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Success Story: Eden Villa, a
Retirement Home in the Erie St. Clair LHIN
Behavioural Supports Ontario focused its attention on the retirement home sector as part of the education plan for the 2013-14 fiscal year. Gentle Persuasive Approaches in Dementia Care (GPA) was offered to this sector to increase their knowledge about progressive dementias and responsive behaviours. Director of Care, Jessica Ceccacci, speaks below about her staff and the benefit of this training: At Eden Villa Retirement and Assistive Living, our vision is that “together we will create an environment where mind, body and soul will be enriched.” Behavioural Supports Ontario has helped our multidisciplinary team with our vision by providing our home with Gentle Persuasive Approaches to Dementia Care (GPA) educational training. Employees who have participated in GPA training have established more positive attitudes towards residents who present with responsive behaviours. The staff now reflect and embrace the concept of person-centered care. Staff also expressed that they are more knowledgeable in their abilities to identify triggers, as well as to assess, document and monitor residents with responsive behaviours. Staff are demonstrating more competency in providing individual resident-focused interventions.
Communication among the health care team (multidisciplinary and interdisciplinary team) has enhanced, ensuring that residents are provided with optimal resident-centered care. Eden Villa Retirement and Assistive Living has GPA, U-FIRST! and P.I.E.C.E.S. trained employees, as we find dementia education extremely valuable and essential to meeting an individual’s needs. More specifically, dementia education allows our employees to maintain the individual’s dignity and independence. The GPA quote “all behaviour has meaning” has really shown us that finding the root cause of a situation will often minimize or eliminate responsive behaviours. Staff have been given tools and knowledge through training, and therefore, the trend of normalizing behaviors no longer exists. Staff at Eden Villa are focusing on resident specific needs, which in turn increases our residents’ quality of life.
Staff from Eden Villa: Deborah Wolfe, Dietary Aide; Tiffany Gange, RPN; Anthony Ceccacci, Food Service
Manager; and Carly VanHorne, PSW.
“I am a unique individual and I am worthy of respect, dignity and
quality care.”
Spring 2014 Newsletter
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Marshall Gowland Manor (MGM) is a 126-bed long term care home located in Sarnia Lambton. MGM employees collaborated with external resources to formulate a plan to implement the Behaviour Supports Ontario Initiative into the home. As part of the plan, a Responsive Behaviour Roadmap was developed by Carol Frankland, RN internal BSO lead; Marie Farquharson, RN Nurse Educator for the County of Lambton; and Susan Boyce, RN Psycho-geriatric Resource Consultant (PRC) from the Geriatric Mental Health Team (GMHOT). This Road Map is helping to guide the health care team at Marshall Gowland Manor through the BSO process in the event of a client experiencing a responsive behaviour. The goal is to guide staff, promote team work and, ultimately, improve the quality of life of the residents. The internal BSO team worked to create and implement an easy to follow algorithm for the care team’s use. The Roadmap incorporates the P.I.E.C.E.S. framework, team huddles, responsive behaviour checklists, assessments and a referral process to both internal and external teams. The aim of the Roadmap is to enhance behavioural documentation, facilitate the collection of accurate data and for intervention to occur early when responsive behaviours present by ruling out common triggers, including pain, constipation, dehydration, etc. This data is to be utilized in the quality improvement process in order to continue to enhance the lives of the residents. PDSA cycles will be implemented to monitor efficacy of the process
and continue quality improvement.
Susan Boyce, RN PRC from GMHOT; Carol Frankland,
RN internal BSO lead; and Marie Farquharson RN Nurse Educator for the County of Lambton
Seven BSO Principles
There are seven values-based principles that
guide the development of health care services for people with responsive
behaviours: 1. Behaviour is Communication 2. Respect 3. Diversity 4. Collaborative Care 5. Safety 6. System Coordination and Integration 7. Accountability & Sustainability
Success Story: Marshall Gowland Manor Working Group – BSO Roadmap
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Many of us were taught reality orientation as a tool to be used to respond to an individual who is exhibiting memory loss. Reality orientation was used to bring the person back to current time and place. Recently, research and studies have shown that validation therapy is more effective when caring for someone with a progressive dementia. This is due to the fact that those with a progressive dementia live in a subjective reality. Reality orientation can be re-examined and used with those individuals who are experiencing early signs of memory loss and who are able to remember some pieces of information. Below we examine the characteristics of each of these tools. As a caregiver, it is important to know the resident, client or patient well in order to know which tool to use. If you do not know the person well, be cautious and use validation.
References: Gentle Persuasive Approaches in Dementia Care (GPA) Feil, Naomi: The Validation Breakthrough
Validation Therapy vs. Reality Orientation
Validation Therapy Reality Orientation
This tool is to be used with someone who has a progressive dementia and who is no longer aware that he or she is ill.
This tool is to be used with someone who is aware that he or she has memory loss and is experiencing lapses in memory.
We need to consider the person’s reality. Where in time does he or she appear to be living?
We need to consider that the person may still be orientated to the time and present reality. However, he or she may have pockets of time that are missing.
Due to change in the brain, the person’s ability to process information and thus conversations and reactions will be emotion-focused. We must validate feelings and support the person’s reality. He or she is living in the present with access to past memories.
The person is able to remember events, however, may have difficulty with all of the details of the event. He or she may ask their caregiver questions in order to fill in the blanks.
We need to meet this person in his or her reality. We need to assist with the pocket of lost memories.
The person is unable to leave this reality, and therefore, it is important not to argue or question the person.
It is important to work with the memories that remain and gently fill in the gaps.
It is important to attempt to determine the meaning of what the person is trying to tell you. Often, they may be frightened, hungry or in pain.
It is important that the person is able to express him or herself and be guided in the search for memories.
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CONTACT INFORMATION
Christina Stergiou ESC LHIN BSO Regional Coordinator [email protected]
Lina DeMattia
ESC LHIN BSO Education Coordinator [email protected]
To read a copies of the ESC LHIN BSO
Action Plan and the Sustainability Plan, please visit: www.eriestclairlhin.on.ca
In our next issue…
Delirium
BSO and Psychiatry
Success Stories
See exactly how BSO is working to assist those affected by responsive behaviours.
In the 2013-14 fiscal year, BSO provided educational opportunities not only to the long term care sector but also to retirement homes, hospitals and community partners. The education provided included: GPA, P.I.E.C.E.S. and U-First! BSO also partnered with the community sector to look at issues surrounding acquired brain injury and mental health disorders, including hoarding. The table (right) provides a breakdown of our education metrics, highlighting designation of staff and sector.
Pillar 3: Knowledge Exchange & Capacity Building –
2013-14 Accomplishments
Number Percent
Total # of Sessions 55 n/a
Total # of Participants 771 n/a
Designation
RN/RPN 313 41
PSW/HCA 192 25
Social Workers 25 3
Other Community Partners 241 31
Employment Location/Sector
Retirement Homes 151 19
Long Term Care Homes 320 42
Hospitals 109 14
Other (Community Sector) 191 25
