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
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.
The Glebe Centre, a non-profit, charitable long-term care home, has partnered with Dementia Care Matters to become the first Butterfly Home in Ottawa. The Butterfly Model is a transformative model of care for long-term care homes that means:
- Total culture change
- More than addressing the clinical needs of the residents
- A place where residents, families and staff form a community of care,
- Relationships matter most and
- Where residents’ preferences for daily activities are respected
“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
The Glebe Centre has done just that and seized the opportunity to be the leader for transformative change for our long-term care homes in Ottawa. They will start with one unit in the fall of 2019. This is a bold and risky step and we offer our hearty congratulations!
Now to get other cities like Brantford, Kingston, Belleville to follow suit.
Sherbrooke Village Long-term Care Home, Saskatoon, Saskatchewan
Below is the letter published in the The Ottawa Citizen in response to the article re “funding cuts jeopardize care homes”. Read the July 22/19 article here.
“Once again, the vulnerable older adults living in our long-term care homes will be penalized by funding cuts. Many residents continue to be frustrated and bored, which often results in aggressive incidents. Staff continue to be exhausted, frustrated and overworked. Funding cuts aren’t the answer. Transforming the way care is delivered and creating a new culture of care with innovative models that already exist is a solution. These innovative models are being used in several communities in the province.
Yes, there is upfront investment but there are projections that the result is cost-neutral. The result? Fewer aggressive incidents, decreased medication use, and a decrease in staff sick days.
These models create an atmosphere that is more homelike and provide a sense of community for residents, staff and families. Wouldn’t you want this kind of transformative care for your family member?
The new Minister of Long-term Care, Merrilee Fullerton, has said that ‘long-term care is a priority for this government.’ CARP Ottawa urges her to include a study of these innovative models of care before making any future decisions regarding cuts.
Rick Baker, President, CARP Ottawa”
If you belong to another branch of CARP or any other organization, please take some action and send letters to your local papers. We need your help!
The Hogewey Village concept, developed in the Netherlands in the 1990’s, was featured in this blog’s first post (September 22, 2017) describing its implementation at Georgian Bay Retirement Home in Ontario; it has also been implemented in Alberta, and is soon to become a reality as a long-term care home in Langley, B.C.
As reported in The Northern View article on June 20, 2019, the Langley complex includes squares, gardens and a park where the residents can safely roam, along with a grocery store, restaurant, bar and theatre streets.
“What we want is to create a space where people can live life to the best of their ability in their own way, ” For the full article, click here.
Even though the Langley project is private and costly, it is a model from which both public and private sectors can build on to improve long-term care homes in Canada. For instance Providence Health Care, a non-profit organization, is now in the process of creating similar purpose-built facilities in Vancouver and Comox.
While change is happening, it is very sporadic in a system devoid of a strategic plan to overhaul the long-term care home system.
We need a strong advocacy voice to pressure governments at all levels to ‘step up to the plate’ and begin a health revolution in bringing about total culture change in the long-term care home system in Canada. Please reach out to friends, families, organizations, politicians, and the list goes on to lobby and advocate to make this long overdue change a reality.
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.
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In January, the Ontario Ministry of Health and Long-Term Care reported it would be hiring 100 more inspectors. Is this really the answer to our ailing long-term care home systems? Read more here.
Not so, according to this family member’s perspective:
“More inspectors are not the answer. Deming and other quality improvement experts have shown time and time again that you can’t just ‘inspect’ quality into a system or workplace. Inspection needs to be partnered with giving workers the tools and resources to do their work. Trying to balance residents’ individual wants and needs with too few staff to meet them is an unwinnable state. The long-term care system needs serious reform that includes feedback from residents, families, staff and the provincial government” – Pat Piaskowsk. Read more here.
The number of inspectors continues to rise – from 102 (2013/14) to 148 (2016/17). And now, 100 more? The cost of 248 inspectors, at an average of $85,000/yr (not including benefits and pensions) is approximately $21 million/year!
The outcry for additional personal support workers in long-term care isn’t new and isn’t the only part of the system that’s broken; perhaps the system would be better served by re-directing some of these dollars into transforming the long-term care home systems with a total culture change that provides a supportive community for staff, family and friends where relationships matter most.
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Why aren’t our leaders on the stage?
“We have an opportunity to be leaders” Toronto City Councillor Matlow says. Where are the champions of long-term care homes in our other Canadian cities?
Recently the Region of Peel in Ontario bought into a transformational model of care for long-term care homes from the U.K. called the Butterfly Model. Following Peel’s lead, Toronto City Council commissioned a report to review the various innovative models in existence in Canada, the U.S., the Netherlands and elsewhere. See the link to the article here.
Time will tell whether or not this leadership from Peel and Toronto will result in the sweeping changes needed for a sustainable culture change in our long-term care home systems.
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