Local long-term care home tries a more feelings-based approach
‘Butterfly care’ model relaxes rules with nurturing approach to residents
The Glebe Centre has embarked on a one-year project to turn dementia care upside down with a model known as “butterfly care.”
Long-term care is ruled by regulations, schedules and procedures that govern almost every aspect of life for residents and staff. Butterfly care, on the other hand, urges the care team to help residents live in the moment, to sit with them, share a cup of tea or a meal, to hold their hands or hug them.
“The art of nursing is based on the idea that feeling matters most,” said Peter Bewert, a registered nurse and CEO of Dementia Care Matters.
“I think one of the things that we have really lost is the art of storytelling. We have to connect with the story that each of us has.”
As David Sheard, founder of Dementia Care Matters, has explained: “People with dementia are no longer always able to cognitively deal with the world of facts, logic and reason, they are more feeling beings than thinking beings. But they still have strong emotions and can remain connected to family and their caregivers if their care is rooted in an understanding of their feelings.”
It might sound warm-and-fuzzy, but butterfly care can result in both better care for residents, a happier staff and improved staff recruitment and retention. The Glebe Centre will be one of the first long-term care homes in the province to adopt the model after a pilot project shook things up in the dementia unit of Peel region’s Malton Village in Mississauga.
The Glebe Centre is a non-profit home, so the $100,000 it will spend on the project is not insignificant. But Malton Village noted a 70-percent drop in staff absenteeism and an improved quality of care, said the Glebe Centre’s project leader Susan Zorz, who has visited Malton Village.
“It looks like a happy place. It feels like a happy place. It’s emotionally focused, less task-focused,” she said. “Staff tell us that they want to spend more time caring for the residents. Obviously you have to care for people personally and medically. But is it so important to eat at 8 a.m. if a resident wants to sleep in to 10?”
One of the first jobs will be to break down processes and schedules and build them back up to meet measurable outcomes. Workers will get eight days of training. In January, the Glebe Centre will open a “living classroom” for up to 30 student personal support workers from Algonquin College.
The movement began in the U.K. about 25 years ago, and has since spread to Australia and Canada. There are already a handful of butterfly care homes in Alberta. Other programs in Europe and North America such as Eden Alternative, Green House and Hogewyk are also working to deinstitutionalize dementia care.
Sally Knocker, a consultant with Dementia Care Matters, has seen examples of how a change in philosophy can benefit both residents and workers. In one case, a resident refused to bathe. The woman loved animals, and felt calm when a dog was present in the bathroom with her.
“What piece of paper says it’s dangerous to have a dog in the bathroom? If it works, what’s stopping us? What’s the worst thing that could happen?” said Knocker.
It is important to ask whether doing something differently is worth the risk, she said. In one example, a resident who loved fishing perched his wheelchair on the edge of dock. In anther, residents cooked hotdogs over a campfire.
Some people won’t like the change and will leave, predicts Doreen Rocque, a member of the Glebe Centre’s family council and the past chair of the Champlain Family Council Network. But the sector needs change.
“People don’t want to work in long-term care homes. They get bitten and hit.”
The Glebe Centre has made a major commitment, said Rocque. “It will turn this place upside down. But this is caring for the whole person.”
It won’t take more staff, but it won’t be an easy journey, said Bewert. “We have to fix the culture first.”