CARP Ottawa calls for change in long-term care now from Institutions to Homes
Media Release July 31st, 2023
Most 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: https://changeltcnow.ca/video/ChangeLTCNow-MeaningfulCareMatters-v6.mp4
https://changeltcnow.ca/video/ChangeLTCNow-SueEllen-v4.mp4
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
“I opened Canada’s first dementia village”
Canada’s first community designed specifically for people with dementia, Langley Village
As noted in his article which recently appeared in Macleans, Elroy Jespersen, came to the conclusion when considering long-term care homes that “The standard approach was to designate a wing or floor of a given building to dementia patients, with locked doors on either end. When the doors wouldn’t open, they would get frustrated and agitated. I’d panic if I couldn’t move about freely—wouldn’t anyone? Newer facilities have doors that open into a fenced-off courtyard instead, but people still feel trapped. The focus was always on their safety; their freedom and connection with others took a back seat. This approach didn’t sit right with me: life should be about more than just safety. “
Fast forward, Village Langley in British Columbia is now thriving. Click here to read more
This is one of several innovative and/or hybrid models that allow residents to live in ‘homes’ and not in institutions. So while the costs at Langley may be too expensive for most, there are other models to choose from or to adapt the Village model accordingly.
If you want to see these types of ‘homes’ become the norm, please help us create more awareness by sharing this post with your contacts, MPP, and City Councillor.
Quebec is all action in transforming its long-term care homes from institutions to homes
The Hover Green House, copied with permission
In his presentation on May 17th, Stéphane Bouffard, long-term care consultant at la Ministère de la santé et des services sociaux in Quebec, was passionate when he spoke about the approach being taken to transform all long-term care homes from institutions to homes. With good reason!
Quebec seems to be ‘all action’ as noted by CBC news in its posting on May 22nd, 2023, “Quebec announces 1st private CHSLDs to get government funding as province moves to fund all” Click here to read more . Quebec is taking seriously the need for drastic change to transform its long-term care home system and ensure that residents in any home receive quality care and have quality of life.
Please join us as Champions for Change Long-term Care Now from Institutions to Homes by forwarding this post to your contacts, MPP and city councillor.
Overhauling Quebec’s long-term care homes with small more “humane’ homes for seniors
A Green House Dining Room
At the May 17th webinar, Stéphane Bouffard, long-term care consultant at la Ministère de la santé et des services sociaux in Quebec, spoke in no uncertain terms about the progress that is being made to do just that. His passionate presentation outlined Quebec’s strategic plan to transform long-term care homes from institutions to homes where the focus on new builds has already begun. The projected size of the units will range from 12 to 15 residents and the care approach has been adapted from existing innovative models including the Green House, and the Hogeweyk Village model.
You can listen to the webinar recording here.
Please join us as Champions for Change Long-term Care Now from Institutions to Homes by forwarding this post to your contacts, MPP and city counsellor.
Transforming City Of Toronto’s Municipal Homes
On April 5th, Councillor Josh Matlow gave a webinar on steps that are being taken to transform care at the 10 Municipal Homes in Toronto. Josh, a community advocate par excellence, has spearheaded a movement which will change the current warehousing approach to one which is called CareTO. This approach, informed by research, will focus on lessons learned from existing innovative models of care and bring evidence into action.
Currently, the CareTO model is being piloted at Lakeshore Lodge and being evaluated by the Wellesley Institute in Toronto. Based on the results of this evaluation, the CareTO model will eventually be rolled out into all the Municipal Homes. To learn more, click here.
We need more long-term care homes that look and feel like “home.” Please help make this transformation from institutions to homes a reality by spreading the word on 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!
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!
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.
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.
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.
2. Did you know that……
Did you know that social engagement is increased in emotion-based models of care?
Boredom and loneliness amongst residents of long-term care homes is well documented. Feelings of loneliness can lead to depression, anxiety, impulsivity, aggressive behaviours and even suicide ideation. The sense of loneliness has only been enhanced during COVID as long-term care homes have closed their doors to family members and others due to increased risk of infection. Group activities were stopped as were outings during the peak times of COVID.
In her book, Happily Ever Older, Moira Welsh noted that Dr. Bill Thomas founded the Eden Alternative model of care to combat what he defined as the ‘three plagues of loneliness, helplessness, and boredom’ all of which conspire to create a miserable existence. (p. 137). Boredom and loneliness can be reduced by creating a more relaxed home-like feel to the day with less task-orientation and more emphasis on people living and working in the home. This is what Butterfly homes are all about and the results are very encouraging. 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!
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!