Author: Lyra Taylor

Stopping the Silence — Rick Gourlie’s Mission to Create an Inclusive Environment for LGBTQI2S+ in Long-Term Care

By Brian McCullough

It was during a New York City cab ride a number of years ago that health care consultant Rick Gourlie says he came up with the inspiration for his award-winning “Mad Poster” project — a series of provocative wall posters aimed at challenging staff attitudes toward LGBTQ diversity in the long-term care (LTC) environment.

The long-time former LTC administrator — and one-time fine arts graduate — says the hateful anti-gay graffiti he saw in the Big Apple that day was shocking. With decades of health sector management experience under his belt, he understood that the graffiti was just a more graphic expression of the widespread, and mainly unspoken, homophobic sentiment he knew remained in our society, despite many advances in the last several decades.

“I believe that intolerance is an internalized process that has been learned,” Gourlie says from his Kemptville, Ontario home south of Ottawa. “A person is taught to be comfortable with it, so it becomes easy, like throwing on a favourite sweatshirt. It’s not until someone points out that what you are wearing is offensive and harmful to other people that you start to realize that maybe you should be wearing something more appropriate.”

When Gourlie became administrator for one of the City of Ottawa’s four LTC homes in 2011, he was aware that the Ottawa Senior Pride Network had approached the mayor with a serious concern: Older members of the LGBTQ community were afraid of moving into long-term care because they felt they would have to remain silent about their sexual orientation — would have to re-closet themselves — because they feared potential abuse by staff and other residents.

Remembering how powerful the street graffiti’s coarse messaging had been several years earlier, Gourlie designed some “wall art” of his own to kick-start an equally powerful conversation about respect and inclusion at work. The posters he created were meant to be seen only by staff, and depicted anonymous personal support workers (PSWs) and residents in various ambiguous workplace scenarios. For each one, Gourlie pitched a situation involving an LGBTQ+ older adult and asked the question – “what would you do?” He asked his team members to write any feedback directly onto the posters.

For example, one poster showed two male residents holding hands, and asks team members what they would do in this situation. His posters also featured situations with trans individuals. The responses were pretty predictable, but Gourlie says that with people’s thoughts now out in the open, he could use them as teaching points during staff meetings. It was all about normalizing an LGBTQ conversation at work, and helping staff understand that creating a joyful, inclusive environment was not only beneficial to everyone, but easily within their grasp.

“I couldn’t jump out of the cab that day to cover the graffiti up with words of my own,” Gourlie says, “but I could certainly start a dialogue on tolerance in my workplace.”

A year into his project, Gourlie was asked to introduce his Mad Posters to the other three City of Ottawa LTC homes. His efforts earned him the 2013 Individual Equity and Diversity Award from the City of Ottawa, and attracted the attention of the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) who were looking for processes to promote inclusiveness in LTC. Rick partnered with the Ontario CLRI to deliver a presentation at AdvantAge Ontario’s annual convention entitled ‘A Home For All: Making LTC Homes Welcoming for the LGBTQI2S+ Community’ as well as a webinar on the same topic.

“It’s about stopping the silence,” he says. “It’s one thing to say, yes, we want an inclusive environment, but what does that look like? If we are going to make any kind of a difference in how we treat people, we have to have conversations about actions that can be taken, and about the processes that can be put in place. Long-term care should not be a place where we people are afraid to go because of their sexuality. We need to change our attitudes and our approach.”

New skin & wound care eLearning course available

Orientation eLearning: Wound and Skin Care in LTC

Orientation eLearning: Wound and Skin Care in LTC

 

 

 

 

 

 

 

 

 

 

The Orientation eLearning courses, created by the Ontario CLRI at the RIA, provide education for new team members during orientation, and for existing team members during their annual training. These scenario-based learning courses ensure that learners have the knowledge and skills needed to assist the people they support and are in line with Ministry of Long-Term Care guidelines. They were developed using evidence-based best practices and adult education principles, in collaboration with subject matter experts and LTC leaders.

Skin and Wound Care in Long-Term Care is a self-paced Orientation course on skin and wound care that will equip or refresh long-term care team members on the knowledge and skills required to support residents. Taking care of a resident’s skin and preventing a breakdown of skin is an important part of care. It’s important for team members to understand skin integrity and wound care as skin breakdown can lead to infection and a decrease in resident’s quality of life. Our new course can equip clinical and non-clinical team members with the skills to prevent skin and wound care issues and to implement skin and wound care interventions connected to their role.

Click here to access the eLearning course for clinical team members

Click here to access the eLearning course for non-clinical team members

 


This eLearning course, part of the Orientation course series, was developed by the Ontario CLRI at RIA in 2022 with the generous support of Schlegel Villages. We would like to thank the people who contributed to the development and review of content for this course including:

Jennifer Bilbie RN, BScN, MCISc, CIC, Long-Term Care Nurse Consultant, Extendicare

Kim Arquette, Clinical Specialist, Schlegel Villages

Ontario Renews CEoL Education Fund for Palliative and End-of-Life Training in LTC

All-In Palliative Care Graphic

Ontario LTC homes can once again access All-In Palliative Care: The Team Approach to LTC (All-In) training to enhance their team members’ skills in both palliative care and end-of-life care! This free training is made possible by the CEoL Education Fund that provides tuition and backfill funding for participation of interprofessional team members.

All-In is an evidence-informed training program that will boost interprofessional care delivery and improve team-wide communication through interactive scenario-based learning on the psychosocial aspects of palliative care. All-In is aligned to the new Fixing Long Term Care Act, 2021 that requires a palliative approach to care for all LTC residents.

“We see everyday that team members want to better the care and quality of life of residents. The All-In Palliative Care training program offers much needed space for reflection and tools for a culturally sensitive, team-based palliative approach to care. Many have taken this training to understand themselves and to deepen their knowledge. They are also engaged because they can promote change for residents, care partners and change within their own LTC team.” says Zsófia Orosz, Director, Ontario CLRI at Bruyère.

By participating, your team will:

  • Clarify the difference between palliative care and end-of-life care;
  • Learn how to strengthen the integration of an interprofessional approach to palliative care;
  • Develop improved communication skills to interact within the interdisciplinary team, with residents and their families; and
  • Contribute to a grief-friendly workplace.

This training will be delivered in an 8-hour virtual course by expert facilitators. One hour of prerequisite eLearning is included in All-In. Interested homes should apply by December 19, 2022. Training takes place in February and March 2023.

Feel free to contact us at ceolfund@bruyere.org or 613-562-6262, Ext. 1985 if you have any questions.

APPLY TODAY! 

 

What do nursing students think about long-term care?

What do nursing students think about long-term care? What do LTC homes do to welcome students and offer them a well-rounded placement experience that ensures that they meet their learning objectives and fall in love with the sector?

These are some of the questions that the Ontario CLRI at Bruyère team has been exploring for many years through different avenues.

The most recent stepping stone along the path of exploration came in the form of a rapid review of the literature, entitled: Evidence to support better clinical placements for nurses in long-term care: A rapid overview of reviews. Commissioned by a research team at St. Lawrence College led by Valerie Fiset, Ph.D., Associate Dean, School of Nursing, the authors of the rapid review described literature focused on nursing clinical placements in LTC settings. Authors of the review also drilled into a very specific area of the literature by combining critical keywords: nursing students (BScN or Practical Nursing) + LTC settings + any educational intervention, such as teaching strategies/activities or other work-study experience, that aimed to improve students’ experience and enhance their interest to work in geriatric care.

The review identified promising strategies for supporting students during their clinical placements. These strategies are related to orientation, effective supervision, and an increased curriculum focus on geriatric care. A close and dynamic partnership between nursing institutions and LTC organizations was highlighted as critical. These findings will support the research team as they develop surveys and conduct interviews with nursing students and the findings will also inform work at the Ontario CLRI at Bruyère.

The Ontario CLRI at Bruyère has been collaborating with St. Lawrence College since 2021 on the Nurturing Nursing Students in Long-Term Care (LTC) project. This mixed-methods study aims to develop an understanding of nursing student clinical placements in LTC homes in Eastern Ontario. The Rapid Review is one element of the project, and other elements of the environmental scan include consulting with clinical instructors and interviewing St. Lawrence nursing students. The project is scheduled to wrap up in December 2022 and will result in the creation of a novel model of clinical placements for the LTC sector

The Rapid Review was completed by Elizabeth Ghogomu, Sierra Dowling, and Vivian Welch of the Bruyère Rapid Review team (BERG), at the Bruyère Research Institute. Please connect with us by sending an email to info@clri-ltc.com if you want to receive a full copy of the report or to learn more about the Nurturing Nursing Students project or about previous Ontario CLRI activities related to understanding and enhancing nursing students’ experiences in LTC.

New Careers in LTC Videos

The Ontario CLRI at the Schlegel-UW Research Institute for Aging has launched new career videos to supplement our LTC career profile web pages. These videos are intended for students, educators, and anyone interested in pursuing a career in LTC, where you can build lasting and meaningful relationships with residents and have a fulfilling career.

Why work in LTC?
  • It is a chance to create meaningful relationships
  • You are making a difference in someone’s life every day
  • Jobs are high in demand
  • There are opportunities for further learning and development for upward mobility or moving into other roles
  • A chance to work with people from diverse backgrounds and life experiences

We know there is a need for more resources to profile career options in long-term care to the younger generations. These videos will help educate students and job seekers about various careers within LTC.

What careers are featured?

These new career videos cover careers in LTC in areas beyond those traditionally associated with the sector:

  • Social work
  • Housekeeping
  • Physiotherapy
  • Food services

You can view the new videos on YouTube or on the LTC career profile pages for each corresponding career option.
We will be adding a music therapy career profile shortly, and you can watch the music therapy video here!
Our career videos have received thousands of views and we hope will continue to spotlight opportunities in LTC to the future workforce!

Have you thanked your Social Worker today?

 

Did you know that March is National Social Work Month? This week is also Social Work Week (March 7-13). Let’s take this chance to highlight the significant role that social workers play in long-term care (LTC) homes and honour the contributions they make in supporting residents and their families and friends.

What is the social work role in long-term care? Social workers practice collaboratively within the interdisciplinary team in LTC. The primary mandate of social workers in LTC is to advocate on behalf of residents and their families. Social Work practice emphasizes building on a person’s strengths to support the maximal quality of life.

Social workers in LTC:

  • have expertise in the psychosocial aspects of care
  • provide support to residents and their families through the transition of moving into the LTC home, complete social histories and psychosocial assessments
  • assist with mediation and conflict resolution as issues arise
  • participate in care planning
  • locate and arrange for resources
  • share the responsibility for the education of residents, families and colleagues. [1]

In honour of Social Work Week and Month, we took the opportunity to explore with members of the SW and SSW in LTC Community of Practice their own reflections on their practice and role in LTC. It’s apparent that social workers (SW) and social service workers (SSW) are an integral part of the team in LTC.

“SW skills are not as visible as what other team members show in day-to-day like prescribing medication, transferring residents. This makes it hard for others to appreciate our skills,” says Gladys, a Social Worker at an Ontario LTC Home. “I wish others can learn to appreciate our skills and see the important role that we play in a multidisciplinary team, no less than any other disciplines.”

When asked what she loves about her role in LTC, Maja, an SSW at an Ontario LTC Home responded, “I love being an SSW for having the opportunity to meet and engage with so many different people on a daily basis.  It’s a privilege to get to know the residents’ stories and build amazing relationships.”

Gladys describes the value of her role within LTC as, “…helping the team to see the residents as persons instead of medical cases and scheduled care tasks.” While Bonnie, an SW at an Ontario LTC home describes, “The value of having a social worker in LTC is difficult to measure. We take care of an individual’s mental and spiritual well-being both in this pandemic and prior to it.”

In collaboration with Family Councils Ontario, the Ontario CLRI at Bruyére has been supporting the SW and SSW in LTC Community of Practice with virtual meetings since May 2020. These monthly sessions provide members with an opportunity to connect with their peers, share resources and discuss challenges that they are experiencing. Topics of discussion have ranged from ways to help residents experiencing loneliness and social isolation, supporting essential care partners, self-care in the context of the COVID-19 pandemic, to ethical dilemmas in LTC. If you are working in an Ontario LTC home as an SW or SSW we invite you to join – Registration Form.

If you know an SW or SSW who works LTC, please take some time this month to thank them for their important work and visit this link from the Ontario Association of Social Workers for ideas on how to celebrate Social Work Week and Social Work Month.

Learn more about the role of Social Workers in LTC on our Careers in LTC web pages and videos!


[1] Canadian Association of Social Workers, Social Work in Long-Term Care, Accessed online: https://www.casw-acts.ca/en/social-work-long-term-care

Call for participants for studies in spirituality and design in LTC homes

The Ontario CLRI at Bruyère team has explored different tools to understand what residents perceive a good quality of life to be and how to enhance it even further. This year we continue to advance our understanding through collaborating with university researchers.

Two of these research projects are now recruiting participants:

Spirituality and service design: Supporting spiritual care in Ontario long-term care homes

Spirituality is a key element for many people’s quality of life. It plays a key role in meaning-making, adapting to change, and holds particular importance with aging.

This Carlton University study explores how spiritual care is supported across long-term care homes in Ontario.

Long-term care home administrators are invited to share their knowledge and perspectives as valuable contributors and partners in the development of this research.

Take the 10-15 minute survey: https://carletonu.az1.qualtrics.com/jfe/form/SV_81FpJ7BTnpvPo58

Questions, comments? Please email sophienakashima@cmail.carleton.ca for more information. This project was reviewed and cleared by the Carleton University Research Ethics Board-B (Clearance #116644). If you have any ethical concerns with the study, please contact the Carleton University Research Ethics Board at ethics@carleton.ca. During COVID, the Research Ethics Staff are working from home without access to their Carleton phone extensions. Accordingly, until staff return to campus, please contact them by email.

Development and psychometric testing of the 5 Senses screening tool for LTC

A student at the University of Ottawa is looking for feedback on a new tool from residents, families/care partners and LTC team members. Participants are asked to test a new screening tool that examines how the design of their LTC home takes into consideration residents’ senses (hearing, vision, taste, touch, and smell). This is particularly relevant because we know that our senses deteriorate with age. Participants are asked a series of questions to find out how sensitive a home’s environment and processes are to its residents’ senses: how it smells, what the food looks and tastes like, whether residents can easily access outdoors, etc.

Staff: www.surveymonkey.ca/r/staffltc

Resident or care partner: www.surveymonkey.ca/r/caregiverltc

This study has received approval from the University of Ottawa Research Ethics Board.

Recipe Contest Generates Nutritious Options for LTC Menus

The Ontario CLRI at the RIA hosted a recipe contest as part of the Nutrition in Disguise (NiD) project in the fall of 2021.

Students from Conestoga College, George Brown College, and Humber College developed  nutrient-dense snack or breakfast items for LTC residents that were healthy and delicious!

Mealtimes bring residents much joy. It is important that these meals contain sufficient protein, vitamins, minerals and fibre to support overall health and sustain independence in older adults. Most LTC residents are not consuming enough key nutrients to stay healthy and independent. A recent study by Professor Heather Keller, Research Chair in Nutrition and Aging at RIA showed that enhancing recipes through small changes to ingredients can meet the need for more nutrient-dense food in LTC.

The recipes generated through the contest will help us build a library of recipes that long-term care homes can work into their menus without breaking their budget.

Students were asked to develop a recipe for a snack or breakfast item with increased protein. In addition, they could also choose to increase the fibre content and calcium and reduce salt, for bonus points. Finalists were selected based on whether the recipes met the criteria provided.

Judging event

A judging event took place at the Research Institute for Aging in Waterloo in December 2021. Nine final recipes were cooked by Schlegel Villages, Ruby chef, Kasey Wesley. The recipes were tasted and scored by a panel of judges:

  • Dr. Heather Keller, RIA Research Chair
  • George Madelena, Culinary Specialist, Schlegel Villages
  • Becky Golbeck, Director of Food Services, Schlegel Villages
  • Liz Barre, Assistant Director of Food Services, Schlegel Villages
  • Charlotte Graham, Resident, University Gates
  • Phil Fiess, Resident, University Gates

All COVID protocols and precautions were taken for the judging event, including ensuring participants were vaccinated, had taken a rapid test, were distanced, and masked when not eating.

Contestants competed to win one of three cash prizes: 1st prize: $500, 2nd prize: $300, 3rd prize: $200. Our sponsors, Sysco and Gordon Foods generously provided the second and third prizes.

The winners 

1st prize: Erin Ross, for her Orange Creamsicle Jelly

Orange Creamsicle Jelly

2nd prize: Megan Panagiotopoulos, for her Gooey Baked Oats 

Gooey Baked Oats

3rd prize: Anne Kasper, for her Baked Berry Oatmeal 

Photo Gallery

Judging event with contest judges sitting at individual tables

Chef Kasey Wesley with some of the contest dishes

George Madalena, Culinary Specialist, was one of the judges, tasting a dish

Charlotte Graham, a long-term care home resident, tasting a dish

Professor Heather Keller, RIA Researcher, judging a dish

Hearty Creamy Oats dish

Shilpi Majumder, Host of judging event, tasting a dish

Becky Golbeck, Food Services Manager, judging a dish

Phil Fiess, resident judge, chatting with event organizer, Holly Hebner

Charlotte Graham, resident judge, judging a dish

Chef Kasey Wesley, getting ready to serve Sweet potato & cheese fluffy tofu cup cake to judges

Sponsors:

Sysco logo

PSW Learning Preferences Survey Results

In early 2020, the Ontario CLRI launched a sector-wide survey to begin to understand PSWs’ learning preferences and identify potential solutions and supports to mitigate some of the educational challenges PSWs presently face.

Thanks to the 200 respondents, the Ontario CLRI identified several opportunities to align with the educational preferences of PSWs in long-term care (LTC).

Please note that the survey was launched during the early days of the COVID-19 pandemic. As a result, the number of responses received was likely reduced and may have impacted learning preferences. Future assessments can be completed to capture any change in learning preferences.

It is our hope that the findings of this report will provide valuable insights around actionable steps the Ontario CLRI and other educators in LTC can take to create learning opportunities that align with PSWs’ preferences.


THE TOPICS PSWs WANT TO LEARN ABOUT

EDUCATION FORMAT AND DELIVERY PREFERRED BY PSWs

WHO DO PSWs WANT TO LEARN FROM?

WHERE DO PSWs WANT TO LEARN?

PSWs PREFERRED LEARNING FORMATS

PREFERRED LENGTH OF TRAINING EVENTS


WHO WERE THE SURVEY PARTICIPANTS?
  • Female (91%)
  • Between 35-54 years old (54%)
  • Speak English as their first language (88%)
  • Caucasian (80%)
  • 10+ years as PSW (53%)
  • Currently work in long-term care (88%)

THE TOPICS PSWs WANT TO LEARN ABOUT

PSWs respondents told us the topics they would like to learn more about, including learning preferences for team members and leaders. The top five training topics included resident, personal and staff mental health and well-being, responsive behaviors, personal expression, end-of-life care, palliative care, Alzheimer’s, and dementia.

  • 87% – Resident mental health and well-being
  • 84% – Resident responsive behaviors, personal expressions
  • 82% – End-of-life and palliative care
  • 81% – Team member mental health and well-being
  • 79% – Alzheimer’s and other dementias

EDUCATION FORMAT AND DELIVERY PREFERRED BY PSWs

PSW respondents reported on why and how they would prefer to learn.

WHY DO PSWs WANT TO LEARN?

Why do PSWs want to learn? 24% want to be better at their job. 24% want to gain credible skills. 19% like learning. 17% want to advance their career. 16% want to make their job easier.

Figure 1. A pie chart demonstrating why PSW respondents want to learn. The top three reasons included to be better at their job, to gain credible skills and because they enjoy learning.

WHO DO PSWs WANT TO LEARN FROM?  

  • 86% – Professional educator/teacher
  • 74% – Experienced PSWs
  • 60% – Nurses or other clinicians
  • 39% – Clients/residents, families
  • 39% – Managers/supervisors
  • 30% – Researchers

WHERE DO PSWs WANT TO LEARN?

  • 47% – Where they work
  • 30% – Somewhere local
  • 22% – Where they live
  • 9% – Somewhere that requires travel

PSWs PREFERRED LEARNING FORMATS

PSWs preferred learning format. 82% prefer demonstration. 62% prefer coaching. 51% prefer discussion. 50% prefer listening. 59% prefer simulation. 52% prefer practice. 51% prefer reading. 50% prefer diagrams.

Figure 2. A pie chart demonstrating what formats PSW respondents want to learn from. The top three responses included demonstrations, coaching and discussion.

A bar chart demonstrating PSW respondents’ preferred modalities of training. The top three modalities included hands-on, videos and presentations.

Figure 3. A bar chart demonstrating PSW respondents’ preferred modalities of training. The top three modalities included hands-on, videos and presentations.

PREFERRED LENGTH OF TRAINING EVENTS

A pie chart demonstrating PSWs respondent’s preferred length of training events. Both longer (3-4 hours) and shorter (30 minute) events were preferred.

Figure 4. A pie chart demonstrating PSWs respondents’ preferred length of training events. Both longer (3-4 hours) and shorter (30 minutes) events were preferred.


Based on these findings, PSWs were most interested in learning about residents and personal mental health and wellbeing. Most would prefer this training to take place at their site of work, via demonstrations, hands-on, video and presentation formats and be taught by a professional educator and/or instructor. Half-day (3-4 hour) training sessions were preferred by PSWs followed by shorter (30 minutes – 1 hour) sessions. Likely a mix of both longer and shorter training sessions would be ideal.

 

Release of French IPAC and Nursing Leadership eLearning Courses

The Ontario CLRI is proud to announce the release of our French IPAC and Clinical Nursing Leadership eLearning courses. These courses were developed with experts from the IPAC and nursing community in Canada. Courses can be used to train Registered Nurses (RNs), Registered Practical Nurses (RPNs), PSWs, LTC team members, volunteers and families or essential care partners.

IPAC courses now in French

  • Break the Chain of Transmission: IPAC Core Concepts and Practices – This eLearning Course reviews the IPAC core concepts and practices that are essential for preventing and controlling infection. It is the prerequisite for the scenario-based courses in the IPAC series. The course is for LTC team members and essential caregivers.
  • IPAC While Travelling to and From an LTC Home – This eLearning course will apply the skills and knowledge from Break the Chain of Transmission to typical situations that can happen while travelling to and from an LTC home. The course is for LTC team members and essential caregivers.
  • IPAC While Supporting Residents at Mealtime  – This eLearning course will apply the skills and knowledge from Break the Chain of Transmission to scenarios about supporting a resident at mealtime in an LTC home. The course is for LTC team members and essential caregivers.

Clinical Nursing Leadership  courses now in French

  • Module 1: Communicating Effectively  – This module allows nurses to use effective communication techniques in a variety of contexts and with a variety of people(e.g., colleagues, residents, families, different departments, etc.). Nurses will learn the difference between effective and ineffective communication approaches, be able to describe techniques for giving feedback and recognize the possible consequences of effective and ineffective communication techniques. Anticipated outcomes include improved communication skills to increase team morale and provide the best quality of life for residents.
  • Module 2: Handling Conflict with Care  – This module allows nurses to use effective strategies for managing conflict in a variety of contexts and with a variety of people (e.g. colleagues, residents, families, different departments, etc.). Nurses will learn how to describe several effective strategies for managing conflict and recognize several ineffective strategies for managing conflict and recognize the possible consequences of both approaches. Anticipated outcomes include improved ability to manage conflict and the ability to model how to handle conflict with care.
  • Module 3: Being a Leader – This module will help nurses recognize how they can demonstrate leadership in their day-to-day work. Nurses will learn how to describe characteristics of transformational leaders, recognize myths and misconceptions about leadership, and recognize the differences and similarities between a manager and a leader. Anticipated outcomes include improved understanding of how to develop leadership skills and how to show clinical leadership on the job.

For more information, or to access these French eLearning courses, visit: https://learn.clri-ltc.ca/?lang=fr.