Culture change in long- term care: an opportunity

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by Sue McDonald ,
former Long-Term Care Administrator of the CARP Ottawa Working Group.

The tragic loss of life in long term care homes due to COVID-19, has exposed many of the problems that have plagued Ontario’s Long-Term Care Home system for many years.

Many strategies have been tried over the years to repair the system, including stronger policies and more regulations, investments in staff, support from specialists, and increased oversight by government.

However, it is evident that these have been insufficient to appropriately address the inherent weaknesses in the current system.

CARP [Canadian Association of Retired Persons] Ottawa has recommended a transformative culture change for Ontario’s long term care system as the most effective means of improving the quality of life and care of residents and of dealing with the inherent weaknesses exposed by the current crisis.

There have been a number of innovative models that have embraced this culture change in the U.S., Europe, Australia and recently in Ontario. Examples of these are the Eden Alternative, Green House Project, Butterfly Homes and Hogewey Villages. The common elements of these models have been:

  • Using a relationship-based approach to care where resident, staff and families feel part of a community;
  • Setting up small home-like environments;
  • Providing more hours of direct care for residents;
  • Employing full-time well-paid staff who are trained in empathy and culture change;
  • Recognizing families and caregivers as integral members of the team;
  • Engaging volunteers who are trained in empathy and culture change.

The benefits of these models include decreased use of medications, decreased number of aggressive incidents, decreased visits to hospitals, reduced food waste and reduced staff sick time, all while increasing positive interactions with staff, families and residents.

There is a growing awareness of the pressing need for significant reform in the long term care home system. We must take advantage of the present opportunity afforded by the Provincial Commission to spread the word in our communities about the need for culture change and to communicate with local MPPs and Municipal Councillors to demand a culture change in the system.

We owe it to current and future residents of long term care, to change a system that has not always provided them with safe, quality care, focused on their individual needs.

For more information go to : changeltcnow@gmail.com.

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