The recent CBC news article regarding a female resident in an Alberta nursing home who was abused before she died from dehydration and a urinary tract infection is appalling and should never happen in our health care system in Canada. Unfortunately, abusive incidents do occur and indicate yet again that traditional medical models of care in long-term care homes need to be changed. Read more here.
Yes, our long-term care homes need to keep residents safe and comply with regulations but if person centered care was provided where residents matter and are considered to be a member of the family rather than a person to be “cared for”, then abuse would not occur.
The CBC news report says that the nursing home reported that “there was a shortage of staff and experience” and that “employees needed better education about nutrition, hydration and monitoring infections”. Yes, staff need to have that knowledge but surely it is more than that! Staff education and training is required in order to change the culture of care from one of “giving” care to a relationship based approach with the residents.
Innovative models of long-term care that are featured in this blog will do just that.
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Here is an update on the exciting journey that Bonnechere Manor and Miramichi Lodge have begun in the implementation of the Butterfly model.
The Butterfly approach was pioneered over 20 years ago in the United Kingdom by Dementia Care Matters and over the past year or so has been adopted or emulated in a few long-term care homes in Ontario. It is a social model of care that shifts care from a traditional medical care approach to:
• Prioritising emotional care that is person centered
• Creating busy, filled up, engaging places that feel like ‘home’
• Providing relaxed, freed up comfortable environments
• Involving people in the running of their own home
• Emphasizing a more informal, best friends and family like approach.
Miramichi will start by focusing on a unit of 27 people and at Bonnechere Manor, a unit of 20 people. Eventually the Butterfly approach will be used throughout both homes.
“Long-term care homes are not a place where people go to stay; they are places where people go to live and that at the heart of long-term care must be family, friends, and community”. Read more here.
Kudos to Renfrew County! Let’s hope that more long-term care homes will see the benefits of adopting an innovative approach to care.
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Paul, who wrote this poem, has been residing in a long-term care home for two years due to a degenerative physical condition. He has been waiting all this time for a transfer to his first choice of a long-term care home so that his husband of 38 years, who doesn’t drive, can visit him without having to travel by bus for several hours each time. Paul now believes that, at this rate, it will take another 5 years or so before he can move to the home of his choice. This is just heartbreaking.
IN LONG-TERM CARE (in the style of John McCrae’s “In Flanders Fields”)
By Paul Gregory Leroux
The wait lists longer daily grow
And move excruciating slow;
We seniors have no place to go
For long-term care.
We only ask for our fair share;
But the resources aren’t there,
No room for seniors anywhere
In long-term care.
Our parents fought the war and won;
Our battle’s only just begun,
As Baby Boomers now they shun
From long-term care.
We, it seems, no longer matter.
Politicians just get fatter,
As our dreams they blithely shatter
While we despair.
Bereft of dignity and pride,
We have no hope left deep inside,
As if already we had died.
The only thing we haven’t tried
Is mass assisted suicide.
But do we dare?
More about Paul’s journey to appear in a future blog post.
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Making Moments Matter at The Glebe Centre:
No More Beige!
An update from the Glebe Centre (Ottawa) : Although the team from Meaningful Care Matters (formerly Dementia Care Matters) observed many exceptional moments of care, there were indeed areas that needed improvement and did not follow a person-centered model of care.
This will be our journey over the next year, to transform and re-think care on Bankwood (one of the care units at the Center) from a neutral/task based model of care to a person-centered, house-hold model of care.
Meaningful Care Matters has sent an extensive, formal report with recommendations on making meaningful change.
An audit was completed on the physical space on Bankwood and recommendations for change and transformation. Over the last few months we have started to create a relaxed home-like feel to the day with less task orientated activities and more emphasis on the people living and working on Bankwood.
We have begun the process to re-design Bankwood to be more welcoming and intimate, filling the house with the “stuff of life” so that residents can connect with a variety of colours and objects that reflect their past lives, work and hobbies. And staff training begins this month!
Person-centered care is front and foremost as Bankwood undergoes change and transformation! Please forward this blog post to at least one other contact you know who may be interested.
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Instead of building homes in which people feel homeless, let’s build communities where people belong”. Sonya Barsness.
In June, 2019, Canada’s first Dementia Village opened. The Village’s design was inspired by Hogewey, the world’s first dementia village, in The Netherlands. Langley will become home to 78 people with dementia housed in six cottages. Care will be provided by 72 specially trained staff.
After 4 months, Langley has admitted 38 residents, one couple, and more residents are being added from its wait list every week.
- Two cottages are full and two more are at 50% capacity.
- The General Store is stocked and open for shoppers (pet food is popular).
- Elroy’s Cafe & Bistro is open for baking, lunch, coffee or a cold beer.
- The kitchen is the centre of activity and the smells permeate the house and stimulate the senses and appetite of the residents. Residents are involved in the daily food prep, plating and cleanup to the best of their abilities.
- Residents have created their own Newspaper complete with real and imagined stories and clippings contributed by each household member.
- Music is also important to the residents playing instruments when able to express their own particular interests.
The Village is about doing things differently. It is about putting the interests and needs of the residents first and making each house a home.
Although the Village Langley in British Columbia is privately owned and will not be affordable to all, we hope that this kind of innovation will influence others to bring culture change to their own long-term care homes.
Please forward this link to your friends, colleagues and your local city councillors, MPs or MPPs.
The city of Toronto is planning to revamp their long term care homes! Their plan will include the implementation of an “emotion focused care model”. All staff will receive in-depth training on this model which focuses on empathy, creating friendships and engagement of activities that give life purpose.
The city of Toronto examined innovative models of care such as: the Butterfly model, the Green House Project, and the Eden Alternative and decided to use a Toronto-created approach.
“The proposal calls for extra staff members, beginning with six new front line workers in a 2020 pilot project at Lakeshore Lodge in Etobicoke. Starting in 2021, roughly 55 additional workers would be hired each year until 2025, when a total of 281 new staff members would be in place throughout the city’s 10 facilities.” An evaluation component, conducted by the University of Toronto, will be built into the pilot project at Lakeshore Lodge. Read more here.
Way to go Toronto! Let’s hope other cities will follow suit.
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Taking the time to care
In 2011 Brian was diagnosed with dementia. Last summer he died after being in long-term care (LTC) for 4 1/2 years. I tried my hardest to care for him at home but Lewy Body Dementia defeated us.
I will always feel guilty: nearly 20 years ago I retired from my working life as a therapist which included visiting residents in LTC. I knew how unhappy he would be there.
I was right. Little had changed in the quality of life of the residents: the way staff worked was still hierarchical, the medical model firmly in place. Care plans barely took into account the life experience, interests and personality of the resident. Front line staff did their very best but were dominated and constrained by “Ministry” regulations.
The time is rapidly approaching when I and thousands of “baby boomers” may need a place in LTC.
Culture change is needed now and is possible through putting each resident’s emotional and social needs at the core of their care. Change: to make living spaces home like and comfortable; time filled with companionship and meaningful activity, change to give staff the time and satisfaction of taking care of a resident known for who they were and are now.
Should I need a place in LTC I don’t want to be in a home where I am kept alive: I want to be helped to live.
Submitted by Janet