Congratulations to Sunnyside Home Long-Term Care home, the first home in Waterloo Region to be accredited in the “Butterfly” model of care, which creates a more homelike space for residents.
Connie Lacy, Director of Seniors’ Services at the Region of Waterloo, says that “It’s not about the task, it’s about the kind of care a family member would give.” Staff engage with residents in more human ways: having tea, offering a hand massage or painting fingernails”. Read more here.
Sunnyside has 49 beds within their LTC home converted into the Butterfly model of care. The home has seen a reduction in the use of antipsychotic medication, increased resident and staff satisfaction and improved quality of interactions.
Sunnyside long-term care home has joined nearly 20 other long-term care homes in Ontario in providing a model of care that promotes dignity and quality of life for our seniors. What about the long-term care homes in your area. Have they embraced an emotion-based model of care or are they still sitting on the fence? It can be done and is proving to be successful!
On July 6, 2022, Jarlette Health Services announced that it has begun a transformation to the Butterfly Approach to care at its Avalon long-term care home in Orangeville, Ontario.
It is embracing “the Butterfly Approach” to help create a more natural home and community setting. This includes fostering stronger interpersonal relationships between residents and team members, building daily routines around peoples’ needs and interests, and creating a living environment which more strongly resembles a private dwelling.
The care model, which has already been implemented in parts of Ontario, elsewhere in Canada, the United Kingdom, Ireland and Australia, has a proven record of positive outcomes for residents, including improved physical and emotional health and well-being, reduced use of medication, and greater engagement by residents in daily life.
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.
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.
‘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.
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
In February, 2021, The Toronto Star ran a Special Edition called “Crisis of Care” which focused on our broken long-term care home system and the decades of reporting on tragic failures in long-term care with little action to change the status quo. The last article in this special edition, written June 24, 2018, focused on Redstone at Malton Village, Region of Peel.
Redstone embraced the Butterfly model of care and after one year of data, they report that staff sick days are down, fewer residents are falling, antipsychotic drug use is lower and social engagement is higher, all of which saves money! The article, entitled The Fix: Part IV Butterfly’s future is full of wonderful stories about the changes in the people living there. Residents are smiling, engaged in activities, and people who were non-verbal or progressed back to their first language, are starting to speak English again. Redstone is now a place of engagement and love. More information can be found in “The Fix: Part 4”, The Toronto Star, June 23, 2018 which was republished in the Special Section: Crisis of Care, The Toronto Star, February 7, 2021.
When will the Ontario government take notice that good things are happening in Ontario and that there are models of care that are working and have been proven to save money! This is not a matter of profit versus non-profit long-term care homes. By the way, Malton Village is a Municipal Home! The issue is all about how care is delivered. COVID-19 has shone a light on so many atrocities in long-term care homes. These failings were there long before COVID-19 appeared. More staff, more direct care hours, better PPE, will help but will not fix our long-term care homes! We have an opportunity now to change the system. Let’s just do it!
Malton Village, Peel Region, the Toronto Star, June 23, 2018
Imagine living in a long-term care home with 8 to 12 people where the focus of care is on people and relies on emotional intelligence, the ability to understand another person’s feelings and respond with compassion. There are no task sheets such as the bath list, mobility list, or activity list. Activities are not scripted but rather there is a natural flow towards individual interests. People are helping to set the dining room table, peel potatoes, fold laundry, music is playing and laughter can be heard. Those with memory loss are allowed to live in their moments, which some may call humane dishonesty.
This is what is happening on the Redstone Dementia Unit at Malton Village. An elderly woman with dementia thinks she is 10 years old and is calling for her mother. The Butterfly Model approach is to try and understand what the woman is seeking. Is it comfort, love, or reassurance and if so the Butterfly program says give that to her instead of the truth. Another person, who doesn’t understand why the staff member wants to change his briefs, gets scared and defensive. His hand balls into a fist. With the emotion-based care approach, in this situation the staff member recognizes that the person is scared and decides to give him a big hug then says, let’s go to the toilet. They walk arm in arm down the hallway. More information can be found in “The Fix: Part 3”, The Toronto Star, June 23, 2018 which was republished in the Special Section: Crisis of Care, The Toronto Star, February 7, 2021.
The emotion-based approach to care is a learned approach and it takes time for staff to adapt to this new way of caring for and about those living in their home. Giving hugs, hand-holding, sitting down and spending time listening to those living in the home is the norm. And meeting the person where they are at becomes more important than telling the truth.
Over the past 15 years the Toronto Star and other Ontario newspapers have written many stories about life in long-term care homes. Yes there are good stories to be told, but what we remember are those stories about neglect, abuse, urine-soaked sheets, loneliness or angry, aggressive incidents.
There is no-one among us that doesn’t abhor reading these awful stories and wonder how we are letting these incidents happen;regrettably it has taken the pandemic to bring the seriousness of the long-term care home situation to the forefront.
Most of the staff are trying their very best to deliver care according to what is expected of them. But is this the problem? “Is keeping our elderly clean, fed and safely tucked away” the best way to provide a quality of life?
In a recent article in the Toronto Star, we read stories about residents who live in LTC homes which have undergone transformative culture change. There is Inga who asks for a piece of toast, butters it and shares it with another resident. Or the Professor who is known for his crankiness, who starts to cry when hymns and wartime songs are played on the piano. And then all of a sudden, begins singing the words to these songs! Read more here from a recent article called Crisis of Care, The Toronto Star, February 7, 2021: The Fix: Part 2: Republished from 2018).
The good news is that where there is a willingness to change, lives are transformed. There is no excuse not to now. We know how much we have dreaded the traditional model of nursing care. We know, now, how much better a different model can be, and how joy, respect and community can actually be experienced by residents, families and staff. If the word “care” in our system of healthcare means anything, we need to get on with it.
There are over 78,000 people living in one of 630 long-term care homes in Ontario. These homes are controlled by more than 300 regulations that keep staff focused on the tasks of feeding, scheduling, and cleaning, all documented for government collection. Every day, at least 60 minutes is spent by staff filing ministry updates. They tap icons for mood, mobility, meals, bowel movements but there are no icons for laughter, conversation, human touch or sense of purpose. It is a detached, antiseptic end to life which some have called a culture of malignancy.
A long-term care home in Peel has moved away from a traditional model of care and took a gamble on fun, kindness and affection. It is Malton Village in Mississauga and they are focusing on laughter, friendship, energy, tenderness, freedom and hope. That is not to say that they are not meeting the Ministry regulations. They are doing that but in a different model of care. In a recent article in the Toronto Star, we read about Bill, a resident, who has been kicked out of multiple long-term care homes because of violent tendencies, until he arrived in a Butterfly home. He became docile, enjoyed his days and staff came to know him as a “lovely man”. Or there is the dietary aide who helps Roger with his dessert. She talks to him about her childhood memories visiting peach groves and before you know it, Roger has eaten all of his dessert. Read more here from a recent article called Crisis of Care, The Toronto Star, February 7, 2021: The Fix: Part 1: Republished from 2018).
Do we want our seniors to live out their days in long-term care homes that dehumanize their existence? We can help to change this by transforming our long-term care homes into innovative models of care such as the Butterfly model of care. Please support Transformative Culture Change in Ontario’s Long-Term Care Homes by sending an email to info@LTCcommission-CommissionSLD.ca or to your local MPP https://www.ola.org/en/members/current.
Congratulations to Henley Place Home in London, Ontario for receiving its Butterfly Model of Care accreditation in December 2020. It joins Henley House in St. Catharines, Ontario which received it accreditation in December 2019.
When will other long-term care home providers rise to the challenge and begin to implement innovative models?
Kudos to Primacare Living Solutions, the provider of these homes for their leadership in implementing transformative culture change in their homes. And yes, more to come – Primacare has a third home (Burton Manor in Brampton, ON) currently undergoing Butterfly accreditation that should be completed in the fall 2021.
Please advocate for change by contacting your local councillor, your MPP, or organizations urging them to bring this change to your community.