended that the Government implement an innovative model in its homes, one of several recommendations in the Commission’s Report.   We encourage you to write to your MPP and demand that the government invest in a provincial strategy to implement emotion-based care within all LTC homes in Ontario.

 

 

 

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Hugs become OK in Sunnyside Home!

 

 

 

 

 

Congratulations to Sunnyside Home Long-Term Care home, the first home in Waterloo Region to be accredited in the “Butterfly” model of care, which creates a more homelike space for residents.

Connie Lacy, Director of Seniors’ Services at the Region of Waterloo, says that “It’s not about the task, it’s about the kind of care a family member would give.” Staff engage with residents in more human ways: having tea, offering a hand massage or painting fingernails”. Read more here.

Sunnyside has 49 beds within their LTC home converted into the Butterfly model of care. The home has seen a reduction in the use of antipsychotic medication, increased resident and staff satisfaction and improved quality of interactions.

Sunnyside long-term care home has joined nearly 20 other long-term care homes in Ontario in providing a model of care that promotes dignity and quality of life for our seniors. What about the long-term care homes in your area. Have they embraced an emotion-based model of care or are they still sitting on the fence? It can be done and is proving to be successful!

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Where Is The Air Conditioning?

There is so much to be done yet the need for radical change in Ontario’s long-term care home system seems to keep falling on deaf ears.

For example, as reported in the August 2022 CARP ACTION bulletin, “Approximately 90 long term care homes in Ontario still do not have air conditioning despite promises and commitments by various elected officials including Premier Doug Ford.”

Bill VanGorder, Chief Operating Officer and Chief Policy Officer, comments, “This year there was legislation that all long-term care homes have air conditioning in place and many of them don’t. Once again, we’re seeing a regulation that’s in place to protect seniors and it’s not actually enforced.”  Click here to read more: CARP Action

Get involved and demand change now in Ontario’s long-term care homes: contact and meet with your MPP, write letters to the editor of national and local newspapers, organize a petition, and the list goes on.

 

 

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Transformation to Butterfly model of care coming to long-term care home in Orangeville

Photo courtesy of Jarlette Health Services
Photo courtesy of Jarlette Health Services

On July 6, 2022, Jarlette Health Services announced that it has begun a transformation to the Butterfly Approach to care at its Avalon long-term care home in Orangeville, Ontario.

It is embracing “the Butterfly Approach” to help create a more natural home and community setting. This includes fostering stronger interpersonal relationships between residents and team members, building daily routines around peoples’ needs and interests, and creating a living environment which more strongly resembles a private dwelling.

The care model, which has already been implemented in parts of Ontario, elsewhere in Canada, the United Kingdom, Ireland and Australia, has a proven record of positive outcomes for residents, including improved physical and emotional health and well-being, reduced use of medication, and greater engagement by residents in daily life.

The Butterfly Approach will be implemented at other Jarlette Health Services communities in the months ahead.”   Read more here  Butterfly Approach to care in Avalon Care Centre

 

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Municipalities can make an important difference!

Redstone, Malton Village, Region of Peel

Most municipalities in Ontario manage at least one long-term care home.  In larger cities like Toronto and Ottawa, they manage several homes.

Here is a brief recap of Ontario’s long-term care home system: (from a previous blog post – March 16, 2020)

There are 626 long-term care homes in Ontario (as of 2019); of these, there are 3 categories:

For-Profit: 58%,   Not-for-Profit: 24%,   Municipal: 16%

What are the commonalities?

  • Funding: All 3 types are funded by the Ministry of Health and Long-Term Care through the Local Health Integration Network (LHIN) based on the same formula.
    In addition: Municipalities can opt to top up funding for their homes through tax payers’ dollars.  Some of the other homes have either foundations or fundraising programs that can top up their funding for capital expenditures or program enhancement.
  • Resident costs: In all 3 types, residents are required to contribute a co-payment for accommodation of basic ($1848.73), semi-private ($2,228.63) or private ($2640.78).  These costs are as of 2018 and there is a cost of living increase each July.
  • Legislation:  All 3 types are subject to the same standards, rules and regulations.

How are the homes managed?

  • The for-profit long-term care homes are managed by their corporate office through their Chief Executive Officers (CEO’s)
  • The not-for-profit long-term care homes are managed by a Board of Directors through their CEO’s
  • The municipal or city-run long-term care homes have a formal mechanism in place for their management through a committee of City Council and a staff director.

In our last blog post, we featured the innovation in city-run homes in Toronto including a joint model of funding.  The Region of Peel led the way a few years when it adopted an innovative model for its homes.  Homes in other municipalities like the Glebe Centre in Ottawa have also shown similar leadership.  Please make this an election issue in the upcoming municipal elections.

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Transformation is coming to Toronto city-run LTC homes!

A Green House Dining Room (copied with permission)

Toronto City Council is embarking on a new venture called CareTO, transforming their city-run LTC homes into social models of living from the traditional task-and-schedule driven model. This $16.1 million program is a jointly funded effort over a five-year period, with $12 million from the province and $4.1 million from the city.

A 12-month pilot program has been launched at Lakeshore Lodge Long-Term Care Home in Toronto and if it meets city council’s expectations, the transformation will be undertaken in all 10 city-run homes.

The pilot program will be evaluated by researchers from Sunnybrook Health Sciences Centre and the University of Toronto and evaluation will focus on resident falls, staff absenteeism and satisfaction reports from residents or their families. Read more here.

The CareTO approach redesigns living spaces to be more intimate and less institutional and care focuses on an emotion-centred approach to meet the needs of residents.  Existing staff receive additional training and education to transition to the new model of care.

Just think what could be accomplished in other city-run LTC homes across Ontario if this joint model of funding was adopted!  Let’s make this an election issue in the upcoming municipal elections!

 

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Leadership Matters: How to make a LTC Home a “home”

On June 8th, Rebecca Priest presented a webinar on the importance of leadership in emotion-based models of care. A leader herself, Rebecca has spent 20+ years working with seniors, serving as a social worker, Green House Guide, and Licensed Nursing Home Administrator and Chief Operating Officer for a large non-for-profit serving elders in upstate New York. 

Rebecca said that a leader is one who:

  • really listens to elders in the home as well as the staff who support them.
  • Wants to hear views from all involved.
  • Values people and partnerships.
  • Fosters relationships between elders, staff and families.
  • Believes all staff are good and want to do a good job.
  • Is not necessarily the person with the title.

“Leadership is not associated with role but with influence.” This person “knows” his/her staff and empowers them in their role. Rebecca’s presentation also compared the Green House model to traditional LTC homes in terms of staff turnover, satisfaction rates, and clinical outcomes. In all cases the Green House model was assessed at better levels. (See ppt here)22 Green House – Leadership and relational models of LTC ppt June 8

“Good relationships lead to good clinical outcomes.” The Green House model is one example of an emotion-based model of care that ensures that all elders live life!