‘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.
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!
Kudos to CBC for its recent encouraging report on the Green House – a successful initiative in long-term care homes in the United States.
The top two floors of this building just blocks from the Canadian border in Detroit, Michigan, house another Green House Project home. Advocates say the model is adaptable to larger cities as well as rural areas and smaller communities. (CBC News)
In her news article posted on December 12th, Melissa Mancini, a producer with The National, focuses on how smaller long-term care homes can help address big elder-care issues.
As noted in the previous blog post, the Green House model has been implemented extensively in long-term care homes in the United States with proven positive results both in for-profit and non-profit homes, including experiencing fewer number of cases and less deaths than traditional homes during COVID-19.
“It’s a model of nursing home care that allows people to live life in retirement as close as possible to the way they did in their adult lives. It starts with the building — small homes with just 10 or 12 seniors living in them — and extends throughout all aspects of life there”.
“There are 38,000 people waiting for a spot in long-term care homes in Ontario alone and the government is preparing to build hundreds of facilities to meet demand, but some say we should also be reshaping how elder care is offered.”
“I would really challenge those that are investing in this to look at alternatives that are out of the box,” said Tammy Allison, who runs a small long-term care home in Monclova, Ohio. “You can do long-term care differently and you can do it better. And we feel like we’re doing that.”
To read the full article and see related-videos (including interviews of residents with CBC’s David Common), click here
Before we know it Ontario’s provincial election will be here. You have a voice – make bringing an innovative model such as the Green House or the Butterfly Home to long-term care homes a priority and a ballot box issue!
Leonard Florence Center for Living outside Boston, Massachusetts
On November 24th, around 200 people registered for the webinar, The Green House Model: A Blueprint for Change. Susan Ryan, Senior Director of The Green House Project gave a dynamic presentation on the model and its positive impact on the lives of elders in the United States. The Green House model is “revolutionizing care and empowering lives’’ Susan said.
Here are just a few key comments that Susan shared about this emotion-based model of care:
During COVID-19, every Green House home fared much better in number of cases and less deaths than traditional homes. Smaller is better!
A meaningful life is about relationships, autonomy and control, purposeful engagements, honouring natural rhythms, and social connectedness.
Transformative culture change is all about deinstitutionalizing long-term care
We all want/need to be seen, heard and known as unique individuals
Ongoing learning is required by all for sustainability of any culture change.
Please listen and share this inspiring presentation. Click on the link here.
Nora, a PSW, and Lionel, a resident, in one of the many rooms with tranquil murals – photo is courtesy of the Glebe Centre
There are lots of innovative models for long-term care homes to ‘fly with’ and make culture change a reality. The Glebe Centre in Ottawa has chosen to ‘fly with Butterfly’ and the Centre is the first Home in Ottawa to implement this innovative model.
“Every resident comes into long-term care with a history of family, friends, work, passions, desires, likes and dislikes. Each has individual wants, needs and expectations. Many come into care with reluctance and apprehension. Long term care is often a necessity because of their physical or mental fragility.
So, what does the Butterfly Model involve and why is it different from other forms of care?
It is all about BEING not DOING. It is about enabling and supporting those in care rather than passively caring for them. Doing things WITH the residents and NOT for them.
We don’t DO Person-Centred care, we need to BE “Person-Centred.”
The Butterfly Model is all about getting to know each resident. Understanding their previous life stories and connecting— using active listening skills and maintaining a positive view of the importance of everyone’s emotional life journey. It is about treating each resident more like a friend than a patient.
Staff must be enthusiastic, have positive energy and be able to look at the world from the resident’s perspective.
The physical space is different in this model. Who wants to live with grey, green or beige walls? Talk about institutional! The colours used on a Butterfly floor are bright, sunny, and happy. The walls are filled with murals and each resident door is a different colour and design.
Donna read about the Butterfly Model, watched the video and got excited thinking of how her 98-year old mother with dementia would flourish in this environment.
But when she saw a completed floor at The Glebe Centre and experienced the full impact of how this works, she was very impressed! It far exceeded her expectations. The sense of calm and soft music provides a peaceful setting. The place felt like home, safe and secure – a family atmosphere. The staff were relaxed, flexible, smiling and affectionate towards each other and the residents.
Many of you reading this article are starting to think about future care. Person-Centred Care is the way of the future. We have to make long-term-care a place where seniors go happily and not with dread and reluctance.”*
Let’s hope that other long-term care homes in Ontario ‘fly’ with an innovative model and pave the way for a happier future for their residents.
Please encourage the Ontario Government to bring culture change to its long-term care homes. 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.
*Extract from the Glebe Centre Long-term Care Home and Abbotsford House 2020-2021 Donor Community Newsletter
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.
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.
On Sept 15th, C.A.R.P. Ottawa provided a webinar on The Eden Alternative with speaker Suellen Beatty, CEO Sherbrooke Community Centre and Co-Regional Coordinator for Eden Alternative in Western Canada. Nearly 100 persons registered for this event and those that did attend were very pleased with the speaker and content.
The Eden Alternative is a philosophy of care that focuses on relationships. The philosophy has seven domains of well-being which residents and staff focus on to create a home. Their goal is to create a human habitat where people thrive and grow. They care for the human spirit as well as the human body. The staff know that people need to have a reason to get out of bed each morning, so they spend time focusing on what brings pleasure to each person and then they try to provide that program or activity at Sherbrooke.
Within Sherbooke Village, they welcome intergenerational communities: a Day Care Centre of 36 children on site who bring joy and pleasure to the residents: an Igen (Intergenerational) Program where a class of Grade 6 students use space at Sherbrooke for their classroom studies. In between, they build relationships with the residents.
To see a video recording of the webinar, click here.
What is needed to change an institutional model LTC home into Eden Alternative home? It requires a change in attitudes, beliefs, and behaviours. It requires a culture change which allows the resident to direct the type of life they wish to live and staff who are fully engaged and valued. It requires leaders who become coaches and empower others.
Wouldn’t it be wonderful to be able to spend our later years in a home where there is identity, growth, autonomy ,security, connectedness, meaning , and joy. It would be “A Life Worth Living”.
Please do your part to 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.
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.
It has been decades since any stripe of government has paid heed to or lived by the fundamental principle in the Ontario Long-Term Care Homes Act, 2007 and Regulation 79/10 (which came into force in July 2010): i.e. “[A] long-term care home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met.”
Supposedly the Ontario Government is in the process of proposing changes to the Act by the fall 2021.
The Government has long fallen short in meeting the existing Residents’ Bill of Rights (which falls within the Act). Implementing an emotion-based model of care would meet those expectations:
Every resident has the right to be properly sheltered, fed, clothed, groomed and cared for in a manner consistent with his/her needs. A culture change to an emotion-based model of care would make this happen.
Every LTC resident has the right to NOT be neglected by the licensee or by the staff. Transformative culture change to an emotion-based model of care would ensure no LTC resident is ever neglected.
Every LTC resident has the right to be protected from abuse. Transformative culture change to an emotion-based model of care would make sure no LTC resident is ever abused.
Every LTC resident has the right to be treated with courtesy and respect, in a way that recognizes their individuality and respects their dignity. A culture change to an emotion-based model of care is a MUST.
Please do your part to bring 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.
Over 290 Green House model long-term care homes exist in the United States and their focus is to deinstitutionalize, destigmatize and humanize care.
The model can be built as stand- alone small homes often 12 to a “home”, or a cottage model having two floors with a Green House model on each floor, or in a vertical building of over 200 residents with elevator access and smaller “homes” inside. There is a separate kitchen, living room, dining room, private or semi-private rooms and bathrooms. Resident rooms have a front door with a door bell and it looks welcoming. Meals are cooked in their “home”, there is consistent staffing who carry out cooking, cleaning and assistance with personal care and each “home” has access to the outdoors. The point is, the environment and life within the home is “homelike”.
When the pandemic hit, it became apparent that the small homelike aspect of this model, fewer staff entering the home, as well as staff having a consistent assignment, all helped to save lives. The advantage of smaller units of elders is that there are fewer infections and there is more ability to control exposure to infections. This is not to say that there were no COVID-19 cases in Green House homes but there were significantly fewer cases and deaths than those housed in institutional settings. Take a look at this short video: Green House: Made for this Moment – YouTube
The pandemic was a terrible tragedy for those living in long-term care homes and we have no way of knowing whether another pandemic will occur. The Green House model provides a safe home for its residents. There are other innovative models of care such as the Eden Alternative, Hogewey Village and the Butterfly models. All promote safe “homelike “environments. Please do your part to 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.
A Green House Dining Room (copied with permission)
At a recent virtual workshop on the Green House model intended for a Canadian audience, people from Alberta, B.C., Ontario and the Maritimes participated. Hopefully this will translate into action on the Ontario scene where bringing transformative culture change is long overdue. Continue reading “Will the Green House model be coming to Ontario?”
Leonard Florence Center for Living outside Boston, Massachusetts
