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?

 

4 Replies to “A Tale of Two Long-term Care Homes – It Can Be Different!”

  1. We have asked for change for. Years. Maybe now since the pandemic has brought this to the forefront the information of all things will change. But we will all have to push for change, and keep pushing to make this happen

    1. You are so right. We – a collective ‘we’ – need to keep pushing to make this happen!

  2. I agree with you. My wife has dementia and has been in St.Patricks home in Ottawa for almost 7 months. It is the 32 person model which operates pretty much as you describe. Your alternative model would be much better but how do you implement it in an LTD home that was built 7or 8 years ago. What would it cost to renovate 5 floors and 10 sections and is it even feasible. The government needs to finance this new model instead of the 32 person model but I do not see it happening with this government in Ontario. So how do we fix St. Pat’s to make it more like your new model. First, we need more and better paid PSW”S and nurses. We need more activities. We need better communication between caregivers and staff. We need it to feel more like a home so maybe we take the 32 people on the floor and break them up into 5 groups of 6, 4 groups of 8 or whatever works best. Then have these groups of 6 run by a committee of caregivers, staff, family, and management meeting once a month to finetune everything. All groups would eat together, and do activities together in the open common area but more attention would be given to the health, hygene,etc. of the residents. An effort should be made to reduce the cost per resident although I say this without knowing the current budget details. I do know that a for profit group home of 30 women residents was paid a minimum $50 per day per resident which adds up to $547,500.00 per year. Figures from 7 or 8 years ago’. Probably, a little higher amount per day now. And the owners made money while owning a three story building. If I projected these numbers to St. Pats 10 units would receive $5,475,000.00 per year from the Ontario Government. How does the government finance non- profit LTD homes? I don’t know if they pay money to Ltd Homes but 16 single rooms bring in $518,400 a year and16 double rooms bring in about $384,000 a year my guess for a total of $902,400 a year. So you have to know the numbers to get to some of these answers. just throwing some ideas out there.

    1. Thanks so much for your thoughtful observations. While it is clearly a challenge to bring major reform to Ontario’s long-term care home system and it won’t happen overnight, we need to keep pushing for this change. We have already seen some successes with the implementation of an emotion-based model in both the for-profit and non-profit long-term care homes in Ontario – e.g. Malton Village in Peel; and Henley Place in London. Closer to home, the Glebe Centre is in the process of implementing an emotion-based model, as are Bonnechere Manor and Miramichi Lodge.

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