Long-term care reform: what seniors need and deserve



St. John’s Green House home in Penfield N.Y: residents eat together at a communal table. The Green House project focuses on residents’ emotional and social well-being.

“…….The COVID-19 crisis has highlighted that we need new ways of providing LTC to protect residents from plagues of communicable disease. But we also need to eradicate the noncommunicable plagues of old age identified by the architects of the Eden Alternative — loneliness, helplessness, and boredom.

We need new models of care that prioritize human relationships, dignity, and safety. That means a moratorium on new LTC facilities that don’t look like Sherbrooke Community Centre’s Poppy Lane…..” (a long-term care home featured on this blog site on November 16, 2017)  says Dr. Michael Rachlis, a public health physician and an Adjunct Professor at the University of Toronto Dalla Lana School of Public Health that appeared in The Star on May 8th, 2020.  Read more here


Another innovative model – now in Waterloo


“Sunnyside Home is adopting a new approach to make the Kitchener long-term care facility feel more like a home, and staff like family, for its residents with “dementia.”………

Sunnyside has been working for a few years to improve care by moving away from a medical model. The butterfly approach will take that to the next level to ensure residents have a full life” as reported in an article by Johanna Weidner in The Waterloo Chronicle.

This is another example of the increasing number of innovative long-term care home models that are striving for the transformative culture care we are hoping for in the future for Ontario. Unfortunately, the COVID-19 virus crisis has obviously put a damper on this kind of major change from moving forward at this time. We look forward to encouraging these homes in their quest for culture change once this crisis is over.



COVID-19: Hats Off to Long-Term Care Home Workers

Hats Off!

Across Canada, there is a group of health care workers, those working in long term care homes, who are placing their own lives at risk while they do all that they can to care for and protect their residents. Residents living in long term care homes are particularly vulnerable to COVID-19 and long term care homes are one of the toughest places to contain an outbreak. This is because the people who live there are elderly, often have compromised immune systems, and they live and socialize in close quarters –in some of the older homes, even 4 per room.

Long term care homes are now prohibiting visitors, which adds more stress to both residents and staff. Residents, who look forward to visits from family and friends, may experience feelings of isolation and loneliness and staff are not only concerned about their own health but also those in their care. As one staff member has said, “You don’t know who’s going to still be there the next day.”

However, there are some amazing stories that are now coming out about the creative ways that long term care workers are promoting social connectedness while keeping residents physically distant from one another.  Read more here.

Our hats go off to these wonderful, caring, compassionate health care workers. Thank you very much for everything you are doing to try and keep your residents safe and healthy!

Could Ontario’s long-term care home system be any more complicated?

There are 626 long-term care homes in Ontario (2019); of these, there are 3 categories:

For-Profit: 58%,   Not-for-Profit: 24%,   Municipal: 16%

What are the commonalities?

  • Funding: All 3 types are funded by the Ministry of Health and Long-Term Care through the Local Health Integration Network (LHIN) based on the same formula.
    In addition: Municipalities can opt to top up funding for their homes through tax payers’ dollars.  Some of the other homes have either foundations or fundraising programs that can top up their funding for capital expenditures or program enhancement.
  • Admission/wait lists: All 3 types are subject to a central admission/wait list process controlled by the LHIN
  • Resident costs: In all 3 types, residents are required to contribute a co-payment for accommodation of basic ($1848.73), semi-private ($2,228.63) or private ($2640.78).  These costs are as of 2018 and there is a cost of living increase each July.  
  • LegislationAll 3 types are subject to the same standards, rules and regulations.    


What are the differences? 

  • Management:
  • The for-profit long-term care homes are managed by their corporate office through their Chief Executive Officers (CEO’s)
  • The not-for-profit long-term care homes are managed by a Board of Directors through their CEO’s
  • The municipal or city-run long-term care homes have a formal mechanism in place for their management through a committee of City Council and a staff director.   

Please note that unlike long-term care homes, retirement homes are not publicly funded and operate outside the domain of the long-term care home system.   More details here.  

Please comment on the blog if further clarifications are required. 





Will this ever end?

blog feb2020The 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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Butterfly Approach takes flight!

Butterfly Approach launch at Miramichi Lodge

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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An Insider’s Perspective in Verse



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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