Category: Ontario’s Long-Term Care Homes System

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COVID in the HOUSE of OLD

COVID in the House of Old is a storytelling exhibit that tells nine stories as shared by residents, family members and staff pertaining to the horrific events that unfolded during COVID across Canada within long-term care homes. Who can ever forget the pictures of military personnel who were deployed to save seniors stranded in COVID-ridden long-term care homes where frail elderly residents appeared dehydrated, unfed, and covered in urine and feces. In fact, 82% of the first wave deaths due to COVID were residents of long-term care homes. Residents were locked away from the world and health care workers were left unsupported during the pandemic. Read more here.

COVID in the HOUSE of OLD calls on all Canadians to act and specifically calls on the provincial and federal government to transform long-term care homes into a caring, positive option for seniors and a rewarding place to work. A petition is part of the exhibit and within the petition are 7 recommendations for action. One of these recommendations calls on the government to fund a Canada-wide pilot project of 24 new model LTC facilities, consisting of small, home-like units, constructed to limit the spread of infectious disease!

Take a look at the report, sign the petition, and do your part to make sure this never happens again!

https://covidinthehouseofold.ca

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CARP Ottawa calls for change in long-term care — from Institutions to Homes

Media Release July 31st, 2023 

ChangeLTCNowMost of Ontario’s long-term care homes (LTCHs) are still being operated as institutions. This despite four decades of systemic weaknesses that were brought to light because of the horrific tragedies of the pandemic. 

We are calling on the Ford government to mandate and fund the ongoing transition of LTCHs from institutions to homes so that residents can live in dignity and with the respect they deserve. 

Positive changes in models of care already exist in the province. For the last five years, CARP Ottawa and other like-minded organizations in Ontario have been working hard to highlight those positive changes. The models include: The Eden Alternative, The Butterfly Approach, Hogeweyk Villages, and the Green House Project. Other homes, such as the municipal homes in Toronto, have opted to use a hybrid model. They all use the same philosophy of care. 

More awareness is needed. Residents deserve to live with respect and dignity.  Georgie’s compelling story, described in the video shows how The Butterfly Approach enabled her to come to life again, even though living with dementia. The other describes ‘The Eden Alternative model – how its philosophies care for the whole person and create a home – and how it values its staff, resulting in a remarkable 95% staff retention rate.  View the videos here:

Watch Georgie’s Story
Watch The Eden Alternative Model

There are many long-term care home operators in Ontario, other provinces and internationally, that have already transformed their institutions to homes.  The Quebec government has just announced it will be transforming all its nursing homes using similar approaches. These shifts result in significantly better outcomes for residents, staff, and families, both pre and during COVID-19.    

The fundamental principle in Ontario’s Fixing Long-term Care Act 2021 – to provide a place where residents may live with dignity and security, safety and comfort and have their physical, psychological, social, spiritual, and cultural needs adequately met – is not being applied. 

If we don’t begin to fix the long-term care home system now, after two years of horrific tragedies, they will be forgotten again for decades or until another pandemic hits.  

For contact information re interviews with family caregivers, experts and staff, call:

Kathy Wright – 613-808-8978, Chair, CARP Ottawa’s Working Group on Long-term Care or

Marg Eisner – 519-771-1129, Member, Working Group on Long-term Care.

www.carp.ca  – a New Vision for Aging is Canada’s largest advocacy association for older Canadians promoting equitable access to health care, financial security, and freedom from ageism. There are more than 300,000 members nationwide. 

We urge you to share this with your friends, families and contacts as well as with your MPPs (for easy reference the link to the MPPs – click here   

 

 

 

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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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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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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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Ontario Election Day, Thursday June 2nd

The CARP 5
This is what CARP heard in the campaign:

CARP members will be glad to know that their issues were indeed a major part of most party platforms! The Report Card above illustrates where each party came down on the CARP 5 issues. Whatever the result of the June 2nd election, this campaign for change does not end. THE CARP 5 issues will be the first topics of discussion with elected Ministers and MPPs. Your support and the collective voice of all people is needed to continue to press for needed investments and improvements in our long-term care home system!

 

 

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Omicron: The pandemic of staff shortages

Malton Village, The Toronto Star, June 22, 2018.

In a recent Toronto Star article by Moira Welsh, the headline is “Long-term-care residents struggle with loneliness, physical, and mental decline amid staffing crisis”. 4000 staff members are infected across the province which translates into lack of hands-on-care for the many residents within LTC. Residents, particularly those living in institutional type LTC homes are struggling from loneliness and lack of physical movement. Some LTC homes are on full lockdown with residents isolated in their rooms! Click here

The staff shortage that came about is too complex to delineate here.  Certainly, many are infected with Omicron. And also problematic is government legislation that has capped pay increases at one per cent annually for three years. LTC Homes are seeing staff leave their jobs as they accept higher paying positions elsewhere.

If there is any good news about this, then look at the smaller emotion-based models of care where 8-12 residents live in homelike settings. These residents do not suffer loneliness to the same degree as they live in an environment where staff, residents and volunteers are like family. One private operator with 14 homes, has tried to attract workers by paying for accommodation, meals or transportation. They also planned ahead for the staff shortage and increased their staffing levels.

Currently, the provincial government is developing Regulations to accompany the new “Fixing Long-Term Care Act, 2021″. Sufficient staffing is key to meeting quality improvement criteria without living in a continuous emergency situation. The use of full-time, consistent staff, who are provided a living wage and provide four hours of direct care must begin now, not 2024!

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Social Connection is Essential in Long-Term Care Homes

 

The Hover Green House, Longmont Colorado copied with permission

Currently there are over 40 Ontario LTC homes with one or more staff and/or residents affected by COVID-19. Over a year ago, there were nearly 4000 residents who died from this virus. We have come a long way since then! We now have residents double vaccinated and boosted, staff required to be vaccinated and we have learned that as the virus numbers rise, action needs to be taken immediately to help keep residents and staff safe.

And so, Rod Phillips, Minister of Long-Term Care just announced that residents will not be allowed to leave their home for social purposes and access to long-term care homes by general visitors will be paused but that designated caregivers may continue to enter long-term care homes. These visits by designated caregivers are so important for the residents as they struggle with loneliness and isolation. For more information click here.

In institutional type LTC homes where there are 32 bed-units often with two residents in a room and long hallways, the infection control measures that are put in place such as eating meals in residents’ bedrooms, and no scheduled activities, diminish the residents’ feelings of social connectedness leading to loneliness, depression, and isolation.  On the other hand, we know that in emotion-based models of care, social connectedness remains during viral outbreaks. These LTC homes have small homelike spaces for 10 – 12 residents, with common dining and living areas that are not closed to the residents.  The physical design of the emotion-based models provides an environment where the transmission of viruses is easier to contain.   Activities continue and residents feel like they are at home!

We urge you to do your part to bring an emotion-based model of care to long-term care homes in Ontario. Contact you MPP and make this a “ballot” issue in the upcoming provincial election!

 

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More staff for long-term care homes!

 

Hats off to Long-Term Care Minister, Rod Phillips, and the Ontario Government for providing funding to hire more than 4000 new staff in long-term care (LTC) homes! This concrete step will help move the yardsticks towards increasing direct care hours for residents to an average of four hours/day. All residents in Ontario LTC Homes will benefit from this news.

This is a first step towards transforming our LTC home system and one which demonstrates that the Ontario government recognizes and values the care that staff provide. However, staff recruitment for LTC homes is becoming an issue. A strategy to help mitigate this crisis is to create LTC homes where staff want to work and residents want to live!

Let’s hope the government will build on this first step of increasing staffing by looking at how care is delivered. There are emotion-based models of care in existence which have shown how to use the funded hours of direct care most effectively resulting in residents who enjoy a quality of life and staff who enjoy working with those who live in the LTC homes.

We urge you to do your part to bring an emotion-based model of care to long-term care homes in Ontario. Write to your MPP or to your City Councillor, or write a letter to the editor, or any other action that you think will help to promote a quality, dignified life for our seniors living in long-term care homes.

If we don’t speak up for our seniors who will?

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Long-term care home system: a ray of hope on the horizon

The Ontario government is currently reviewing and revising the LTC Act.  Now is the time to ensure that the Residents’ Bill of Rights is no longer violated.

This new legislation ‘will look fundamentally at what the foundation of long-term care needs to be in Ontario” and respond to recommendations from Ontario’s Long-Term Care COVID-19 Commission and others.

While all the recommendations in the Commission’s Report merit implementation, the following two recommendations are critical and need to be included in the revised LTC Act:

  • Ensure that family members are never denied access to their loved ones in long-term care homes (recommendation #31), and
  • Recognize the need for a transformative culture change using an emotion-based approach to care where residents, staff and families feel part of a community and are treated with dignity and respect; where there are small home home-like environments, where there is adequate, full-time, well-paid staff, who are trained in empathy and culture change and where family members are integral members of the team (recommendation #58)

Please encourage the Ontario Government to do the right thing and bring transformative culture change to long-term care homes in Ontario.  Write to your MPP or to your City Councillor, or write a letter to the editor, or any other action that you think will help to promote a quality, dignified life for our seniors living in long-term care homes.

 

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Will the Ontario government finally clean up its Act! continued…..

 

As noted in the previous blog post, the Ontario Government has long fallen short in meeting the existing Residents’ Bill of Rights (which falls within the Act).   Here are several more aspects of the Bill where expectations aren’t being met and where implementing an emotion-based model of care would meet those expectations:

  • Every resident has the right to live in a safe and clean environment. Transformative culture change to an emotion-based model of care would make this happen.
  • Every resident who is dying or who is very ill has the right to have family and friends present 24 hours per day. A culture change to an emotion-based model of care would ensure this happens.
  • Every resident has the right to receive personal care that accommodates physical, medical, emotional, and social needs. To succeed, we need a culture change to a resident-centered, emotion-based model of care.
  • Every resident has the right to receive assistance towards independence based on a restorative care philosophy to maximize independence to the greatest extent possible. An emotion-based model of care is needed.
  • Every resident has the right to have his or her lifestyle choices respected. Transformative culture change is needed to ensure this happens.

The urgent need for this transformative culture change cannot be repeated enough!  Already this issue seems to be disappearing from the Ontario Government’s radar.

We urge you to do your part to bring an emotion-based model of care to long-term care homes in Ontario. Write to your MPP or to your City Councillor, or write a letter to the editor, or any other action that you think will help to promote a quality, dignified life for our seniors living in long-term care homes.

If we don’t speak up for our seniors who will?