Category: Bruyère

Elevating Palliative Care in Ontario Long-Term Care Homes: The Transformative Power of the All-In Training Program

Posted on September 21, 2023 by - Bruyère

The importance of evidence-informed, culturally appropriate palliative care in long-term care (LTC) homes cannot be overstated. Through the All-In Palliative Care Training Program, the Ontario Centres for Learning, Research and Innovation in Long-Term Care (Ontario CLRI) team at Bruyere is pioneering a new approach to training interprofessional team members in recognizing palliative care myths, accommodating the needs of those in mourning, and practicing end-of-life communication skills.

 

A Compassionate Approach

What sets this program apart is that it offers much needed space to team members for reflection and provides tools for a culturally sensitive, team-based palliative approach to care. Confronting experiences of grief, dying, death, and bereavement head on, learners deepen their practical knowledge and report increased understanding of themselves. They are better able to care for residents, their loves ones, and their own team members.

The information and examples were relatable in terms of what is experienced on a daily basis on the frontline in LTC. I liked how the examples drew from 2SLBTQIA+ community, Indigenous community, and the overall content felt inclusive and highly informative. The discussions probed more questions and have created some very valuable discussion among the team members here.

 

Aligning with Legislation for Better Care

The All-In Palliative Care training program is not just a thoughtful initiative. It is a necessary one. This FREE one-day, virtual education is aligned to the new Fixing Long Term Care Act, 2021 that requires a palliative approach to care be available for all LTC residents.

 

Enroll Today

Committed to enhancing the quality of life and care for residents living in Ontario’s LTC homes  by building capacity through training, education, innovation, and knowledge mobilization, the Ontario CLRI has trained over 1500 interprofessional team members from 165 LTC homes through this program since 2021. Accredited by the Canadian Nurses Association, this program doesn’t just impart technical skills. It serves as a catalyst for self-discovery and change.

If you are interested in elevating the level of palliative care in your LTC home, enroll today! Enrollment for the All-In Palliative Care training is open. Interested homes should apply by October 6, 2023. Training takes place in October, November, and December 2023.

For more detailed information, email ceolfund@bruyere.org.

Apply today!

A Year and Legacy of the “Leading & Learning with Pride” Tool Kit

Posted on June 20, 2023 by - Bruyère

2SLGBTQI+ inclusion has become a hot topic among LTC homes, care providers and seniors. Last spring, we shared that the City of Toronto refreshed an older version and launched the Leading & Learning with Pride Tool Kit. We wanted to catch up with Joseph Friedman Burley, staff lead and one of the co-creators of the Tool Kit to learn more about what’s happened since launch.

SSLTC has achieved great success over the first year of implementing the Tool Kit. Joseph, a Management Consultant, Seniors Services and Long-Term Care (SSLTC), described that he and other SSLTC team members had the “experience of a lifetime creating this Tool Kit,” connecting and working with older members of the 2SLGBTQI+ community. The Tool Kit has been rolled out in the ten City of Toronto directly-operated LTC homes. Over 40 presentations on the Tool Kit have been delivered, reaching 1000+ providers in LTC homes and seniors services across the province. SSLTC also worked with The 519 and the Senior Pride Network, two local 2SLGBTQI+ organizations to develop, deliver, and evaluate interactive workshops on the Tool Kit for staff. These workshops engaged SSLTC staff in thoughtful dialogue and exercises to enhance their capacity to provide more inclusive care to Rainbow Seniors in LTC.

Each of the City of Toronto’s ten long-term care homes has appointed a Pride Lead on staff to champion 2SLGBTQI+ inclusion. Many of these Pride Leads have helped create initiatives to advance  2SLGBTQI+ inclusion, such as Pride events and a Gender and Sexuality Alliance (GSA). True Davidson Acres (TDA) is one City of Toronto LTC homes that has taken strides to implement recommendations from the Tool Kit. They have many 2SLGBTQI+ identifying residents, coordinate pride celebrations and community outings to The 519 , and TDA’s GSA connects with the GSA at the local middle school for intergenerational initiatives, including a Pen Pal program.

Many lessons were learned through the Tool Kit refresh. Burley highlighted the value of  bringing diverse people and perspectives to the table, noting that “No one knows everything, but together we know a lot”. The Tool Kit helped unite LTC providers, residents and community stakeholders to share knowledge on this critical topic. Burley explained how this experience taught him how to work with Rainbow Seniors to effect change and transform care and services. Since every individual in the 2SLGBTQI+ community is different and has unique needs, providers must listen to and support them based on their needs. It is vital to listen to multiple perspectives from the community as each individual has their own intersectional identity and lived experience in healthcare and LTC.

Building Stronger Nursing Student Placements in Ontario’s Long-Term Care Homes

Posted on May 25, 2023 by - Bruyère

Ontario’s long-term care homes are critical for the success of our healthcare system, and nurses play an essential role in homes’ operation and system integration. The Government of Ontario has invested significantly in ensuring that well trained, motivated nursing students are graduating from Ontario’s 40+ nursing programs each year.

Students across the province in the Bachelor of Science of Nursing and in the Practical Nursing Programs spend a significant amount of time training in real life care environments through clinical student placements. Ontario’s long-term care homes offer placement opportunities at different stages of nursing education and represent important training grounds for students.

Understanding the importance of nursing in addressing the challenges presented by an aging population, the Nurturing Nursing Students in Long-Term Care¹ research project is examining the factors that support nursing students in choosing gerontology as their specialization after graduation. The goal is to build a student placement model that encourages the right students to choose a clinically and personally rewarding nursing career in long-term care.

Since 2021, the Ontario Centres for Learning, Research, and Innovation (Ontario CLRI) at Bruyère has been collaborating with St. Lawrence College researchers to better understand how the College’s clinical instructors get students ready for and how nursing students experience their placements in Eastern Ontario’s long-term homes. Putting this together with learnings from a rapid review² as well as information gathered from long-term care homes through the Ontario CLRI’s Preceptor Resource and Education Program in Long-Term Care (PREP LTC) program, the research team is developing an optimal model for nursing student placements in long-term care settings.

 

“The myth is that nursing in long-term care is limited in scope and that you lose your skills. But it’s very complex care. You also get to work with residents holistically. You get to improve their quality of life.” Jessica Hogan, Nursing Student and Research Project Coordinator.

 

For over 10 years, the Ontario CLRI has been working to improve the experience and practice of nursing students in long-term care. Discover how the Ontario CLRI and its collaborative efforts are shaping optimal models for nursing student placements below:

Want to become involved in the Nurturing Nursing Student in long-term care? Join the research team when they present at the International Council of Nurses (ICN) Congress 2023 and the Synapse St. Lawrence College conference. Read an interview with Jessica after her presentation at the Kingston Nursing Research Conference.

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

Posted on February 7, 2023 by - Bruyère

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.”

Achieve your EDI goals with the 2023 Diversity and Inclusion Calendar!

Posted on January 23, 2023 by - Bruyère, Research Institute for Aging

The Ontario CLRI at Bruyere and the Ontario CLRI at RIA is excited to share the 2023 print Diversity and Inclusion Calendar. Our print calendars are available in English, and for the first time ever, in French!

The calendar features religious and spiritual days of significance, cultural celebrations, awareness days and health promotion days. Learning about the many cultures, religions and days of significance is fundamental to inclusion, and this calendar can help you achieve your EDI goals in your home.

Take some time to explore the dates within the calendar! Staying aware of these days and scheduling activities around them will help you create an inclusive home, 365 days a year. You can also follow the links to learn more about each date in our digital version.

This calendar has been developed as a resource for LTC teams to demonstrate commitment to honouring and celebrating diverse communities, cultures and faiths of those who live, visit and work in LTC homes.

We have been hearing from a number of organizations, including LTC homes and hospitals that are using the calendar regularly to support their planning, their learning, and it is helping to guide their communications both internally and externally about days of significance.

“At the City of Toronto, Seniors Services and Long-Term Care utilize the CLRI Diversity Calendar alongside the Days of Significance Calendar for the Toronto Public Service to advance Equity, Diversity and Inclusion when communicating to stakeholders, in divisional communication and when planning resident and client focused events and celebrations. We have very diverse LTC residents, community-based programs clients and staff members, and these tools are helping us support divisional initiatives such as the Confronting Anti-Black Racism in the Workplace Action Plan, Indigenous Cultural Competency and Advancing the Truth & Reconciliation Action Plan, and Leading & Learning with Pride: A Tool Kit, Video, and Campaign to enhance support for 2SLGBTQI+ Seniors.”

Jennifer Dockery, General Manager, City of Toronto, Seniors Services and Long-Term Care

Click here for the printable English calendars.

Click here for the printable French calendars.

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

Posted on November 17, 2022 by - Bruyère, News

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?

Posted on June 15, 2022 by - Bruyère, Unclassified

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.

Welcome to Our Summer CO-OP Students

Posted on May 30, 2022 by - Bruyère, Central CLRI

This summer, the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) at Bruyère welcomes seven University of Ottawa co-op students that will be joining our team virtually or in-person.

The students come from a wide range of fields, including biochemistry, communication, political science, and more. Their academic backgrounds and diverse strengths will support their contributions to Ontario CLRI portfolios such as sustaining palliative care, equity, diversity and inclusion in long-term care (LTC), clinical nursing leadership, recreational therapy, and central communications.

As part of our commitment to educating the current and future LTC workforce, the Ontario CLRI is proud to provide developmental training and experiences for these students.

“Our team is excited to offer a supportive workspace of growth and learning for co-op students this summer. We are investing in an enhanced student development so that the students have an optimal experience and may increase their interest in a career supporting seniors.”
— Zsófia Orosz, MA, MHA, Director, Ontario CLRI at Bruyère

During the first two weeks of their placement, the students participated in an engaging orientation process to facilitate team-building, self-reflection, and an understanding of Ontario CLRI initiatives.

The students will be working with their respective teams at Ontario CLRI at Bruyère or the central Ontario CLRI team until they resume their studies in September.

Meet Some of our Students

Are medical students ready to lead the change in long-term care?

Posted on April 5, 2022 by - Bruyère, News

"student reflections on a LTC research project"

By Ammar Saad.

During some of the darkest months of the past two years, most Canadians heard the grim news coming from long-term care (LTC) homes, and many witnessed first-hand the heartbreaking and devastating impact of the COVID-19 pandemic on the lives and wellbeing of LTC home residents and their families. 

As students, we wanted to help, but many of us didn’t know how. LTC homes were “locked-down” and we were “locked-out”. We also lacked the training and experience needed to provide long-term care, so we decided to learn through experiment, gain experience through research, and start by shedding light on the health inequities of LTC home residents during the COVID-19 pandemic. 

We formed a research team of medical, nursing, science, epidemiology, and public health students. We designed a research study to explore how the initial lockdown impacted LTC home residents’ lives, and if the visitation strategies that followed were of any help. With the supervision of a frontline physician who had expertise in long-term care, and support from the Ontario Centre for Learning, Research, and Innovation in Long-Term Care at Bruyère, we were ready to undertake an adventure of a lifetime, one that would ultimately shape our perspectives and careers. 

Our project entailed surveying and virtually interviewing LTC home residents, their family members, and designated caregivers. We believed that one-on-one interviews would allow residents and family members to speak their minds and tell us about their experiences and stories candidly and safely. For some of us, this was not our first research study collaboration, but for all of us, it was the first time that we had the opportunity to hear real-life stories and experiences in LTC homes during the pandemic. Residents and their families had a lot to say, their words were emotionally charged, their stories laden with anger, despair, guilt, and confusion. We felt what they felt, ached as they ached, and at certain points, could not believe what we had heard.

This was a challenging time for everyone, including us, students, who were navigating a changing education system, coping with COVID-19 stress, and trying to see this research study through. While many argued that we did not have the capacity to take on an emotionally charged study such as ours, we found solace in what this adventure brought to us and what it would bring to the scientific community for years to come. Through this study, we found a purpose and cause to fight for, a channel to streamline our efforts, and an opportunity to expand on what health equity means in long-term care and COVID-19. We were and still are, confident that the stories we heard and experiences of residents and family members that we documented, coupled with our robust approach to research will shed light on an understudied issue; the health inequities experienced by LTC home residents. Our findings can serve as the first step towards making sure that LTC home residents never have to experience the same inequities they have ever again.

“So where do we go from here?” we asked ourselves as we submitted the research paper for publication earlier this year. We are now equipped with the experimental knowledge we need to shape our careers and support equitable and evidence-based care to LTC home residents, but how about other students who were not able to share this opportunity with us? Our work cannot be exclusive to our team or it will defy its purpose and objective. All and every student with the desire to learn more about the health inequities brought by the COVID-19 pandemic to LTC home residents should have the opportunity to do so. Our next step going forward will be to lead the way for other students to learn as we learned and shape their careers as we did. We now have the duty to lead the change. Through advocating for the integration of long-term care education into our undergraduate and graduate curricula, and through working with our respective university programs to create new initiatives, such as community service-learning programs, we can provide students the opportunity to care for and improve the health equity of LTC home residents. We are now ready to lead the change in long-term care. The real question remains: who is willing to help us lead this change?

Learn more about our study, and our protocol

Ammar Saad is a medical student who pursued a master’s degree in Epidemiology from the University of Ottawa. He is the lead author on the aforementioned research paper, Health Equity Implications of the COVID-19 Lockdown and Visitation Strategies in Long-Term Care Homes in Ontario: A Mixed Method Study

 

Supporting Resident Quality of Life During Isolation

Posted on March 7, 2022 by - Bruyère, News

So many LTC homes face continual challenges that come with residents being made to isolate because of COVID-19. This was the topic of a recent question brought up by our Social Worker and Social Service Worker Community of Practice, a group supported by the Ontario CLRI at Bruyère and Family Councils Ontario. Our social work (SW) and social service work (SSW) colleagues shared what they have been doing to mitigate loneliness and isolation for residents during times when they are spending the majority of the day in their rooms. Below is a compiled list of strategies and resources to support the quality of life for residents during periods of outbreak and isolation they may have to go through. We hope hearing from other homes will spark ideas and solutions for your own home and/or community.
Social Worker in LTC Virtual Community of Practice.

Three key themes emerged from the group around enhancing the quality of life of residents in isolation or in outbreak protocols:

  • Technology: There’s a variety of ways to get technology into the hands of residents in your home and it will make all the difference to virtual engagement – especially if they come with Wi-Fi access. Residents have enjoyed using YouTube or iTunes to watch movies/videos or listen to music that can help boost the morale of residents. These devices can also help support virtual visits with family and friends. Look to the community for donations of old tablets and phones with Wi-Fi capabilities.
  • Public library resources: Utilize your local library – Public libraries often have book sets (including audio books) for lending and a variety of online programs. Read books either in resident groups or via aloud over the PA system to reach residents in their rooms.
  •  1:1 Check-Ins: Taking the time to check in with residents and their families, as team members are able, is crucial to residents; well-being during outbreaks/isolation. This is a role that SWs and SSWs in LTC are fulfilling regularly.

Hallway activities

Hallway activities bring residents together at their doorways and can allow for appropriate spacing between residents, while still being able to follow COVID-19 protocols. Some examples for hallway activities SWs and SSWs shared are listed below:

  • Art: Painting or drawing is a great way to help residents express their creativity.
  • Bingo: Use printed Bingo pages; you can also use themed Bingo pages.
  • Music program: Residents can use bells, shakers, or other instruments to create songs
    and play along to music.
  • Drum Fitness: Using exercise balls and drumsticks (or cut pool noodles as an adaptation)
    is a great activity where everything can be sanitized.
  • Spiritual programs: Prayer Groups, Hymn Sing (when singing is permitted), chair yoga, and mindfulness activities such as setting intentions, reading reflections, breathing exercises, and guided meditation.
  • Collaborative story or poem: Using a whiteboard or iPad have the residents pick a theme and take turns adding sentences or lines to the story/poem.
  • True or False: Using paddles, have one side representing “True” and the other representing “False.” As you ask your questions, residents raise their paddles with their answers for everyone to see.
  • Crosswords/Trivia: Print copies of your clues/questions for residents to follow along. Giant crosswords can be mounted on boards to make them portable and easy to set up on a stand in the hallway.
  • Leisure Time: Prepare a variety of activities for residents based on what they feel like doing in that moment.

Additional Resources

  • Strategies for Building and Maintaining Social Connection for Long-Term Care Home Residents – This report (done earlier on in COVID-19) provides strategies identified from published research and illustrated with stakeholder input that can help build and maintain social connections in LTC residents. (ENCOAR Research Team)
  • Social Relationships are Important for the Mental Health of people living in long-term care homes – An Infographic (available in French and English) showing the connection between social connectedness and physical and mental health and well-being. (ENCOAR Research Team)
  • A Guide to Virtual Creative Engagement for Older Adults – this guide can help LTC address the under-stimulation and loneliness felt by residents from restrictions due to the COVID-19 pandemic. The VCE Guide features a curated list of free virtual services appropriate for residents with various health conditions and ability levels. The guide is intended for recreation therapists, social workers, nurses and other team members in LTC.  (Ontario CLRI at Baycrest)
  • Boredom Busters – Developed in the early days of the COVID-19 pandemic to reduce boredom and loneliness for residents in LTC, this tool pulls together links to free resources and activities. The tool can be utilized by family care partners (and team members) who are spending time with residents and looking for creative ways to engage. Available in English and French. (Ontario CLRI at Bruyere and iGen Ottawa)

Thank you to the members of the SW and SSW in LTC Community of Practice for bringing up this important question, for the spirit of sharing ideas and willingness to have these ideas shared more broadly.

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