Seniors group makes push to transform long-term care
CARP urges Ottawa, provinces to consider emotion-focused program featured in Star series
Canada’s most influential seniors’ group is pushing federal and provincial governments to transform long-term care with emotion-focused programs like the Butterfly Model that turned a Peel Region dementia unit into a home of empathy, warmth and friendship.
“We are looking at this across the country and working with local communities to see if the Butterfly Model or similar types of models would be the best fit,” said Laura Tamblyn Watts, national legal director of CARP, formerly the Canadian Association of Retired Persons.
“I can tell you there is significant interest,” added Tamblyn Watts, a lawyer whose organization has 300,000 members over the age of 50. Its events draw Prime Minister Justin Trudeau, federal Conservative Leader Andrew Scheer and the new Minister of Seniors, Filomena Tassi.
The Redstone dementia unit in Peel was the focus of a Star investigation called The Fix. It detailed a year-long experiment that tossed out Ontario’s traditional task-focused system, allowing workers to spend more time with the people in their care. The program is used in five Alberta seniors homes and one nursing home, and is one of several such programs being considered by long-term care leaders in Toronto.
The Butterfly program teaches nursing home workers to find ways to connect with residents’ memories, through music, conversation or activities related to past careers.
Other, similar programs include the U.S.-based Green House Project and the Eden Alternative.
Tamblyn Watts said she has recently discussed such programs with Tassi, the new federal seniors’ minister, Ontario Health Minister Christine Elliott and other provincial leaders across the country. CARP chapters in Ottawa and Nova Scotia are among those pushing for programs that enhance quality of life in nursing homes, she said. Both CARP chapters said they are lobbying local governments for emotion-focused programs.
Tamblyn Watts said the Star’s stories have created an eagerness for discussion because people are seeking “a more engaged way of living and a more humane way of living.”
“The Star’s Butterfly series had an enormous effect in raising awareness … that long-term care can be different and that the types of change possible are really inspiring to people. It sparked conversations from coast to coast to coast,” she said.
Peel Region is now making the same changes to dementia units in its four other homes, and a private long-term care chain, Primacare Living, is adding Butterfly to its three existing homes in St. Catharines, Brampton and London. Primacare is also building a new longterm care home in the Flamborough area of Hamilton using Butterfly designs for small “households” of eight to 10 people instead of the traditional designs for 32 people.
Ontario’s two long-term care associations are now also pushing for similar change.
In their 2019 budget requests, both groups are asking the provincial government to create small households with pro- grams that put the residents’ interests first.
Together, Advantage Ontario and the Ontario Long Term Care Association represent the province’s 628 nursing homes that care for 78,000 people.
“Our population is aging and dementia is on the rise and we need to make sure that our system is ready for that,” said Lisa Levin, CEO of Advantage Ontario, which represents 36,000 residents in 180 not-for-profit and municipal homes. “We are at a critical crossroads.”
Advantage Ontario is asking the province to support emotion-focused programs that allow workers to connect with the people in their care, developing close relationships that alleviate the boredom, loneliness and loss of purpose that many feel in their final years.
Called “The Challenge of a Generation: Meeting the Needs of Ontario’s Seniors,” the Advantage Ontario report says, “Unique care models like Butterfly, Green House and Eden Alternative are transforming the way we think about seniors’ care. These person-centred emotional care approaches provide people with a more caring, calming and compassionate environment in their final years. They also help retain staff and reduce turnover.”
Candace Chartier, CEO of the Ontario Long Term Care Association, which represents mostly for-profit homes, said the government should allow nursing homes to divide their units into smaller, more intimate households. “These are the homes that will take us into the future,” Chartier said.
Chartier said the health ministry needs to find ways to lessen some regulations, making it easier for homes to focus on the people in their care. “Right now, we don’t have the flexibility of staffing to do those creative approaches to programming,” she said.
Chartier and Levin said administrators are so overwhelmed by Ontario’s strict regulatory system that they are afraid to try new ideas, fearing inspectors will hit them with violations. But Peel has said its annual inspection did not lead to any violations related to the Butterfly program.
Levin, of Advantage Ontario, said her personal experience with a family member living with dementia has shown her how “emotions remain intact after so many other things have slipped away.”
“It really has reinforced for me just how important it is to have the right kind of care and the right kind of environment for people who have dementia.
“You can just set people off with the wrong word, the wrong environment, too much stimulation. It makes me feel even more strongly that we need to have different kinds of care than we had in the past.”
On Monday, staff in another Peel Region long-term care home, called Sheridan Villa, near Southdown Rd. and the QEW, started Butterfly training, which requires they connect with their own emotions to empathize with the people in their care.
The program is being added to Sheridan Villa’s “special behaviour support unit.” It is a transitional home for people with dementia, mostly from the community, who have serious behavioural problems, such as aggression. Mary Connell, the Butterfly project manager, said it is possible that some people, who don’t have additional mental-health problems, may be simply struggling with boredom or lack of social interaction.
Within a few months, Sheridan Villa’s brown-on-brown rooms will be painted brighter colours and workers will be sitting with people in their care, massaging hands, talking about their past, instead of racing to finish tasks.
Primacare and Peel Region are in talks with academics from the Centre for Aging at Sheridan College for an independent evidence-based study examining the outcomes of the Butterfly program for the residents and staff in the home. If the study gets funding, the academics will evaluate resident quality of life and health impacts.