This story highlights the dedicated work The Glebe Centre is doing to transform culture in LTC moving away from a medical/institutional model of care. Leaders from The Glebe Centre are members of the Champlain Region Person-centred care (PCC) in LTC Community of Practice. Sign-up to our newsletter for more information about PCC, including our upcoming provincially expanded Person-Centred Care in LTC Community of Practice.
The Glebe Centre is home to 254 residents in Ottawa’s vibrant downtown Glebe neighbourhood. The LTC home agreed to open their doors to the Ontario Centres for Learning, Research and Innovation in Long-Term Care and share their journey focusing on emotion-based care and embedding the Butterfly Approach® into the culture at their home.
Our team was delighted to meet with Susan Zorz, Director of Resident Operations and Compliance, and Emma Tibbo, Chief Executive Officer, to learn more about The Glebe Centre’s story. Their culture change story began about eight years ago at a conference. Susan attended a lecture on emotion-based care by Dr. David Sheard, who founded and pioneered the Butterfly Approach in the late 1990s. Emotion-based care prioritizes relationships, empathy, and fostering a sense of self in a culture upheld by dignity and respect. Susan described this lecture as “speaking her language” and she returned to The Glebe Centre enthusiastic and energized to get the work started.
By 2019, The Glebe Centre was ready with the funding, the majority obtained through donations, and resources needed to begin their work toward adopting the Butterfly Approach® with Meaningful Care Matters. The Butterfly Approach® emphasizes the importance of emotion-based care, connecting people in a dignified way through person-centred approaches.
The Glebe Centre started by focusing on their Bankwood Home Area, a secure home area for residents living with dementia. Leadership received intensive training and education sessions with support from consultants with Meaningful Care Matters. Leaders from the home visited Peel Region to learn from them and their journey. In 2018, Peel Region’s home Malton Village was the first LTC home to adopt the Butterfly Approach® in Ontario. The Region has since expanded to all five of their LTC homes implementing the Butterfly Approach®.
In 2020, due to the impacts of the COVID-19 pandemic, the work and progress The Glebe Centre had made were sidelined. New compliance and legislation priorities took priority.
After mandated restrictions began to be lifted, the Glebe Centre resumed their training and education, pivoting to virtual options and Susan taking on leading some of the training herself. The home was determined to maintain the momentum. In 2023, the Glebe Centre received their first Accreditation as a Butterfly Home with Meaningful Care Matters, proudly meeting 100 standards in their Bankwood Home Area. They have received two years of accreditation and will be working on their third next year.
Photographed Susan Zorz, Director of Resident Operations and Compliance (Right) and Emma Tibbo, Chief Executive Officer (Left)
Susan and Emma recognize that culture change can be challenging in LTC. Emma shared that one of the biggest challenges is shifting mindsets. People working in LTC homes are working in challenging times, with staffing shortages, and increasing complexity of resident care needs. Often, there is a ‘task-focused’ sense of pressure that persists due to the circumstances and realities. Susan explained, “It’s never going to be perfect and you’re never going to be done but it’s taking on manageable pieces”.
“I ask naysayers what’s the alternative? You make a difference in the dining room by talking to a resident about a movie you saw the other day as you support them at meal-time as opposed to sitting there [silently]. It doesn’t cost anything to do that,” said Susan.
Nursery Area Meaningful Activity
So what does providing emotion-based care actually look like? Emma and Susan provided many examples of changes they are implementing at the home.
One of the exercises is “What can you do in 30 seconds?” If each team member takes 30 seconds every day to mindfully engage with a resident, then that adds up to many meaningful interactions for that resident throughout the day. These interactions can include singing a song with a resident while putting away their laundry or engaging them in a conversation about the photographs in their room.
Emotion-based care is all about getting to know the individuals within the care home community, including the team members who work for the Glebe. In addition to capturing life stories of all residents, The Glebe Centre posts life stories of team members on the walls of the home areas. This provides residents and their caregivers/care partners the opportunity to know the team members as people, and learn more about those caring for the residents each day. The home also has life stories on a recurring loop on a TV in a common area. Susan explained that life stories help to break down barriers and encourage connections and relationship-building for everyone in their LTC community.
For these culture change efforts to be most impactful, everyone needs to be included in the process. Emma and Susan emphasized that these steps have been taken in consultation with residents, caregivers, team members, leaders and the Board of Directors. Engagement with residents and caregivers is particularly important, and the home has spent time working with the Residents’ Council, Family Council, and hosting family information nights.
The Glebe Centre is now focusing on sustainability and embedding emotion-based care in their home. The home is working on sustainability in a number of ways, including:
- Keeping residents at the centre of every decision
- Ongoing education and training
- Home area specific Champions
- Team Huddles
- Administering surveys and tools to measure the impacts of these culture changes
- Having dedicated resources to someone to lead and drive the change efforts
Hallway leading to Bankwood Home Area
The Glebe Centre is delivering education and training in a phased approach: refresher training to team members working in the Bankwood Home Area followed by emotion-based training in each home area. Providing training across all the home areas is a critical step towards infusing the philosophy organization-wide. Emma said, “sometimes you can see lightbulb moments [from team members] with the education, and the challenge is how to bring and sustain that in the day-to-day. That’s when you need a good supportive team, especially in a home as large as ours, and so creating those champions on every home level is vital to keep it going.” The home has also embedded emotion-based care in its policies. If someone wants to work at The Glebe Centre, it is the expectation that care will be provided with an emotion-based care approach.
LTC homes often experience turnover and that’s why Susan explained that it’s very important over the coming years that they dedicate time to the training so that there are always champions in each home area. Huddles are based on the framework of the Butterfly Approach®, and include bi-monthly observations of each home area for one hour. During the huddles, team members have the opportunity to check in with each other, highlighting good things and also providing opportunities for ongoing constructive feedback.
Emma noted the importance of having a committed leader to help drive their culture change journey. She said, “as a leadership team, you can get caught up in operations and the day-to-day and it’s good to have at least one person dedicated to moving this work forward and bringing it into every conversation. Susan does that for our team. She always says, ‘What about the resident’, reminding people this is about someone’s life.” The home keeps residents at the centre of everything they do and every decision they make.
Photograph of Emma’s mug “Just Keep Swimming” – Emma’s advice for other LTC homes on their culture change journey
The Glebe Centre is focused on keeping their momentum going as Emma shared, “You have to be determined. It’s two steps forward and four steps back some days.” The home is looking forward to continuing their work to improve the quality of life of the residents, learning and growing with their team through this journey.
Learn more about The Glebe Centre’s Transformation Journey:
CBC radio interview: https://www.cbc.ca/listen/live-radio/1-63-the-current/clip/16134637-putting-dignity-centre-long-term-care
Champions of Change: From Institutions to Homes – webinar co-hosted by Family Councils Ontario and CARP Ottawa
Take a look at our other culture change initiatives and stories happening with other LTC homes in Ontario:
- Build your own culture change journey: The City of Ottawa’s model for embedding person-centred care
- “‘I see it, I see it happening here’ and that felt really good.”: How Osgoode Care Centre’s Eden Journey is Changing Culture
Written by: Rachel Lithopoulos, Knowledge Broker, Ontario CLRI at Bruyère Health and Michelle Fleming, Senior Knowledge Broker, Ontario CLRI at Bruyère Health.