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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.

 

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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.

 

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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

 

 

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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:

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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.

 

 

 

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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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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.

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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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Kudos to the CBC!

 

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!

 

 

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The Green House Model: A Blueprint for Change

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.

 

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“Let’s Fly With Butterfly”

 

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

 

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