Presenter: Monica Goodban
Since 2018, Peel Region has been on a journey to change the culture of care in our homes, first through the implementation of Meaningful Care Matters’ Butterfly Approach in select home areas, as well as through the expansion of emotion-based care philosophies through our service areas and with our system partners. Join FCO and CARP Ottawa as we welcome Monica Goodban to share the full story. Q&A to follow.
Webinar recording from Jan 17th, 2024
One of the three Colour It Your Way long-term care homes in Grey County
On October 25th, CARP Ottawa’s Advocacy Group on Long-term Care and Family Councils Ontario, co-hosted a webinar featuring Jennifer Cornell, Director of Long Term Care, Grey Gables, Lee Manor, and Rockwood Terrace Care Communities, Grey County. Jennifer shared the story of Grey County’s Long-Term Care culture change journey through the power of creating a shared purpose. Their ‘Colour It Your Way’ journey was 10 years in the making and has become an ongoing journey.
Their journey addressed many aspects including vision, purpose, care approach, leadership coaching, staff support and training, and the list goes on. Jennifer also spoke with enthusiasm about a new redevelopment project for their long-term care homes and looking into smaller size of units. Click here to learn more.
Changing ‘institutions’ to ‘homes’ is happening in Ontario, Canada, and beyond. Please join us as Champions for Change in Long-term Care Now by forwarding this post with your contacts, MP, MPP, and city councillor.
Media Release July 31st, 2023
Most of Ontario’s long-term care homes (LTCHs) are still being operated as institutions. This despite four decades of systemic weaknesses that were brought to light because of the horrific tragedies of the pandemic.
We are calling on the Ford government to mandate and fund the ongoing transition of LTCHs from institutions to homes so that residents can live in dignity and with the respect they deserve.
Positive changes in models of care already exist in the province. For the last five years, CARP Ottawa and other like-minded organizations in Ontario have been working hard to highlight those positive changes. The models include: The Eden Alternative, The Butterfly Approach, Hogeweyk Villages, and the Green House Project. Other homes, such as the municipal homes in Toronto, have opted to use a hybrid model. They all use the same philosophy of care.
More awareness is needed. Residents deserve to live with respect and dignity. Georgie’s compelling story, described in the video shows how The Butterfly Approach enabled her to come to life again, even though living with dementia. The other describes ‘The Eden Alternative model – how its philosophies care for the whole person and create a home – and how it values its staff, resulting in a remarkable 95% staff retention rate. View the videos here:
https://changeltcnow.ca/video/ChangeLTCNow-MeaningfulCareMatters-v6.mp4
https://changeltcnow.ca/video/ChangeLTCNow-SueEllen-v4.mp4
There are many long-term care home operators in Ontario, other provinces and internationally, that have already transformed their institutions to homes. The Quebec government has just announced it will be transforming all its nursing homes using similar approaches. These shifts result in significantly better outcomes for residents, staff, and families, both pre and during COVID-19.
The fundamental principle in Ontario’s Fixing Long-term Care Act 2021 – to provide a place where residents may live with dignity and security, safety and comfort and have their physical, psychological, social, spiritual, and cultural needs adequately met – is not being applied.
If we don’t begin to fix the long-term care home system now, after two years of horrific tragedies, they will be forgotten again for decades or until another pandemic hits.
For contact information re interviews with family caregivers, experts and staff, call:
Kathy Wright – 613-808-8978,
Chair, CARP Ottawa’s Working Group on Long-term Care
or
Marg Eisner – 519-771-1129,
Member, Working Group on Long-term Care.
www.carp.ca – a New Vision for Aging is Canada’s largest advocacy association for older Canadians promoting equitable access to health care, financial security, and freedom from ageism. There are more than 300,000 members nationwide.
We urge you to share this with your friends, families and contacts as well as with your MPPs (for easy reference the link to the MPPs – click here
Did you know that social engagement is increased in emotion-based models of care?
Boredom and loneliness amongst residents of long-term care homes is well documented. Feelings of loneliness can lead to depression, anxiety, impulsivity, aggressive behaviours and even suicide ideation. The sense of loneliness has only been enhanced during COVID as long-term care homes have closed their doors to family members and others due to increased risk of infection. Group activities were stopped as were outings during the peak times of COVID.
In her book, Happily Ever Older, Moira Welsh noted that Dr. Bill Thomas founded the Eden Alternative model of care to combat what he defined as the ‘three plagues of loneliness, helplessness, and boredom’ all of which conspire to create a miserable existence. (p. 137). Boredom and loneliness can be reduced by creating a more relaxed home-like feel to the day with less task-orientation and more emphasis on people living and working in the home. This is what Butterfly homes are all about and the results are very encouraging. Read more here
Emotion-based model of care is one which has smaller environments, 8-16 residents/unit; communal dining room and kitchen; where full time staff actually know their residents and where residents, staff and families are all valued as a part of the team sharing times of laughter, joy and meaningful activities.
What is most important is that your family member has quality of life in the years remaining. Learn more about emotion-based models of care at www.changeltcnow.ca and contact your MPP now to advocate for emotion-based models of care in all our long-term care homes!
Did you know that the use of antipsychotic medications is lower in emotion-based models of care?
Queen’s University IRC (Industrial Relations Centre), published a paper in 2019, “Dementia Care Innovation in the Region of Peel” by Francoise Morrisette, which showed that one year after implementing the Butterfly model in long-term care homes, the use of antipsychotic medications was lower and aggressive events were less.
The same result was achieved in the Green House model. George Heckman, a Geriatrician and the Schlegel Research Chair of Geriatric Medicine at the University of Waterloo, said any long-term care homes that want to further reduce the number of antipsychotic drugs prescribed ‘potentially inappropriately’ can adopt the Green House model, which has been studied by his team. “The Green House model data shows antipsychotic use being much lower. They also have fewer hospitalizations. They have a better quality of life. The staff who work there have a better quality of work.” Read more here
Emotion-based model of care is one which has smaller environments, 8-16 residents/unit; communal dining room and kitchen; where full-time staff actually know their residents and where residents, staff and families are all valued as a part of the team sharing times of laughter, joy and meaningful activities.
What is most important is that your family member has quality of life in the years remaining. Learn more about emotion-based models of care at www.changeltcnow.ca and contact your MPP now to advocate for emotion-based models of care in all our 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.
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!
On Sept 15th, C.A.R.P. Ottawa provided a webinar on The Eden Alternative with speaker Suellen Beatty, CEO Sherbrooke Community Centre and Co-Regional Coordinator for Eden Alternative in Western Canada. Nearly 100 persons registered for this event and those that did attend were very pleased with the speaker and content.
The Eden Alternative is a philosophy of care that focuses on relationships. The philosophy has seven domains of well-being which residents and staff focus on to create a home. Their goal is to create a human habitat where people thrive and grow. They care for the human spirit as well as the human body. The staff know that people need to have a reason to get out of bed each morning, so they spend time focusing on what brings pleasure to each person and then they try to provide that program or activity at Sherbrooke.
Within Sherbooke Village, they welcome intergenerational communities: a Day Care Centre of 36 children on site who bring joy and pleasure to the residents: an Igen (Intergenerational) Program where a class of Grade 6 students use space at Sherbrooke for their classroom studies. In between, they build relationships with the residents.
To see a video recording of the webinar, click here.
What is needed to change an institutional model LTC home into Eden Alternative home? It requires a change in attitudes, beliefs, and behaviours. It requires a culture change which allows the resident to direct the type of life they wish to live and staff who are fully engaged and valued. It requires leaders who become coaches and empower others.
Wouldn’t it be wonderful to be able to spend our later years in a home where there is identity, growth, autonomy ,security, connectedness, meaning , and joy. It would be “A Life Worth Living”.
Please do your part to 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.
It has been decades since any stripe of government has paid heed to or lived by the fundamental principle in the Ontario Long-Term Care Homes Act, 2007 and Regulation 79/10 (which came into force in July 2010): i.e. “[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.”
Supposedly the Ontario Government is in the process of proposing changes to the Act by the fall 2021.
The Government has long fallen short in meeting the existing Residents’ Bill of Rights (which falls within the Act). Implementing an emotion-based model of care would meet those expectations:
Every resident has the right to be properly sheltered, fed, clothed, groomed and cared for in a manner consistent with his/her needs. A culture change to an emotion-based model of care would make this happen.
Please do your part to bring emotion-based model of care 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.
Malton Village, The Toronto Star June22, 2018
Ontario’s Long-term Care COVID-19 Commission made 85 recommendations that need to be enacted in order to keep residents and staff safe in future viral outbreaks. The recommendations were divided into five areas. Highlighted here are the remaining three areas of the Report.
Person-centred care: Human Rights Code, the Long-Term Care Act and Residents Bill of Rights: With years of neglect, sweeping reforms are needed in our long-term care homes to protect residents and provide a quality of life. The Report highlights person-centred care but In order to provide person centred care, all the residents’ needs should be assessed and respected including lifestyle choices, diversity and emotional needs. (Recommendations: #29, #37, #38)
Staffing issues: A severe staffing shortage and a work force poorly trained with few infection control measures compounded the COVID-19 situation. All the staffing recommendations in the Report are important. There is an urgent need for skilled staff but recommendations are not explicit enough in what training is required. Person-centred care requires staff to have emotion-based training. Recruitment and hiring practices need to be addressed. Staff recruitment should assess the attributes of emotional intelligence, empathy, compassion. All staff and students should have experience in settings where new models of care are being provided. Most importantly, there needs to be commitment from leadership to promote person-centred care practices. (Recommendations: #40, #41, #42, #49)
Design Standards: Poor facility design and resident overcrowding heightened sickness and death in long-term care homes, with nearly 4,000 residents and 11 staff dying of COVID-19. All the design manual recommendations are important but alternative person-centred models and provision of incentives in order to create smaller home-like units needs to be included. (Recommendations #61 and #64)
Transformative culture change is needed in our long-term care homes. Please send a letter to your MPP encouraging the government to take action NOW on the recommendations in this Report.
