Driving change in long-term care
October 19, 2021
For 15 years, the RIA has supported research and initiatives that enhance the quality of life and care of older adults, including those who call long-term care (LTC) home. The COVID-19 pandemic forced many to face the long-standing challenges in Ontario’s long-term care system and highlighted how essential our work is. Now is the time to redouble our efforts.
The pandemic has taken (and continues to take) an immense toll on those who live and work in long-term care. Ontario’s Long-Term Care COVID-19 Commission released their final report this past spring, highlighting key next steps for the province to ensure what was experienced by residents, families and team members during the pandemic is never repeated.
In October, Health Standards Organization released the findings from their inaugural national survey on long-term care. The feedback from Canadians will inform HSO’s development of new national standards. Schlegel Research Chairs Heather Keller and Veronique Boscart are supporting this work.
The RIA has many initiatives already underway that support these provincial recommendations and national needs. We are providing skill-building education to team members and building leadership capacity. We are attracting the next generation to pursue rewarding careers in long-term care. We offer thoughtfully developed tools and resources to support homes in adopting person-centred care.
We’ll be featuring stories highlighting how the RIA is supporting long-term care to put living first. Please click on the article titles below to expand.
The number of people needing long-term care (LTC) has steadily risen and won’t slow down anytime soon. Unfortunately, the number of LTC home team members has not increased at the same rate. There is a significant shortage, and the Canadian Institute of Health Information (CIHI) cited a correlation between the lack of team members (particularly personal support workers), the use of agency staff, and increased severity of a COVID-19 outbreak at a home during the first wave.
Adequate staffing is critical to ensure quality care for LTC home residents, including an appropriate mix of staff roles to address residents’ complex needs. Having the team resources to support care needs, mealtimes and a wide variety of recreational and leisure activities can make all the difference for resident quality of life.
The Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) at the RIA is prioritizing workforce challenges in the sector. Through a variety of initiatives, we have been engaging with youth to teach them about careers in LTC and the immense value working with older adults in long-term care can add to their lives.
Through the many resources available online, youth are exposed to various career opportunities including social worker, recreation aide, nurse, personal support worker and more. The outreach team connects with Ontario school boards to include profiles of different careers on the platforms ChatterHigh and Blueprint. The outreach team also presents to co-op students and those who access YMCA employment services, sometimes with LTC team members to share their story.
To get LTC homes engaged, the Ontario CLRI has created a guidebook to help establish meaningful and impactful partnerships to create experiential learning placements for students, including cooperative education and Specialist High Skills Major (SHSM) placements.
Next, the team will grow the resources available with more career options. Also, in response to interest from students, the Ontario CLRI at the RIA will create a video following a resident for a day to show how various LTC team members engage with residents.
To learn more about workforce development in long-term care, visit https://clri-ltc.ca/careersltc/.
Since opening in 2005, the RIA has worked diligently to bring best practices to long-term care (LTC) to enhance quality of life for those who live, work and visit there. We are committed to driving research and innovation across the LTC sector and we do this by bridging the gap between research and practice.
The RIA’s world-class research team has extensive expertise in LTC research and explores aging across a variety of topics: nutrition, heart health, spirituality, arts, and dementia to name a few. Through strategic partnerships, the research evidence is used to create and improve care practices, health-care services, and training and education. What is learned is then shared to benefit all LTC residents, team members and families.
In 2012, our efforts to support LTC were accelerated with the establishment of the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI). The RIA is one of three organizations awarded funding from the Ministry of Health and Ministry of Long-Term Care to support this program. The collective expertise, resources and partnerships of the host organizations (RIA, Baycrest and Bruyere Research Institute) help advance the program’s provincially mandated goals.
Supporting the province’s 600+ LTC homes, the Ontario CLRI shares resources and provides education that addresses key challenges, such as increasing care complexity in residents and workforce recruitment and retention. The Ontario CLRI at the RIA has a number of initiatives underway to address the pressing needs of the sector:
- Engaging personal support workers, a voice often not represented, in discussing and generating solutions to workforce shortages.
- Creating an eLearning hub to allow easy access to virtual education for team members in LTC.
- Supporting the development of resources for LTC homes to create inclusive communities that celebrate diversity.
- Exploring ways to improve nutrition by recreating classic recipes with nutrient-dense ingredients.
To date, the program has been very successful. The Ontario CLRI has reached 99 per cent of LTC homes in the province providing education to over 75,000 team members. Moreover, in 2020-2021, 82 per cent of rural and 87 per cent of northern LTC homes have access to resources, ensuring uptake across the province. In collaboration with various sector stakeholders, the team developed and released 250 new resources in 2020-21 – all with the goal of enhancing quality of life.
To learn more about the exciting work of the Ontario CLRI, visit clri-ltc.ca.
It’s no surprise that Ontario’s Long-Term Care (LTC) COVID-19 Commission report highlighted the need for enhanced infection prevention and control (IPAC). The report calls for all team members and caregivers to be trained in IPAC regularly. This means LTC homes need easily accessible, on-demand training.
The Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) at the RIA is committed to supporting best practices in long-term care and mobilized quickly to meet the urgent need for IPAC education. The team worked with IPAC experts and team members in LTC to develop a collection of e-learning courses to support IPAC in LTC.
IPAC isn’t any one person’s job, it needs to be everyone’s responsibility. All team members, family members and visitors to long-term care have a role play. It’s essential that they understand how COVID-19 and other illnesses spread, and the most effective ways to break the chain of transmission. This is the focus of the first course. It is an interactive 30-minute session that gives learners the knowledge and skills they need to stop the spread. Additional courses focus on key topics, like travelling to and from work and supporting residents at mealtimes.
To inform course development, personal support workers and other team members in LTC were engaged in conversations to understand their current knowledge and IPAC skills, as well as their education needs with respect to specific situations or tasks. Subject matter experts, care providers and LTC team members participated in development meetings to provide feedback on the content and delivery. The courses were developed using principles of human-centred and iterative design to ensure they would meet the needs of LTC.
The first three IPAC eCourses were released in June 2021. There were over 220 course completions in the first four weeks. It’s clear these courses are in high demand, and additional courses will be released in fall 2021.
To access the IPAC education, visit clri-ltc.ca/ipac.
With an urgent need to increase the number of team members in long-term care (LTC) during the pandemic, recognizing that LTC environments require unique skill sets can be easily overlooked. Long-term care looks very different today than it did a decade ago. The care that residents need is becoming increasingly more complex and there is a shift away from institutional models of care to provide person-centred care. This requires team members to have unique skill sets. The RIA believes access to high-quality virtual education on person-centred care is essential to equipping team members with the tools they need to thrive.
In 2021, Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) at the RIA received $4M to offer training through the Personal Support Worker Education Fund for Long-Term Care (the PSW Fund). The PSW Fund provides tuition and backfill reimbursement to LTC homes for their team members to participate in skill-building education and adopt person-centred models of care, a priority identified in recommendations from the Ontario Long-Term Care COVID-19 Commission. The training is funded by the Ontario Ministry of Long-Term Care.
The PSW Fund supports the virtual delivery of both the Excellence in Resident-Centred Care (ERCC) and the award-winning LIVING the Dementia Journey (LDJ) programs. ERCC, co-developed by Conestoga College and the RIA, provides team members with practical skills in person-centred care and includes a focus on infection control. New this year to the PSW Fund, LDJ participants gain an awareness and understanding that changes the way they view dementia and the way they support people living with it. LDJ was created by the RIA and the Murray Alzheimer Research and Education Program in collaboration with people living with dementia and their care partners.
To date, the PSW Fund has supported training of more than 18,000 team members in 250 long-term care homes across the province since 2017.
In addition to the programs offered through the PSW Fund, the Ontario CLRI at the RIA curated and mobilized crucial resources to support rapid hire orientation during the pandemic and ensure new team members were ready to support residents.
To achieve this, we worked collaboratively with sector partners to understand what those new to LTC needed to know. Topics covered a general overview of LTC and COVID-19, proper use of personal protective equipment, and how to communicate with residents and families and more.
While the purpose of these orientation resources was to address an immediate need during the COVID-19 crisis, the Ontario CLRI team plans to continue and expand the resources available.
To learn more about the exciting work of the Ontario CLRI, visit clri-ltc.ca.
The needs of older adults today are often complex, and the older adult population continues to grow rapidly. The combination of these factors, highlighted by the COVID-19 pandemic, demands leaders in the senior living sector who have a unique skill set to adapt and provide the best care.
The Leadership in Senior Living Program equips current and aspiring leaders with the skills they need to effectively lead high-functioning teams and support person-centred care in today’s senior living sector. Through five online courses, learners engage in group discussions, examine real-life scenarios and learn from leading experts. Program graduates foster individual, team and organizational success, creating senior living environments where everyone thrives.
To make the program as accessible as possible, learners access course content based on their own schedule and can continue full-time employment. Learners can be any team member with an interest in leadership, including those wanting to transition to a career in senior living.
By focusing on a social model of living, person-centred care and a team-based approach are emphasized. Case studies, written assignments and reflections teach learners philosophies of care, ethics, palliative approaches, domains of well-being, emergency planning and more. Videos are integrated throughout where leaders from senior living share strategies and approaches, advice and offer recommendations based on their experiences.
Beyond the topics traditionally found in similar programs, there is discussion about the physical and psychological impacts of COVID-19 and outbreaks throughout the program. The program also explores older adults’ experiences with transition and recommends services available to support them. The program discusses the importance of interRAI and provides guidance on analysis and planning for reportable indicators such as pain, falls, pressure injuries, use of restraints, rates of depression and use of antipsychotic medications.
This program produces leaders who effectively lead teams, support organizational change for aging well and provide high-quality person-centred care.
We know the way we support our oldest citizens needs to change, and that starts with changing the culture of aging and long-term care. The RIA is driving the Canadian culture-change movement to challenge ageism and shift institutional models of care toward social models of living. We strive to create a nation where person-centred care is the norm.
One of our key accomplishments to drive culture change in Canada is co-hosting the Walk with Me conference with our Alberta partners, CapitalCare. Walk with Me brings older adults, health-care professionals, researchers, educators and policymakers together to challenge ageism and learn with and from each other. Those from across the senior living and community sectors attend to share innovative and creative solutions to benefit older adults regardless of where they live.
The next conference will take place in Calgary, Alberta on May 26-27, 2022. Walk with Me will provide the forum we all need to reconnect and reimagine senior living and long-term care.
Another key initiative to challenge ageism is addressing how we speak with and about people. The Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) at the RIA is bringing awareness to the power of language.
Behavioural Supports Ontario (BSO) and the Ontario CLRI have been working with an expert panel since 2017 to bring attention to person-centred language. The work highlights the stigma surrounding certain words often used in long-term care (LTC). For example, using the term “facility” paints a very different picture than describing long-term care as a resident’s “home”.
A variety of resources were launched in 2020, including the free Person-Centred Language e-Courses for those working in LTC homes. Since the launch in February 2020, over 1,950 people have completed the education and over 5,000 have made a pledge to use person-centred language. The e-courses were co-developed by BSO and the Ontario CLRI at the RIA in collaboration with the Division of e-Learning Innovation at McMaster University.
Building on this initiative, the Ontario CLRI, BSO, and Family Councils Ontario (FCO) made recommendations to the Canadian Press, which provides national guidance on language use to journalism, public relations, and communication sectors, to adopt person-centred language. The intense media coverage during the first and subsequent waves of the pandemic highlighted that journalists are often not using person-centred language when describing LTC homes. These recommendations, such as using terms like “home”, “resident”, and “person living with dementia”, have now been incorporated into the Canadian Press style guide and shared with journalists and media outlets across the country, encouraging them to use respectful and life-affirming language when reporting on LTC.
To learn more about Walk with Me, visit the-ria.ca/walkwithme. To learn more about person-centred language, visit clri-ltc.ca/pcl.