Blog

Posted on

From Institution to Home: It Can Be Done

Nora, a PSW, and Lionel, a resident in one of the many rooms with tranquil murals – photo is courtesy of the Glebe Centre

On February 22nd, 2023, Susan Zorz, Executive Director (Acting) of the Glebe Centre, a long term care home in Ottawa, gave an informative and animated presentation on how the Centre transformed its Bankwood Unit from ‘institution to home’ with the implementation of the butterfly model of care.   The journey was longer than anticipated as Covid created a bit of havoc with their schedule but the Centre was steadfast in its determination to complete the process and attained its ‘butterfly’ accreditation status in November 2022.  The Centre is strategically planning to bring this approach to its other units.

As Susan noted in her presentation about the cultural transformation, “The introduction of the Butterfly Model of Care requires changes in staff roles, training, day-today operations as well as to the physical design of the home…..”

Some key outcomes and improvements include decreasing use of psychotropic/sedative medications; reaching people’s emotional reactions and distress responses; people living with increased well-being; meaningful engagement; fewer falls through greater independence; and reduced staff turnover – less absenteeism.

To view this exciting presentation and learn more, please click here .

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; or with your municipal or provincial representatives; or with your local community papers or other media contacts who might help promote this cause!

Posted on

Resident autonomy over institutional effectiveness

More than 300 people registered for the webinar, Humanizing Dementia Care in Long-Term Care on Feb 11, 2023. Aimée Foreman began her presentation saying, “Aging is a social experience, and our emphasis in long-term care should be on the social experience as opposed to clinical care.”

Aimée presented information on the Hogeweyk model of care for those with advanced dementia and explained why this village model promotes quality of life for the residents. Hogeweyk villages emphasize a household model where normal activities of living occur inside the home and exterior design allows for other activities that usually happen outside the household such as shopping, concerts etc.

Some of the key points in her presentation include:

  • Normalizing dementia is key.
  • Resident autonomy and self- identity trumps institutional effectiveness.
  • Language is important. Use of the words “programs” or “therapy” implies a clinical approach.
  • We need to measure quality of life based on the experience of the person living in the home.
  • Quality of life implies choice and with choice comes risk.

To view the presentation, please click here.  

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.

 

Posted on

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.

 

 

Posted on

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.

 

 

Posted on

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!

 

Posted on

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.

 

 

Posted on

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.

 

 

 

Posted on

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!

Posted on

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.

 

 

Posted on

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

 

Posted on

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.