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The Toronto Star article on Crisis of Care printed Feb 7, 2021, focuses on the “inertia” of government that has led to a failure of the long-term care home system.

For more than four decades, a doctor working in the system has witnessed:

• Poor business decisions that affected delivery of quality of care
• Too much time spent on paperwork and not enough time on direct care of residents
• Not enough adequately trained staff
• Verbal, physical or sexual abuse of residents

And now more than 3000 residents have died from COVID-19. In April, Premier Doug Ford called “the widening cracks in the long-term care system a wake-up call to the world” and spoke of the need to form an “iron ring” around vulnerable seniors. Well, that has not happened. In fact since April, there have been many more deaths due to Covid-19 than there were in the first wave. When will the government stop promising and start doing? How many more deaths are needed before inertia turns to action. Our vulnerable seniors deserve nothing less than to live their remaining years in a safe, caring environment. Read more here.

Please support Transformative Culture Change in Ontario’s Long-Term Care Homes by sending an email to info@LTCcommission-CommissionSLD.ca

#ChangeLTCNow!

According to a recent article in the Toronto Star, since January 15, 2021, 2721 residents of long-term care homes and 8 staff members have died from COVID-19. Read here. Thousands more are sickened, neglected and denied basic rights! Since the pandemic began, some 87% of all COVID deaths in Ontario have been among those over the age of 70 and about 61% of deaths have been in long-term care homes.

The long-term care system is broken and has been for many years!  We are slowly losing a generation of people to this pandemic. They are our elders, our grandparents, mentors, visionaries who paved the path for a better world for all of us. And when they need more care than they can receive in their home, we move them to a medical institutional warehouse, remove their ability to make choices, take away their individuality and stifle their creativity. We schedule their day from morning to night, medicate them when they resist, and when family members become upset, we wonder why. Then COVID-19 arrived and the inadequacies of how we care for and about our elders in long-term care homes have come to light!

As of October 2020, there were 11 long-term care homes in Ontario that had either adopted or were in the process of adopting the Butterfly model of care.  These homes along with the Green House Project homes in the U.S. that have embraced transformative culture change have reported better outcomes both pre and during the COVID-19 pandemic and have experienced fewer deaths than the institutional models of care that exist in most of our traditional long-term care homes. 

Please consider sending an email to your local MPP or City Councillor urging them to look at what these homes have done so that the Ontario government can bring an end to the inhumane treatment and needless deaths of our vulnerable elders.  Enough is enough!

Members of C.A.R.P. Ottawa’s Advocacy Working Group on Long-Term Care presented to the Independent Long-Term Care COVID-19 Commission on November 26^th, 2020.  

The purpose was to explain how transformative culture change, an emotion-based model of care, would not only improve the quality of life for residents, families and staff in Ontario’s Long-Term Care Homes but would also help to mitigate the impact of future viruses.  

Key points presented were as follows:

-The fundamental principles of transformative culture change are consistent with the principles outlined in Ontario’s Long-Term Care Act which states:

“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.”

Despite many new regulations and many millions of dollars spent on education and new programs, it is obvious these principles have not been adequately met – for decades.

–Transformative culture change is a philosophy that uses an emotion-based approach to care where residents, staff and families feel part of a community and are all treated with dignity and respect: where there are small home-like environments; more direct hours of care for residents, where staff work full-time, are well-paid and are trained in empathy and culture change and where families and caregivers are recognized as an integral part of the team.  Staffing, inspections, design and family involvement are all critical elements of transformative culture change. 

-There are four innovative long-term care models that have successfully embraced transformative culture change.  These models have existed for years in the USA, Europe, the U.K. and more recently in parts of Canada and even Ontario:  The Butterfly Model, The Eden Alternative, The Green House Project and the Hogewey Villages. These homes have experienced better outcomes than our traditional homes both pre and during COVID-19. 

The “ask”: That the Commission recommend the Ontario Government commit to move towards transformative culture change in Ontario’s Long-Term Care homes.   This commitment could start by examining the long-term care homes that have already embraced this model of care to determine best practices and lessons learned, including how they have managed financially within current budgets and the current legislation.  This commitment could also include revisiting the new builds that are being fast-tracked to ensure Ontario does not end up with the same old institutional designs, that once built, will be with us for the next 3 decades.

We know this can be done since it is being done right here in Ontario, right now.  These innovative models are being led by a few who have taken the leap and the risk to improve the lives of residents, families and staff.  There are currently 11 long-term care homes in Ontario that have either implemented or launched the Butterfly Model of Care resulting in transformative culture change. 

Anyone wishing to support Transformative Culture Change in Ontario’s Long-Term Care Homes can send an email to info@LTCcommission-CommissionSLD.ca

For more information on the Commission www.ltccommission-commissionsld.ca

The Ontario Ministry of Long-Term Care Staffing Study Advisory Report, released on July 30, 2020, identified a number of challenges to the current staffing strategy for long-term care. Apart from workload and funding issues as well as increased acuity needs of residents, the Report also identified that “the culture of long-term care is one based heavily on compliance, which can create a punitive environment for staff.” 

Their recommendation states that, “The culture of long-term care needs to change both at the system and individual level.” The Report calls for a look at the philosophy of care within long-term care homes and specifically cited models of transformative culture change such as the Butterfly model and the Eden Alternative as models of care which focus on emotional care and relationship building. The Report’s findings indicate that “Operators reported that their staff frequently request working in homes that have implemented emotional models of care as they feel better supported, more collaboration within the team, and are able to spend more time with residents. (Region of Peel Long-Term Care, Submission to the Staffing Study Advisory Group 2020)

For more information about the Long-Term Care Staffing Advisory Report click here

Thank you for your support of transformative culture change. Your letters to your MPPs and City Councillors do make a difference! You can also help by sharing this post and others with at least one of your contacts.

At the end of July 2020, the Ontario Government announced the creation of the Independent Long-term Care COVID 19 Commission.

The three commissioners appointed to the Commission are:

Angela Coke, former senior executive with the Ontario Public Service; and
Associate Chief Justice Frank N. Marrocco (Chair), member of the Superior Court of Justice since 2005;
Dr. Jack Kitts, recipient of the Order of Canada and recently retired as President and Chief Executive Officer of the Ottawa Hospital.

“The Commissioners of Ontario’s Long-Term Care COVID-19 Commission have a mandate to investigate how and why COVID-19 spread in long-term care homes, what was done to prevent the spread, and the impact of key elements of the existing system on the spread.”  The Commission will have a secretariat of 12 FTEs (full-time equivalents) and will submit its report by April 30, 2021.  For more information about the Commission including its Terms of Reference and guiding principles, go to: https://www.ltccommission-commissionsld.ca/about/index.html

Many thanks to those of you who sent letters to your MPP’s and City Councillors as a result of our last post.  Your help makes a difference! CARP Ottawa, with whom we continue to work, subsequently sent letters to both Minister Fullerton and the Commissioners requesting that recommendations for transformative culture change be developed.