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!”

Long-term care home system: a ray of hope on the horizon

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.

 

Will the Government Take Action?

The long awaited Report from the Independent Long-Term Care COVID-19 Commission is now available! Since COVID-19 began over a year ago, nearly 4000 residents in LTC homes have died as well as staff who worked in these homes. After the first wave, recommendations were made to the government regarding staff, PPE, and infection control measures but the government did not act. As a result, there were more deaths from the second wave of COVID-19 than the first!

We now have the Report from the Commissioners, who should be congratulated for listening to the more than 700 persons interviewed, because they got it! The problems in LTC homes have been years in the making. COVID-19 exacerbated all the failings that we knew were there! The commissioners made 85 recommendations covering all aspects of LTC but the quote that stands out is, “We need a philosophy of care that is anchored in respect, compassion and kindness for the people who live and work in long-term care. There needs to be a transformation toward a person-centred care model, which motivates different behaviours, and rewards innovation that leads to better outcomes for residents and staff.” Click here for the full report.

What is needed now is the government to act! Leaders at every level need to step up and make a commitment to make sure that the recommendations of this Report are carried out. Our residents, families and staff in long-term care homes deserve nothing less.

There is great danger that this Report will sit on a shelf along with other past Reports that have addressed the failings of LTC. Please send a letter to your MPP encouraging the government to take action NOW on the recommendations in this Report.

#CHANGELTCNOW!

As you know we are working with CARP Ottawa to bring about transformative culture change in Ontario’s long-term care homes through a grassroots movement.  To this end we have asked the members of CARP Ottawa and its collaborating organizations in Ontario to send an email to their own local MPP’s about this matter.  We would like to ask you, our blog followers, to do the same.

Thank you to all the blog followers and friends who responded to our last request by sending letters to Minister Fullerton to recommend that CARP Ottawa be appointed to the Independent Commission on Long-term Care.

In the end, only three individuals were appointed to the newly named Independent Long-term Care COVID-19 Commission – Associate Chief Justice Frank Marrocco, Angela Coke and Dr. Jack Kitts. Now it is even more imperative to bring awareness and influence regarding this change to not only the Commissioners but also to our local politicians. 

Here’s How YOU Can Help

Send the email below to your own local MPP (contact info here) and copy your local mayor or city councillor (contact info here). Personalize the email with your own words on the need for culture change in Ontario’s long-term care home system. Or if you and your family have been affected by the COVID-19 virus, describe the impact it had on you.     

Copy us at our email changeltcnow@gmail.com We’d like to know how many of you are still interested.

Subject line: CARP Ottawa calls for transformative culture change in Ontario’s long-term care homes.

Email:

As a member of your constituency and someone who is very concerned about the long-term care home system in Ontario, I would like to express my support for Ontario’s Independent Long-term Care COVID-19 Commission.  However, I believe strongly that a transformative culture change is needed to fix the systemic failings apparent in these homes. 

I agree with Minister Fullerton and Premier Ford who have said on many occasions, “We have been clear the long-term care home system in Ontario is broken.”  Now we must fix it.

There are new models of care that exist in the U.S., Europe and even in Ontario, which have embraced the same guiding principles: a relationship-based approach to care; person and family-centred care; small home-like environments; higher staff to resident ratio; full time, well-paid staff who are trained in empathy and culture change and an environment where residents, staff and families feel a part of a community.

These new models have all embraced transformative culture change and have achieved much better outcomes than our traditional homes in Ontario.  We don’t need to reinvent the wheel. 

These outcomes include a decrease in the use of medications, in the number of aggressive incidents, in the number of hospital visits, in the amount of food waste and staff sick time, all the while increasing positive interactions with staff, families and residents.

“You never change things by fighting the existing reality.  To change something, build a new model that makes the existing model obsolete”.  Buckminster Fuller. 

My request is that you bring this urgent need for a transformative culture change in Ontario’s long-term care homes to the attention of Minister Fullerton and Premier Ford. If you would like more details on the existing models or this kind of culture change, please contact CARP Ottawa at changeltcnow@gmail.com

I look forward to hearing from you.

Your name…

Help us change Long-term Care NOW!

Please join our grassroots movement to bring transformative culture change to Ontario’s long-term care homes.  You can do this by sending the following letter, or something similar in your own words, to the Minister of Long-term Care, Merrilee Fullerton. Please copy your own MPP (MPP names and emails are here) and CARP Ottawa at changeltcnow@gmail.com to help us evaluate the interest in this campaign.

“Dear Minister Fullerton, (Merrilee.fullerton@ontario.ca)

Thank you for setting up the Independent Commission to look at what changes need to be made regarding our long-term care home system in Ontario.

As a concerned citizen of Ontario, I would like to strongly recommend that you invite CARP Ottawa to have representation on this Commission.  CARP is Canada’s largest non-partisan advocacy association for older Canadians, with more than 320,000 members, most of whom are in Ontario.  In the past, CARP has successfully advocated for more federal funding for homecare, a reduction in the senior’s drug co-pay in Ontario, free high-dose influenza vaccine to adults over 65 in Ontario and an inquiry into safety and staffing in Ontario long-term care homes.

With seniors in Canada outnumbering the number of children, policy making in Canada that affects other Canadians is more important now than it has ever been.  CARP past successes in healthcare, combined with the strength in their membership uniquely positions them to represent the interests of older Ontarians.  CARP is advocating for a transformative culture change within the long-term care home system.

I believe, as you have stated many times, that Ontario’s Long-term Care Home system is broken.  CARP has a vision for transforming our long-term care home system.

As a society we all want a long-term care home system that affords our family members a better quality of life.  Please act now to bring transformative culture change to Ontario’s long-term care home system.

Thank you for your consideration.

I look forward to hearing from you.”

Your name

 

#ChangeLTCNow

The residents, families, and staff of Ontario’s long-term care homes need your help.
An urgent update on our work re: Ontario’s Long-term Care Home System.

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Taken from WordPress.com

We have joined the CARP Advocacy Project whose goal is to strengthen Ontario’s Long-term Care Home system through a transformative culture change.

The government has announced that an Independent Commission will be set up in July to review Ontario’s long-term care home system and propose improvements. CARP Ottawa has submitted a request to be involved in the Commission and has recommended a transformative culture change for long-term care homes.

A transformative culture change includes: a relationship-based approach to care; person and family-centred care; small home-like environments; higher staff to resident ratios; full time staff who are well-trained in empathy and culture change; and an environment where residents, staff and families feel a part of a community.  The Eden Alternative, Green House Project, Hogewey Villages and Butterfly Homes are examples that have been implemented in Europe, Australia, the U.S. and recently a few in Canada.

HELP US CREATE A GRASSROOTS MOVEMENT – #ChangeLTCNow

We want organizations and individuals to provide input that will encourage the Commission to consider recommendations for transformative culture change. Awareness of the need for major reforms in LTC has never been so evident. This is a unique opportunity.

We need to act – NOW.

Support this grassroots movement. Get involved.

Email – changeltcnow@gmail.com
Be a part of #ChangeLTCNow.

 

Tell your candidates that Canada needs a fully funded Dementia Strategy

On June 17, 2019, the Government of Canada released the country’s first-ever national dementia strategy: A Dementia Strategy for Canada: Together We Aspire

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Status quo
     Pct 1picture2
  Relationship-based model of care

A fully-funded strategy will allow Canada to meet the challenges of dementia with a coordinated, focused approach to care and research. The strategy will address the overwhelming scale, impact and cost of dementia in Canada through three key objectives:

• Prevent dementia,
• Advance therapies and find a cure, and
• Improve the quality of life of people living with dementia and caregivers.

Within the report, it states that: “integrated, person-centered quality care based on best practices will be available across all care settings and people living with dementia will feel welcomed and well-cared for”. In this blog, you have read that we need to create person-centered, relationship-based long-term care homes. This is just one of the ways that we can improve quality care.

Today 90% of residents in long-term care homes have some form of cognitive impairment with over 65% having a diagnosis of dementia. The opportunities for change are now.

The federal election is October 21st, 2019. Attend All-Candidates Meetings in your Riding or write to your local MP candidates, and ask for a fully-funded national dementia strategy.

You Can Bring Joy to Life in Long-Term Care

“You never change things by fighting the existing reality.  To change something, build a new model that makes an existing model obsolete”

 R. Buckminster Fuller.  

Blog post #6

Barely a week goes by, when we hear yet another bad news story about our long-term care homes in Ontario. (See recent articles in the Ottawa Citizen and Toronto Star).

Despite the many millions of dollars injected into the system over the last 30 years, we seem to have fallen into an abyss from which we cannot escape.  Throwing good money after bad has not worked.  We need to transform our system!

The Ontario government has promised 5,000 new long-term care beds by 2021/22.  Models exist now such as Hogewey Villages (Netherlands), Eden Alternative models (in Canada and U.S.) and other innovative models which help to reduce aggressive incidents and promote quality of life.  Currently Langley, B.C. and Tasmania are building new homes designed after Hogewey Villages – 25 years after this model was created.

We cannot wait another 25 years for progress in Ontario. We need a willingness to act for significant change to our long-term care home system.  With new beds coming on stream, now is our opportunity to demand our government consider a new model of care!  Our residents deserve it.

The Ontario election is in June.  Please personalize the information in this post and send to your MPP urging them to address this situation!  Click here for MPP information.

And you can help to promote change by sharing this with all your contacts, posting on your Facebook page or on your Twitter account.  And FOLLOW US!

 

The opportunity to act is now!

Did you know …

… that renovating an existing facility or increasing funding for education for staff has been going on for decades in Ontario and it just won’t do the trick?  We do know that there are many innovative models used in long term care that increase quality of life and decrease the need for medication (some examples in previous posts).

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If you agree, please ask your MPP to urge the Ministry of Health to restrict funding for these new beds to those who will commit to an innovative environment and not the same old Ontario model!  For a list of all the Ontario MPPs and their contact information click here

Follow us by clicking on the button to the right side of this post and link to your  Facebook or twitter account if you have one. 

“You never change things by fighting the existing reality. To change something, build a new model that makes an existing model obsolete.”  R. Buchminster Fuller