Category: Innovative Models

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He Broke the Law to Build a Better Nursing Home

Is growing older a good thing? Or is the idea of aging something to be feared leading to isolation, loneliness and a lack of autonomy?

In 1991, Dr. Bill Thomas became the medical director of a nursing home in upstate New York. He found the place, as the Washington Post put it, “depressing, and a repository for old people whose minds and bodies seemed dull and dispirited.”  Read article here.

So, what did Thomas do? He decided to transform the nursing home. Based on a hunch, he persuaded his staff to stock the facility with two dogs, four cats, several hens and rabbits, and 100 parakeets, along with hundreds of plants, a vegetable and flower garden, and a day-care site for staffers’ kids.

All those animals in a nursing home broke state law, but for Thomas and his staff, it was a revelation. Caring for the plants and animals restored residents’ spirits and autonomy; many started dressing themselves, leaving their rooms and eating again. The number of prescriptions fell to half of that of a control nursing home, particularly for drugs that treat agitation. Medication costs plummeted, and so did the death rate. “He named the approach the Eden Alternative.”

What do you think? Do our beliefs about aging affect our expectations about quality of life? Are our expectations about aging one of the reasons it is so difficult to implement innovative models within long term care homes? Please share your comments.

If you are on Facebook, Twitter or Linkedin, please share with your followers or pass along to your contacts.

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Canada’s first Dementia Village!

Dec 2018

Canada’s first community designed, specifically for people with dementia opens in June 2019 Langley B.C.

It’s called The Village. Comprised of six, single-story cottage-style homes and a community centre, The Village will be home to 78 people with dementia, an umbrella term that includes people suffering from Alzheimer’s and other degenerative brain diseases associated with aging. Care will be provided by 72 specially trained staff.

At The Village, residents are not seen as dementia patients; they see the person and their story first. They believe that every person’s fundamental desire to achieve well-being, purpose and fulfillment does not diminish with age or dementia.

The Village’s design was inspired by Hogewey, the world’s first dementia village, in The Netherlands. What makes The Village different from traditional nursing homes is that residents will be able to shop, have a coffee, walk their dog, get their hair cut and take part in activities such as gardening by themselves. Continue reading “Canada’s first Dementia Village!”

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6th Graders in a Long-Term Care Home?

18SherbrookeVillageSaskatoon6thgradersCBC

What is unusual about this picture?

Sherbrooke Community Centre Nursing Home in Saskatoon is the home to 263 high-needs residents. It’s also the site of an intergenerational school. Every year, after winning a city-wide lottery, a batch of sixth graders ditch the traditional classroom and spend a year attending school at Sherbrooke.  Listen to this story from CBC’s Sunday Morning radio show here.

At Sherbrooke, there are no classrooms, no desks, and no blackboards. Students get together with their teachers in the chapel in the morning and again at noon, but the rest of the time they are free to go where they want, and sit with anyone they feel like talking to.  The school is a life-changing experience for the elders as much as it is for the kids.

“If we didn’t see the kids, we would just be a bunch of old people in this building, and that is stark and it’s ugly. Without the kids, I just feel that a part of me dies,” one resident says.

In western Canada, Sherbrooke Community Centre Nursing Home is the first care home to register as an Eden Alternative ® home.

Another innovative model for us to consider….

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“A Program Like This Should Spread Like Wildfire”

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Staffer Chelsea Martens sits with Piotr (Peter) Wojcik while he peels an orange. The Butterfly program says touching food, peeling fruit and vegetables in advance of meals helps people with dementia start thinking about food and builds an appetite.(Randy Risling/Toronto Star).

The Toronto Star article “The Fix”, June 20th, 2018, states “in Peel Region, a couple of bureaucrats decided to take a risk on a care model that promotes, well, love…shoving aside the old clinical ways with plans for laughter, friendship, energy, tenderness, freedom and hope”.  And guess what?  It’s working!  Residents, staff and families from one unit are living as a community resulting in a decrease of aggressive incidents, decrease in psychotropic drugs as well as a decrease in staff sick days.

Click here to view the 21 minute video that shows how this unit was transformed. You will be amazed!

Are other municipal politicians gutsy enough to champion real change?  Mayor Tory seems to be.  He wants ‘The Fix’ in other Toronto nursing homes.  Read more here.

It is a mystery why there has not been a revolution to challenge the problems that have plagued our Ontario Long-Term Care Home system for decades.  But we can all start now by forwarding this blog post to all the candidates who will be running in the October Municipal elections to plant the seeds now and to demand that other cities embrace innovation as Peel has done.

As Peel City Councillor Ron Starr said “A program like this should spread like wildfire”.

And please forward this post to your contacts and encourage them to “follow” our blog to build up support for a transformation in our long-term care home system.

 

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CHANGING OUR SYSTEM, ONE LONG-TERM CARE HOME AT A TIME – IN ONTARIO!

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Sharing the “stuff of life” at a Butterfly Care Home in the U.K

Do you know what the main difference is between Ontario’s institutional long-term care home model and the U.K.’s Butterfly Model just adopted by Malton Village Long-Term Care Home in Peel, Ontario?

Relationships, kindness and compassion 

Sound familiar?  That’s because the Butterfly Model is similar to the Hogewey and Eden Alternative models which were highlighted in previous blog posts.

  • All of these 3 models allow time for staff to develop relationships with residents and families.  Our current medical model of care in Ontario does not.
  • The Butterfly model stresses a departure from “a culture of care that believes the best facilities can do for dementia patients is provide physical safety and hold them in a building” to “a transformation in the way people are cared for, with a focus on people’s emotions and the creation of homelike environments and everyday activities people enjoyed earlier in life”

After the success of its one year pilot project, Malton Village Long-Term Care Centre in Peel has become the first Butterfly Care Home in Ontario.  Read more here.

Once the election is over, contact your MPPs again to urge them to consider these success stories.  All the MPP posts are listed as vacant until the election is over.

AND PLEASE – encourage 3 or more of your contacts to “follow” our blog.  Long-term care home residents need our help!

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Another innovative model in long term care homes

Did you know ….

  • 46% of residents have demonstrated some level of aggression with the most common type being “resistance to care.”
  • Normal daily home activities and creative care that is individualized for each resident will maximize functioning and quality of life.

Blog cartoon

Here is another innovative model that was implemented (even though it hadn’t been done before) and it worked – The Green House Model – not the gardening kind…

 “THE GREEN HOUSE® Residences at Bartram Park in Florida offers Assisted Living to individuals living with Alzheimer’s and other dementias.  The Green House Project counts 242 licensed homes in 32 states to date, with 150 more in various stages of development. https://www.bartramlakes.org/memory-care/what-is-the-green-house-model/

We know the Ontario Ministry of Health will be funding 5000 new beds by 2021/22.  This is an excellent opportunity to inspire innovation

If you agree, please ask your MPP to urge the Ministry to dedicate funding for these new beds to organizations that will commit to an innovative environment such as The Green House or other models we have highlighted in previous posts. The same old Ontario model is not good enough.  For a list of all the Ontario MPPs and their contact information click here. 

We would really like to know what you think!  If you haven’t done so already, please complete the  2 question survey .  Your name will not appear on the blog.

“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.  

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An Innovative Model from Saskatchewan

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

Long-term care resident Jodi Grant says teaching the students enrolled in Saskatoon's iGen program has given her 'a reason to get up in the morning.'

Sherbrooke Village program turns long term care home into a grade 6 classroom. They use an Eden Alternative model of care which focuses on moving away from the institutional hierarchical (medical) model of care into a constructive culture of “home”. https://www.edenalt.org/about-the-eden-alternative/mission-vision-values/

Click here for a W5/CTV interview with the Executive Director of the Sherbrooke Village to see this approach for yourselves: https://www.ctvnews.ca/w5/saskatoon-care-home-offers-unique-approach-for-residents-with-dementia-1.1686936

As we mentioned in our introductory blog, our long term care system in Ontario is broken.  Our goal is not to endorse any particular model of care but rather to present information on innovative long term care models that already exist in our own country or elsewhere in the world and to provide some tools to create the political will for transformation of our system.

And we’d like to know what you think.  If you like the Sherbrooke Village Model or the Hogeway Village model from our first blog post,  please send us a comment to let us know what you like about them.

And YOU can help to transform the system by sending a letter to the Minister of Health and Long-Term Care and copying your local MPP/MP.  For a draft letter that you can personalize, click here:  17draftMPPletter

Don’t know who your MPP/MP is?  Click here…

Please note: The authors of this blog are not endorsing any particular model of care. We are offering this blog as information and as an impetus for change and action. If you agree with what is written and want to take action, then you are encouraged to write to your local newspapers, write letters to your politicians, and speak out at public forums which address elder care. (MPP website). Together we can make a difference!

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One Innovative Model

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

Our long-term care system is broken and it needs to change! Recent news reports from long term care homes in Ottawa and elsewhere highlight the urgent need for transformation. It is time to stop trying to repair a system that is broken and think about what quality care should look like for those living in long term care.

Many strategies have been tried to repair the system such as changes in policies, more education for staff, increased oversight by owners and government departments, and stronger evaluation practises. While these are worthy measures, they have not changed or prevented terrible incidences to occur. This is not to say that there are not compassionate, competent staff who work in long term care homes.

In fact if you ask staff how they feel after their shift, most will say that they did the best they could in a system which does not allow them to spend time with their residents in order to provide quality care. They go home tired, exhausted, and wishing that things could be different. Most will say, “If only there were more staff, more activity programs, and less regimentation, perhaps I could make a difference in the work I do.” Certainly more staff, and more funding would help, but would it really change what is currently happening? Is it time to look at a new way of organizing how long term care is delivered?

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Hogeway Dementia Village, Holland

In March of this year, CBC news reported on an alternative model of elder care, Hogewey Dementia Village in Penetanguishene, Ontario. The concept originated in Holland in 2007 and caught the attention of health care professionals in Ontario and Alberta. Hogewey has a grocery store, a theatre, a barber shop, gardens and community gathering places. It looks less like a sterile hospital environment and more like a cozy little neighbourhood. The only twist is that many of their residents live unaware that their orderly community is actually a nursing home for people with severe dementia. The concept is all about “social inclusion,” something that’s often missing from existing long term care homes. Residents are encouraged in this environment to continue their lives and focus on what they can still do. By normalizing life, especially for persons with dementia, it will help reduce outbursts and promote positive feelings thus enhancing quality of life. For full news article go to: https://www.cbc.ca/news/canada/calgary/dementia-village-alzheimers-alberta-calgary-gerontology-1.4024693

The Hogewey Dementia Village is just one innovative model of elder care available that enhances quality of life. The Alzheimer Society of Canada has identified other models within Canada that are innovative and seem to be offering a “home” where the quality of life is being enhanced for the residents. More research needs to be done but our understanding is that these “homes” do not cost more than the traditional long term care home model. There is no need to re-invent the wheel. There are innovative models of care that already exist in Canada and elsewhere. What is needed is recognition of the need for significant change in our present long term heath care system and a willingness to act! According to the Ontario Long Term Care Association, currently 90% of residents living in Ontario long term care homes have some form of dementia.

Please note: The authors of this blog are not endorsing any particular model of care. We are offering this blog as information and to provide an impetus for change and action. If you agree with what is written and want to take action, then you are encouraged to write to your local newspapers, write letters to your politicians, and speak out at public forums which address long term care homes. You can make a difference! For easy reference, links to MPPs and MPs:

https://www.ontla.on.ca/web/members/member_addresses.do?locale=en https://lop.parl.ca/ParlInfo/Compilations/HouseOfCommons/MemberByPostalCode.aspx?Menu=HOC

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