Category: Bruyère

What is The Java Music Club (CFRA Radio Interview)

Smiling woman with drum sticks

What is the Java Music Club? Listen to Michelle Fleming, a knowledge broker from the Ontario Centre for Learning, Research and Innovation in Long-Term Care at Bruyère and Renate Ysseldyk, an assistant professor at Carleton University in the Department of Health Sciences.

They talk about the Java Music Club, a program aimed at reducing loneliness and isolation among seniors in care homes, including Bruyère.

The Java Music Club is one of the peer support programs being studied through a collaborative research project. Members are encouraged to meet weekly, fostering camaraderie by sharing stories from their lives, discussing engaging topics, listening to music and supporting one another.

Renate Ysseldyk research focuses on the influence of psychosocial factors on the health and well-being of vulnerable populations—particularly seniors.

Click the play button below to listen to the interview.

 

Deprescribing: Essential in Long-Term Care

Tuesday, November 6, Pam Howell, a pharmacist and research associate at Bruyère, presented to Ontario long-term care (LTC) leaders at the AdvantAge Ontario Region 7 meeting on the necessity of deprescribing in LTC homes.

Using an analogy from McMaster University’s Dr. Dee Mangin, Howell compared prescribing to music, explaining that listening to a single song is enjoyable, but if songs are layered on top of one another and the volume is slowly increased, the sound becomes chaotic and overwhelming. Drugs can have a similar effect, accumulating over time and producing unwanted side effects like confusion, balance problems, falls, and increased hospitalizations.

Deprescribing — the planned and supervised process of dose reduction or stopping a medication — is an essential component of medication management that tackles the problem of polypharmacy. Polypharmacy is a term used to describe complex medication regimens and is defined as more medications than needed, or for which harm outweighs benefit. Recent statistics show that 48 per cent of LTC residents in Canada are on 10 or more medications and that LTC seniors take a daily average of 9.9 drugs compared to the 6.7 taken by seniors living in the community.

The success and sustainability of changing people’s views on medications requires awareness and the involvement of a variety of stakeholders. Howell’s presentation got the audience talking about the roles patients, family, doctors, nurses, personal support workers, pharmacists, insurance companies, and policy makers can play in a resident’s medication plan. Incorporating deprescribing in regular medication reviews and considering care goals can foster resident-centred care. To help guide deprescribing decisions, the Bruyère Deprescribing Guidelines Research Team developed five evidence-based guidelines with associated algorithms, videos, and infographics to help caregivers determine whether it is appropriate to stop, reduce, or continue a specific medication class. These tools can also be used with residents and families to explore medication management beliefs, values, and preferences.

Howell spoke to the importance of keeping every stakeholder up-to-date on best prescribing practices to ensure consistency of care:  “If you give people the opportunity, they will step up to the plate to make sure that their residents are safe. This input is crucial to avoid common roadblocks to deprescribing in LTC.”

Attendees shared their own experiences with medication management in LTC — reflecting on how deprescribing improved and simplified their approaches to medication management. One LTC home redesigned their medication order forms to include a mandatory section for medication goal setting. Another representative stated that their nurses would be happy to spend less time administering unnecessary medications and instead spend the time with residents.

In order to keep moving forward with deprescribing work in LTC, the Ontario Centres for Learning, Research, and Innovation in Long-Term Care at Bruyère is working with the Bruyère Deprescribing Guidelines Research Team to continue to meet with various groups to explore ideas for a deprescribing plan that can be applied to homes across the province.

Deprescribing is an essential tool for better medication management. With a thoughtful and inclusive approach, deprescribing can help in optimizing care plans and staying focused on resident’s goals for their health. Tools and resources for deprescribing are available on the Bruyère Deprescribing Guidelines Research Team’s the website.

For more, read recent articles about the value of deprescribing in Home and Long-term Care Magazine and in Long-term Care Today

AdvantAge Ontario Call for Innovations for Future of Seniors’ Care Showcase

AdvantAge Ontario is celebrating their centennial anniversary Convention this spring, and in addition to celebrating the past 100 years, are looking ahead into the future.  New this year, the Future of Seniors’ Care Showcase will feature the most innovative products and technologies that will change care and services for seniors in the coming years.

AdvantAge Ontario is accepting submissions from companies, corporate and academic innovation centres, incubators, accelerators, and organizations to feature products at the showcase at their 2019 Annual General Meeting and Convention, taking place May 6-8, 2019 in Toronto.  This event is a great opportunity to highlight your innovation to an expected 500+ delegates from the senior care sector, including CEOs, administrators, directors of care and managerial and front-line staff from long-term care, housing and community services.

Submission Process

If you have a cutting edge innovation you wish to showcase, please visit the AdvantAge Ontario bulletin for details.  Submissions are due by February 15, 2019.

Innovative Program Helps Reduce Loneliness in Long-Term Care

Residents enjoying Java Music Club

The Ontario Centre for Learning, Research and Innovation in Long-Term Care (CLRI) at Bruyère developed a short documentary series to show the powerful impacts that peer support groups are having on people living in long-term care homes. Our team visited five homes across Ontario to film groups in action and interviewed residents, team members, managers, and researchers. View the video series below:

Over the last two decades, the tides in long-term care have been gradually shifting away from the traditional medical model towards a more social model of care, with the introduction of philosophies like the Eden Alternative, Green House Project, and the Butterfly Model. Despite many improvements, change is slow. Studies show that at least one out of two residents in long-term care homes experience loneliness. Loneliness has been linked to several negative health outcomes – among them depression, dementia, increased hospitalizations, impaired mental health and increased mortality. In fact, loneliness may be as damaging as smoking 15 cigarettes per day.

Although those living in long-term care are surrounded by people, they often report feeling alone. Often when someone moves into a long-term care home, it is following a crisis situation or major change in health, leading to an overwhelming sense of loss: loss of independence, loss of neighbours, loss of their home, sometimes also a loss of spouse. These losses can result in a profound sense of disconnection and social isolation. The Power of Peer Support project team has spent the past year aiming to reduce the impacts of these realities by supporting and researching meaningful peer support programs.

There is a growing body of research that documents the effectiveness of peer support in alleviating loneliness and depression. Peer support enables individuals to learn new ways of coping through identification with others in a similar position. Despite the known benefits of peer support groups for individuals with chronic illnesses, these programs have historically rarely been used in long-term care homes. The Java Group Programs developed a unique model to change this fact. Founded by Kristine Theurer, PhD, Java Group Programs are the first standardized peer support interventions designed to address the critical rates of depression and loneliness in senior living.

The Java Music Club is one of the peer support programs being studied through this collaborative research project. Members are encouraged to meet weekly, fostering camaraderie by sharing stories from their lives, discussing engaging topics, listening to music and supporting one another. The warm atmosphere offers residents the opportunity to unload burdens, learn new coping strategies, reminisce, and develop an increased sense of belonging. Java Memory Care is a vital adaptation for those living with moderate to advanced dementia. These groups are designed to be facilitated by staff, volunteers and/or family members.

“I consider myself very fortunate to have met [fellow Java Music Club members] and learn something about their life experiences,” explains Luella Lemaire, a resident at the Glebe Centre and member of the Java Music Club. “Sometimes we laugh, sometimes we cry, but most of all, we smile. We share lives.”

In 2018, a grant from the Centre for Aging + Brain Health Innovation brought the Java Music Club and Java Memory Care to 33 long-term care and 5 retirement homes across Ontario. Homes have engaged in robust training, including in-person workshops and webinars, covering a variety of topics related to effective group facilitation.

A portion of the grant also advances our understanding of the benefits of peer support for residents through rigorous research. Dr. Renate Ysseldyk from Carleton University’s Department of Health Sciences is leading the research team to understand and monitor both the social and health outcomes in selected homes. The team has been working closely with residents and staff at Élisabeth Bruyère Residence and Riverstone Retirement Communities to understand and document their experiences.

Throughout this project, the team has seen how these peer support group programs offer opportunities for residents to engage with peers in small group settings. Creating these atmospheres where residents are encouraged to open up about their emotions, and share details about themselves and their lives, facilitates powerful opportunities for deeper connections between residents, as well as with staff and volunteers who facilitate the program. Group facilitators have reported this experience to be a professionally enriching experience and volunteers have shared that it has been personally enriching for them. These groups offer a unique way of connecting residents about things that really matter to them personally, and opportunities for them to support one another.”

Loneliness is dangerous for our health, and presents a critical public health crisis, particularly amongst those within our population that are most vulnerable. The opportunity to connect with others meaningfully through peer support groups offers a promising potential antidote to loneliness.


The Power of Peer Support: Reducing Social Isolation in Residential Care project is a collaboration between the Ontario CLRI at Bruyère, Carleton University, Bruyère Continuing Care, and Java Group Programs. This project is funded by the Centre for Aging + Brain Health Innovation, Carleton University and the government of Ontario through the Ontario CLRI hosted at Bruyère. For further information about this project please click here.

Cycling Without Age

Enhancing the Lives of Seniors – The Ottawa Experience

What images come to mind when thinking about community? Strolling around, admiring the neighbors’ gardens, seeing children play, walking to work or to shops… These thoughts about a community are all related to enjoying the outdoor environment. What happens when someone is held back from enjoying this outdoor environment? The risk of isolation and loneliness grows.

As people age, their bodies often become frailer and their range of movement can become more restricted, making it much harder to get outdoors. This would cause isolation and loneliness in anyone, let alone the often frail people living in long-term care.

Recognizing the benefits, Therapeutic Support Services staff at Bruyère Continuing Care decided to look for ways to get residents outdoors. When the idea of of Cycling Without Age came about, they could not turn down the proposal.

Cycling Without Age bike taking residents in forest. What is Cycling Without Age?

Cycling Without Age (CWA) is an innovative program that helps seniors stay active and stay connected with their communities. Originating from Demark, CWA makes it possible for seniors or those with mobility challenges to get back on bicycles, allowing them to enjoy their scenic communities. This initiative started in 2012, and has expanded to 28 different countries.

CWA uses a special 3-wheeled rickshaw bike. These “trishaws” have a two-seater passenger carriage in the front. Volunteer “pilots” who sit on a bike in the back, propelling the bike forward. The bike pilot can easily chat with the passengers, often connecting people from different generations through conversation, storytelling, and reminiscing.

Cycling Without Age at Bruyère

Bruyère Continuing Care (Bruyère) opened Ontario’s first CWA chapter in 2016, in collaboration with community partner Gary Bradshaw. The Ontario Centre for Learning, Research and Innovation in Long-Term Care (CLRI) at Bruyère supported the program evaluation. Bruyère runs two long-term care homes, Saint-Louis Residence and Élisabeth Bruyère Residence, and also operates the Bruyère Village for independent seniors’ living, all located in Ottawa.

Bruyère’s Therapeutic Support Services Department runs the CWA program at all of these sites, and has had tremendous success.

Senior in CWA bike overlooking Parliament.
In the first summer season of the program, the CWA program served 46 residents of Saint-Louis Residence, or 1 in 4 who live in the Residence, as well as 48 Bruyère Village tenants, family members and friends who accompanied residents on their outings. With such a high demand, over 121 hours were pedaled in that first summer alone. Alternating between more than 34 trained volunteer bike pilots, the average ride was 60 minutes long and each participating resident had an average of three rides in the warm summer months.

The first season was an overall success, with a 99% satisfaction rate. Participants commented on their enjoyment of the rides and the beauty of nature, bringing laughter and smiles as they waved at the neighbours passing them on the bike path and in the community. Pilots shared in that enjoyment, loving the exercise, nature, and discussions with new friends. The launch was similarly successful at Élisabeth Bruyère Residence in 2017, proving that this program can run in both homey suburban and busy urban settings.

Want More Information? Watch our Webinar!

Most recently, the Ontario CLRI hosted a webinar covering the CWA program. Presented by Kim Durst-Mackenzie (Therapeutic Recreation and Volunteer Coordinator, Bruyère) and Gary Bradshaw (Community Partner), the webinar focuses on the concept of CWA and why it is an essential program, as well as offers a more detailed explanation of the ins-and-outs of running CWA in long-term care homes with a large group of dedicated volunteers.

A program brochure is also available, outlining useful tool, policies, procedures, and evaluation approaches.

Shorter versions of this article can be found in AdvantAge Ontario’s July Action Update.

To view any of the resources listed above, please visit the CWA resource page.


This article draws on the findings of the evaluation of the first season of the Bruyère Cycling Without Age program, that was partially supported by the Government of Ontario through the Ontario Centres for Learning, Research and Innovation in Long-term Care. Opinions expressed in this report do not necessarily reflect those of the Government of Ontario.

Ontario CLRI in the News! Bruyère’s Life Changing Day

On May 24, 2018, Bruyère Continuing Care held their annual Life Changing Day fundraiser at Saint-Vincent Hospital. The day was incredibly inspiring, filled with touching stories, innovative showcases, and generous community support. With a final fundraising tally of $494,239, the room was positively buzzing.

The Bruyère Research Institute showcased many of its research projects at the event, including the Ontario CLRI project “The Power of Peer Support: Reducing Social Isolation in Residential Care.”

This telethon-style event was being featured on various Bell Media channels throughout the entire day. Michelle Fleming (Knowledge Broker, Bruyère CLRI) was approached by CTV Ottawa to discuss the Peer Support Project in an interview on Facebook Live. Interviewed by CTV Ottawa news anchor Stefan Keyes, Michelle discussed the powerful ways that these programs are reducing loneliness and social isolation in residential care. Grateful to be a part of such an uplifting day, Michelle was eager to thank the project partners (Java Group Programs and Carleton University Department of Health Sciences) and funders (CABHI, Carleton University Department of Health Sciences, and Ontario CLRI).

To watch this interview, please visit CTV Ottawa’s Facebook page.

The Power of Peer Support

Innovative Canadian Program Helps Reduce Social Isolation in Residential Care

The Power of Peer Support: Reducing Social Isolation in Residential Care is a collaborative project between the Ontario Centre for Learning, Research and Innovation in Long-Term Care (CLRI) at Bruyère, Java Group Programs, Carleton University’s Department of Health Sciences, and Bruyère Continuing Care. It is funded by the Centre for Aging + Brain Health Innovation, Carleton University and the Government of Ontario through the Ontario CLRI.

The Issue

It is well established that people who have meaningful social relationships experience better well-being. However, some in society have circumstances that limit opportunities for such interactions, and older adults in residential care are particularly vulnerable. Social isolation and loneliness are common in this population and better strategies are needed to counter its negative health outcomes, including depression, dementia, increased mortality and higher health care costs.[i] Studies show that 55% of residents in care homes experience loneliness.[ii]

Lonely resident

When someone moves into residential care, it is often prompted by a health crisis. There can be a number of other issues that compound the complexity of said crisis. For many new residents, this transition is a very painful and lonely time. These challenges are exacerbated for those living with dementia.

These settings have proven beneficial for people who require physical care, however, research highlights concerns about resident psychosocial well-being.[iii], [iv] An American study found evidence that programs provided tend to be inaccessible or inappropriate for many residents, leading to low participation rates.[ii] Another study explained that 45% of residents with dementia participated in few or no activities, 20% participated only occasionally, and 12% participated in activities that were inappropriate for their needs.v

These numbers show the need for meaningful engagement opportunities, allowing residents to deepen social connections and re-establish a sense of purpose. There is a growing body of research that documents the effectiveness of peer support in alleviating loneliness and depression. Peer support enables individuals to learn new ways of coping through identification with others in a similar position. The Java Group Programs offer a unique model to combat these issues.

The Solution

Residents enjoying Java Music Club Peer support groups are known to benefit individuals with chronic illnesses, yet they are rarely used within senior living. Founded by Kristine Theurer (MA, Gerontology, MTA, PhD(c)), Java Group Programs are the first standardized peer support interventions designed to address the critical rates of depression and loneliness in senior living. Java Music Club is a weekly peer support group for older adults, including those living with mild to moderate dementia. The program is based on the altruistic concept that people are happiest when they are helping one another. It also draws on social psychology and gerontology research findings. Java Memory Care is a vital adaptation for those living with moderate to advanced dementia. These groups are designed to be facilitated by staff, volunteers and/or family members.

Homes that offer Java programs purchase a license and ensure that their staff or volunteers are trained to facilitate Java sessions. Facilitators provide opportunities for residents to unload burdens, learn coping skills, reminisce and increase their sense of belonging. This is done using a standardized facilitation manual which includes themes, questions, photographs, songs, quotes, and an Aboriginal talking stick.

Residents are encouraged to support one another through discussion and to reach out to members who are lonely or isolated. These groups provide opportunities for emotional expression/release, allowing residents to talk in a safe, public setting about complicated topics. There are 52 topics in total covered in the facilitator manual – some other topics include weddings, gratitude and boredom. These topics were originally chosen by residents in long-term care who were consulted as the program was developed. Both programs aim to reduce stigma associated with support groups by reflecting a warm social setting, incorporating coffee and music.

In an effort the enhance residents’ quality of life, many Canadian care homes have introduced Java Music and Java Memory. They have seen residents regain their love of life and sense of purpose, build new relationships and develop increased respect for their peers.

In recent months, a generous grant from the Centre for Aging + Brain Health Innovation has added 35 new locations (see map below) across Ontario where residents now benefit from this evidence-based peer support program. Committed to knowledge mobilization, interactive training workshops, coaching sessions and public webinars are woven together to elevate facilitators’ skills.

Map of homes involved in project

This map shows the locations of the 35 retirement and LTC homes across Ontario participating in the Power of Peer Support program.

Additionally, a portion of the grant advances the overall understanding of the benefits of Java programs through rigorous research. Both Java Music Club and Java Memory Care have shown success in alleviating loneliness and depression. This project will advance our understanding of the benefits to the individual residents (psychosocial and cognitive health outcomes). Dr. Renate Ysseldyk from Carleton University’s Department of Health Sciences is working with residents and staff at Riverstone Retirement Communities and Élisabeth Bruyère Residence to understand their experiences. The team is delighted to explore the benefits of these programs through the partnerships with Riverstone Retirement Communities and Bruyère Continuing Care.

Social isolation of vulnerable populations is a universal issue in our society. The Java Group Programs aim to reduce this problem among residents who live in long-term care or in retirement settings. When it comes to Java, improving residents’ quality of life will always drive program implementation, research and the design of learning and skill building opportunities.


Explore Our Resources

Tools and learning opportunities for recreation therapy professionals and volunteers in residential care settings:

  • Visit our Resource Page to explore the wealth of resources developed throughout this project (including a series of recorded webinars, a documentary, infographics and newsletter series) and media engagement.

 

 


For more information, please contact Michelle Fleming, Knowledge Broker at the Ontario Centres for Learning, Research and Innovation in Long-Term Care at mfleming@bruyere.org.

References:

[i]  Victor, C. R. (2012). Loneliness in care homes: A neglected area of research? Aging Health, 8(6), 637-649. doi: 10.2217/ahe.12.65

[ii] Theurer K, Mortenson WB, Stone R, Suto M, Timonen V, & Rozanova J. (2015). The need for a social revolution in residential care. Journal of Aging Studies, 35, 201-210.

[iii] Kemp, C. L., Ball, M. M., Hollingsworth, C., & Perkins, M. M. (2012). Strangers and friends: Residents’ social careers in assisted living. Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 67(4). doi: 10.1093/geronb/gbs043

[iv] Moon, H. (2012). Risk factors for depression among the oldest-old in urban congregate housing: Contribution of grief. International Social Work, 56(4), 516-533. doi: 10.1177/0020872811429954

[v] L.L. Buettner, S. Fitzsimmons. (2003).  Activity calendars for older adults with dementia: What you see is not what you get. American Journal of Alzheimer’s Disease and Other Dementias, 18 (4) pp. 215-226

Enhancing Excellence at Élisabeth Bruyère Residence

PSWs engaged in learning.

Since October 2017, long-term care (LTC) homes across Ontario have participated in the Personal Support Worker (PSW) Education Fund for LTC. The Ministry of Health and Long-Term Care has worked with the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) to coordinate continuing education and training for PSWs through the delivery of Excellence in Resident-Centred Care (ERCC). The ERCC program is delivered in partnership with Conestoga College. Élisabeth Bruyère Residence (ÉBR) is one of the homes benefitting. The Ontario CLRI recently visited one of the training workshops at ÉBR. It was evident why the ERCC training is important for this small home in downtown Ottawa.

Who is at the centre of attention?

PSWs who work in LTC spend most of their time caring for and interacting with residents. Many residents and their families depend on PSWs to provide necessary assistance with daily activities. This results in a lot of one-on-one time and strong caring relationships. Since PSWs work on the front line and impact the lives of so many residents, they need support. Part of this support is providing best practice-based resources and learning opportunities they can use to continue fine-tuning their skills.

ERCC promotes best practices in senior’s care environments. The program aims to help teams achieve better care and better outcomes. These goals are achieved using a person-centred, train-the-trainer approach to advance practice development.

ÉBR is running several workshops this winter. “These workshops have been a really big eye opener for everyone involved. Sometimes it’s easy to forget to look at situations through a resident’s eyes. The exercises and activities give the PSWs a chance to experience what challenges residents may experience daily,” explains Suzanne Doré. Suzanne is one of the PSW-trainers at ÉBR. “The workshops provide refreshers to remind PSWs of what’s most important in this field – the residents.”

Laying the groundwork, two PSWs from ÉBR participated in an ERCC train-the-trainer workshop in December. As reported at the time, the train-the-trainer workshop brought Conestoga faculty, affectionately known as “super-trainers,” to Ottawa. The super-trainers shared dynamic facilitation skills and tools, all aimed to reinforce teamwork. ÉBR sent PSW team members who were recognised by their peers as champions and role models for resident-centred care.

Advancing practice change at ÉBR

ÉBR’s PSW-trainers returned to their homes empowered by the train-the-trainer workshops. They were eager to share their knowledge with their fellow PSWs with whom they work every day.

Following this, in early 2018, the ÉBR PSW-trainers ran several in-house ERCC workshops for groups of PSWs. Using a module-based approach, the workshops cover a variety of topics essential for PSWs: person-centred care, oral and skin integrity, continence, nutrition and hydration, working with others, end-of-life care, observational assessment, and more. Each module delves into relevant principles, the importance, factors to consider, techniques, and strategies for optimization of care delivery.

“At ÉBR, we’re training 36 PSWs to provide these excellent levels of care to residents. That number is just across one LTC home. This is a great initiative, and I’m excited to see how it will enhance the quality of care provided in LTC homes across the province,” reflects Suzanne on the ERCC experience.

Recognising the important role PSWs play in LTC teams, in 2017, the Ministry of Health and Long-Term Care launched the PSW Education Fund for LTC. The goal of the Fund is to help develop and enhance the PSW workforce in LTC to deliver high-quality and safe care that meets resident needs. The Fund supports LTC homes to train a critical mass of PSWs in elements of resident-centred care and to sustain ongoing learning that will continue to benefit residents. To make the training possible, the Ministry worked with the Ontario Centres for Learning, Research and Innovation in Long-Term Care to deliver “Excellence in Resident-Centred Care” (ERCC), in partnership with Conestoga College.

“Would you be surprised if this resident died in the next 3 months?” – OANHSS Action Update

“Would you be surprised if this resident died in the next 3 months?” Using the ‘Surprise Question’ to Identify Long-Term Care Residents Who Could Benefit from a Palliative Care Approach

As part of a research project, which started data collection in September 2014, this will be one of three questions RAI-MDS* coordinators will ask their interprofessional team members during care plan meetings. Known as the “surprise question”, it has been used in acute care and other clinical settings as a way to identify patients who are at high risk for early mortality and should receive priority for palliative care interventions.

Dr. Jill Rice, Jennifer Ellis, RN, PhD, and Dr. José Pereira are leading a study with the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) and Bruyère Research Institute (BRI) that is being conducted at a large urban long-term care (LTC) home in the Ottawa area. The study’s main purpose is to explore the use of the “surprise question” in order to identify residents in LTC who are believed to have less than six months to live and could therefore likely benefit from incorporating a palliative care approach in their care plan. Residents in this particular LTC home receive a quarterly RAI assessment which includes a review and discussion of their care plan by their health care workers (physicians, nurses, personal support workers, physiotherapists, dieticians, etc.). The study will use these meetings to ask modified versions of the “surprise question” which better reflect the shorter length of stay in LTC.

The three different versions are “Would you be surprised if this resident died in the next…”

a) 3 months,

b) 6 months, and

c) before winter.

Staff responses will be analyzed with RAI-MDS data and results will indicate whether these variations of the “surprise question” are appropriate for use in LTC. In addition, the demographics (staff traits), accuracy, confidence, and comfort will be tested. Afterwards, focus groups or telephone interviews will be used to acquire staff feedback on use of this tool. Results are expected in Spring 2015.

*  RAI-MDS (Resident Assessment Instrument – Minimum Data Set) is an electronic care management tool that helps health professionals in long-term care to assess and monitor the care needs of their residents. It is designed to report function and cognitive performance, indicators of social supports and other resident characteristics. Information from the tool is used to develop and modify individualized, resident-centred care plans based on the changing and complex health status of a resident.

Action Update is a monthly member newsletter produced by the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS).