Get involved and demand change now in Ontario’s long-term care homes!

While change won’t happen overnight we need to start somewhere and there is no better time than now.   The upcoming provincial elections provide an excellent opportunity to demand change.   If we don’t demand change now in Ontario’s long-term care home system, the status quo is likely to be with us for decades to come.

Here are some questions  to consider asking the candidates who are running for office in your riding:

Small homelike environments and COVID

 Ontario’s Long-term Care COVID-19 Commission recommended that the Ontario government promote and provide funding for long-term care homes that change to recognized, emotion-based models of care – where residents, staff and families live in smaller, home-like environments which have shown fewer COVID cases and fewer deaths than in the current institutional models.

Do you agree with this and if so, would you commit to start this process in the first year of your term?

Emotion-based model of care and funding

 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.

Do you agree with this and if so, would you commit to including this in the budget process during the first year of your term?

 New Beds

 Ontario’s Long-term Care COVID-19 Commission recommended creating smaller self-contained home-like units within existing and new homes.

As Ontario looks at developing and rebuilding LTC homes in the future, do you agree with this and if so, what incentives would you put in place to make this happen during the first year of your term?

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?

 

C.A.R.P. asking for public support!

This article was published in the Ottawa Citizen, May 4, 2022

C.A.R.P. asking for public support to make transformation of Ontario’s long-term care home system a ballot box issue

 In a recent opinion piece Grace Welch and Brian Graham articulated well the major shortcomings of Ontario’s long-term care home system brought to light as a result of the pandemic and the type of changes needed.

Within the present system, it is very challenging for staff working in long-term care homes to address all the physical, social, psychological, spiritual, and cultural needs as described in the Long-Term Care Homes Residents’ Bill of Rights.  Ontario has one of the most risk adverse long-term care homes system in Canada where the overabundance of regulations contributes to objectifying residents according to tasks, not needs.

C.A.R.P. – a New Vision for Aging (Canadian Association of Retired Persons) wants to see a drastic transformative change in long-term care homes from a task-based to an emotion-based model of care.  Such models already exist: Eden Alternative, Green House, Butterfly and Hogewey in which the quality of care is understood as a relationship where residents, staff, families and volunteers are treated with dignity and respect in a homey environment, and kindness permeates the home.  These models have been implemented in Canada including Ontario, Saskatchewan, Alberta, and British Columbia, in the United States, and internationally.  No need to reinvent the wheel.

There are a growing number of both public and for-profit long-term care homes in Ontario that have successfully implemented an emotion-based model of care on one or more units in their homes.    Most of these homes did so within existing budgetary and regulatory constraints with plans to expand the model.

Even closer to home, kudos to the Glebe Centre (a non-profit charitable home in Ottawa) which is already in the second stage of implementing the Butterfly model, and to Bonnechere Manor and Miramichi Lodge in Renfrew County which have begun the process of implementing the model.

These homes also experienced better outcomes both pre and during COVID than the traditional homes with fever cases and fewer deaths. Other benefits include improved resident and family engagement; improved staff satisfaction; reduced use of anti-psychotropic drugs; reduced use of food supplements; reduced staff sick leave (huge cost savings for some); and the list goes on.

We recognize that home care services are also broken and need a major revamping. However, our aging population is increasing and so is the number of people with dementia   This means the need for long-term care homes is not going anywhere soon.   Circumstances are such that not every loved one when becoming frail, either physically and/or cognitively, can be cared for at home.  Approximately 85% of all residents in long-term care homes have either some kind of dementia or some complex chronic disease that requires 24/7 care.  It is unrealistic to expect these individuals to be cared for at home.

The action needed is to immediately begin change from task-based to emotion-based care in Ontario’s long-term care homes.  This can’t happen overnight but we need to start somewhere and the sooner we start the better.  There are many ways to do so, including a variety of pilot projects – one unit at a time, one floor at a time, one home at a time.  Residents in long-term care homes have been deprived for decades of the quality of care and quality of environment they so rightly deserve.  This change can’t come quickly enough!

The Ontario Morocco Commission recommended ‘that the Government promote and provide funding for long-term care homes that change to recognized emotion-based models of care”.  Ask your MPPs if they would commit to including this in the budget process in the first year of their term, if elected.

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

Claude Paul Boivin, President, C.A.R.P. Ottawa

Kathy Wright, Vice-President, C.A.R.P. Ottawa

C.A.R.P. – A New Vision for Aging (formerly known as the Canadian Association for Retired Persons) is Canada’s largest advocacy Continue reading “C.A.R.P. asking for public support!”

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.

 

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.

 

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

 

 

Moving from Institutional to Emotion-based Care

 

Malton Village, Region of Peel

Over 125  persons attended a recent webinar on “Moving from Institutional to Emotion-based Care” co-hosted by Family Councils of Ontario (FCO) and C.A.R.P. (Canadian Association for Retired Persons) Ottawa Chapter.

The webinar featured Mary Connell who implemented the first Butterfly Model home in Ontario in Peel Region  and Gerry Kupferschmidt whose wife lives in a Butterfly Model unit at Sheridan Villa Long-term Care Home in Mississauga.

An emotion-based model of care is the heart of all the innovative models (Eden, Hogewey, Butterfly, and Green House) that have been implemented in some long-term care homes in Ontario and elsewhere in Canada.

To watch the webinar,  click here:

A proposed refreshing reform for national standards

As Moira Welsh notes in her article, ‘Draft report on national long-term-care standards could shape Canadian legislation, which appeared in The Toronto Star on January 27th, 2022:  ‘The draft report on national long-term-care standards says residents must be free to engage in activities they enjoy and live in homes designed to feel quiet and safe.’

Sherbrooke Village in Saskatoon where the Eden Alternative has been implemented

“These standards can be so much more than just the basis of accreditation programs,” said Sinha, director of geriatrics at Sinai Health and University Health Network.

Laura Tamblyn Watts, CEO of CanAge, a seniors advocacy group, said the report is a “significant improvement from the previous version and shines a light of hope on a sector which has long been shunted into the dark corners of policy.” “It signals an important shift in culture that has been long needed.” Click here to read more……

Hopefully the Ontario government won’t hide behind the argument of health care being a provincial jurisdiction and forego stepping up to the plate and providing leadership to endorse and make the draft national standards a reality of Ontario’s long-term care homes.  The complacency in the long-term care home sector accompanied by the shockingly long absence of providing our seniors with the kind of improvements proposed in the draft national standards cannot be remedied quickly enough.  An emotion-based model of care needs to be the foundation of an improved long-term care homes system and we need it NOW.

In the upcoming provincial election make it your business to find out how the candidates in your riding intend to implement the spirit and focus of the proposed national standards in Ontario’s long-term care home system.

 

 

 

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!

Life can be beautiful for residents and staff in long-term care homes!

Redstone, Malton Village, Region of Peel

‘Life can be beautiful’ is the name of the exhibit which opened recently at the Peel art Gallery Museum and Archives.

An emotion-based model of care makes a huge difference to an individual’s life.  That’s exactly what inspired Mary Connell (Dementia Advisor and Person-Centred Care Project Manager – March 2017 to November 2021) to lead the way with the implementation of the Butterfly Home in several long-term care homes in the Peel Region, and this gratifying exhibit is her brainchild.   For a virtual visit to the exhibit, click here 

Please do everything you can to convince your candidates in the upcoming provincial election and/or the incumbent MPP in your riding (click here for list)  that this is the route to go.  Make bringing ‘an emotion-based model of care’ to Ontario’s long-term care homes a ballot box issue this June.

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!