Category: Innovative Models

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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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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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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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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!

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A Tale of Two Long-term Care Homes – It Can Be Different!

 

Sherbrooke Village in Saskatoon where the Eden Alternative has been implemented

 Life for Linda is colorless and boring. The atmosphere feels cold and clinical – more like a hospital than a home. She gets up when she’s told to. Is provided with meals when she’s not hungry. Sits all day in a chair by herself staring at the TV, or gazing out of the window.

Linda feels as if she doesn’t matter. She thinks: “This isn’t my home. I don’t have a home anymore.” She feels hopeless and helpless – staff are too busy with a million tasks to have time for her.

One of the staff caring for Linda is Tammy. She works part-time, and holds down two other jobs to support her family. Every shift at work feels the same: she’s rushed to do all the tasks on her list and to record them. She’s stressed. She has too many residents to care for. She believes she’s a compassionate person, but she doesn’t have time to show it. Her job is far from rewarding.

Life is quite different for Sylvie. She too lives in an Ontario Long-Term Care (LTC) home but one which has embraced an innovative model of care.  It feels like home, sounds like home and looks like home, because the residents, staff and family members are all part of the same community. Sylvie feels loved and cared for – she feels that everyone understands who she is, and how she has lived her life.

Sylvie is content. She has meaningful activities each day. She chooses what she wants to do, when she wants to do it. Meals are enjoyed as family-style eating, where residents can select what they want.

 THE NEED FOR CHANGE

Nothing substantive has changed in the past 40 years in how LTC is provided in Ontario. For the most part LTC homes continue to be warehouses where our older, frail citizens are held until they die.

The prevailing attitude to change seems to be: “What’s the point? Nothing ever changes.”

Not true!

Change is happening. A growing number of Ontario LTC homes have embraced a new culture that puts love and respect at the centre of everything they do.

These are homes where family members know their loved ones are getting the best possible care.

A DIFFERENT, EMOTION-BASED, MODEL OF CARE

This innovative model of care replaces institutional, 32-bed units with smaller, homelike environments. Residents have private or two-person rooms and private bathrooms. Each home has a warm, central spot where people can gather and socialize. Family members are respected as a valued part of the care team.

Staff work full-time with good salaries and benefits. They are empowered to care for the residents with compassion and that all-important ‘human touch’. There is less emphasis on the many tasks that must be done (and tracked), and much more on spending quality time with the residents.

This is the fundamental culture change that is so urgently needed!

WHAT DOES IT TAKE?

What does it take to make the change to this new model of care? LTC spaces need to be reimagined and recreated. It takes visionary leadership, and financial investment upfront. It takes commitment from all the players to make it work, education and training in emotion-based care, and a sustainable plan to ensure success.

IS IT WORTH IT?

The benefits are clear and proven. Homes employing this new model of care experience improved happiness for residents, staff and family members. There is more interaction and family engagement, and heightened satisfaction.

There is reduced staff sick time, use of antipsychotic drugs, incidence of falls, and cases of worsened depression. In the US, homes using this new model of care experienced 50% fewer COVID cases, and 30% fewer deaths due to COVID in 2020. Administrative costs per patient were 6% lower.

WHICH WOULD YOU CHOOSE?

Keep the status quo, where most of our elderly citizens will languish in LTC warehouses, leading meaningless lives and risking exposure to future pandemics and other crises.

Or embrace a different, innovative model of care where emotion and connectedness are at the centre.  And where residents thrive.

Which one would you choose for your future?

Get Involved Now!

Ontario’s Long-term Care COVID-19 Commission recommended that the government promote and provide funding for long-term care homes that change to recognized, emotion-based models of care where staff know the residents, the residents are engaged and feel they are home and where compassion and respect are at the centre of everything.

Please get involved and ask candidates in your riding in the upcoming provincial election if they agree with this and if so, would they commit to including this in the budget process during the first year of your term?

 

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No matter which model is used, meaningful care matters!

266 people registered for the webinar led by Sally Knocker on “What does emotion-based care look like in practice?”  Sally, a consultant with Meaningful Care Matters, said that LTC homes need to create a sense of home, slow down the pace, and staff need to sit more with residents and share themselves.

The Butterfly model, an emotion-based model of care, is not just about the environment, but about creating a meaningful environment with pictures and memorabilia that is significant to the resident. The key is to find out what makes sense to the person’s well-being and allow them to express and be themselves.

Based on Kitwood’s flower of psychological needs, the Butterfly model embraces the following elements: a sense of identity, comfort, attachment, inclusion and occupation. Sally then added two more elements. The first was the need for freedom, being able to do the things that makes sense to the person. This requires staff to manage risk in a positive way so that the person feels both safe and free. The second was that fun needs to be foremost, as laughter enhances engagement with others.. Click on link to see more

 Participants rated the webinar very positively with a wish that all LTC homes could embrace this culture of care. Please make this a ballot box issue in the upcoming provincial election and ask the candidates if they will commit to including funding for emotion-based models of care in the budget process in the first year of their term if elected.

 

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Providence Living: Leading the way in Canada

 

On March 30th CARP Ottawa held a webinar on Providence Living Place in Comox BC. Candace Chartier, CEO, presented the webinar and provided slides which can be accessed here.

Providence Living is building a Hogewey village which will have 156 beds. The home will be configured with groupings of 12 private rooms or households that will constitute a “village”.  This new publicly funded long-term care home will be ready in 2024. What is unique about this emotion-based model of care is that they will have an indigenous log house in the centre as well as a chapel. Comox elders are helping to make this space a First Nations spiritual space, a first in long-term care homes in Canada. In addition, they are using a “living lab” concept where staff are currently being trained for three months with 10 residents in this model of care. This means that once the home is built, staff will be ready to move forward with policies in place.  Providence Living is also working with the University of British Columbia to evaluate their progress and outcomes each step of the way.

We have been able to obtain a video which provides an inside look at what Providence Living is hoping to achieve. It will provide an emotion-based model of care which will provide a quality of living focusing on a social model of care, yet residents’ physical needs will be attended to. This video can be seen here.

Hats off to Providence Living for leading the way! This is a publicly funded long-term care home that will provide a model for other provinces to follow. We need other provinces to change to emotion-based care.  With provincial elections coming up in Ontario, please make this a ballot box issue in Ontario.

 

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Another Innovative Model Coming to British Columbia

 

Daring steps forward are making their mark as Providence Living, a new non-profit health care organization established by Providence Health Care is set to redefine seniors’ care in British Columbia.

Construction of Providence Living Place, Together by the Sea, a 156-bed dementia village in Comox, B.C. will take place on the site of the existing The Views long-term care home and the former St. Joseph’s General Hospital. Construction will begin in 2022.

Candace Chartier, President and CEO of Providence Living, recently said “We are so very close to showing BC and the rest of Canada how publicly funded seniors’ care must be provided to create whole communities where people want to live.” Providence Living Place, Together by the Sea will change long-term care from an institutionalized medical model to one that fosters a home-like environment where staff and residents become friends in a culture where families, children, pets and visitors become interwoven into the fabric of life throughout the facility.  Click here

Other provinces ‘are doing it’.   We need a drastic transformative change to emotion-based care in Ontario too.  Please make this a ballot box issue in Ontario.

For more information on existing emotion-based models of care in long-term care homes go to www.changeltcnow.ca