The Power of Peer Support
Resource Audience Type: Leaders & Managers
Deprescribing.org
A framework and tools for encouraging discussions about deprescribing
Older adults living in long-term care (LTC) homes often take many medications each day – sometimes this is not necessary and can even be harmful. Deprescribing is the planned and supervised process of reducing doses or stopping medications.
Decisions about medications for residents are best made when people work together with their health-care providers. Everyone in an LTC resident’s care team can help make medication-related care safe and effective.
The Bruyère Deprescribing Research Team worked with stakeholders across Ontario’s LTC sector to identify four behaviours and develop supporting tools that help deprescribing become a part of the culture of care. Click on the links in each behaviour to access tools such as process guides, infographics, cue cards and videos:
- People living in LTC homes and their families/caregivers will participate in shared decision-making to establish and monitor goals of care with respect to medication use while taking into consideration effectiveness, safety and non-drug alternatives.
- All healthcare providers and personnel will observe for signs and symptoms in the people they care for and report changes as a result of medication adjustments, or changes that might prompt a deprescribing review.
- Prescribers in every health care setting will document reasons for use, goals and timelines for each medication.
- All members of the health care team will participate in conversations about deprescribing.
The Bruyère Deprescribing Research Team is a partner of Ontario CLRI at Bruyère. For more information about how these behaviours were identified, read the Deprescribing in LTC report.
Additional resources and tools for optimizing medication use in older adults
- Five evidence-based guidelines that help health care providers make informed assessments of a resident’s medication and explore possibilities for non-drug treatments.
- “Talking about Medications” workshops that can be offered to residents, caregivers and staff to help people have discussions about medication decisions. “Talking About Medications” Materials – Deprescribing.org
- The Canadian Deprescribing Network raises public awareness about deprescribing and provides resources to address safe drug and non-drug approaches. Do I still need this medication? Is deprescribing for you? (deprescribingnetwork.ca)
Author/Source
Deprescribing.org houses deprescribing guidelines and other resources developed by Dr. Barbara Farrell and Dr. Lisa McCarthy’s research team at the Bruyere Research Institute (Ottawa). Barbara and Lisa are pharmacists who work with older people and are concerned about the risks associated with medications in this population.
To learn more about their work visit deprescribing.org.
Supported by:
The Importance of Resident Engagement
Webinar Description
A webinar presentation offered in collaboration with the Seniors Quality Leap Initiative (SQLI) that explores some of the strategies used by Schlegel Villages to engage residents and enhance resident life in long-term care. SQLI is comprised of 15 leading long-term care (and post-acute providers across North America and is supported by 10 strategic partners. As an active community of practice, SQLI is engaged in an innovative effort to improve clinical quality and safety related to the quality of life of seniors, by sharing performance data and the results of specific quality improvement initiatives.
The objectives of the webinar are to share:
- Ways residents are socially engaged
- How to measure resident engagement and satisfaction through a self-reported survey
- How to involve residents in creating change
This webinar was offered by the Ontario CLRI hosted at the Schlegel-UW Research Institute for Aging and was presented on September 20, 2018.
Presenters
Jennifer Hartwick, MSc. (Kin), Director of Business Process Development, Schlegel Villages
Jennifer Hartwick has a passion for working with older adults and has over 16 years of both Retirement and LTC experience. She has both a Bachelors and Masters of Science degree in Kinesiology from the University of Waterloo. Jennifer has held several positions within Schlegel Villages which currently operates 7 continuum of care communities and 12 LTC Homes in Ontario. Her roles have allowed her to gain experience with a wide variety of operational issues. As the Director of Business Process Development she is responsible for ensuring a variety of projects within operations are supported from conception to implementation. This has included supporting the design, implementation and early monitoring of new projects such as the Quality of Life Satisfaction survey and quality improvement protocols and tracking across the organization. When Jennifer is not working she is kept busy by her family including her two young children.
Jaimie Killingbeck, R.Kin, Director of Quality and Innovation, Schlegel Villages
Jaimie Killingbeck is the Director of Quality and Innovation with Schlegel Villages. She began her journey with the organization in 2003 as a Kinesiologist at The Village of Riverside Glen, and in 2011 joined the Schlegel Villages Support Office as the Program for Active Living Coordinator. She recently moved into her new role and will be supporting the Villages with quality improvement and quality assurance initiatives. Jaimie is passionate about enhancing the experience of residents and teams and sharing her knowledge through clinical and educational support.
Dementia Simulation Toolkit
The Ontario CLRI at Baycrest develops and evaluates innovative educational approaches designed to enhance not only knowledge and skills, but also values and attitudes in learners. With the assistance of interprofessional summer interns, an initial dementia simulation was created and trialed. A final version is presented here in the form of a toolkit. The scripts and resources in this toolkit have evolved over time using a quality improvement approach and are meant to foster participant awareness and insight into living life with frailty and dementia.
This toolkit contains:
- Information facilitators need to know regarding dementia and dementia
- Simulation techniques and sample scenarios based on common experiences of the
elderly in the healthcare system - Additional modifications for the scenarios
- Ideas on how to structure the simulation session for an interprofessional audience,
including the debrief
As a result, this toolkit will allow users to:
- Identify and utilize dementia simulation techniques and scenarios
- Use these simulations to engage participants in reflection and develop a deeper
understanding of dementia and frailty
Developing Culturally Grounded Dementia Educational Materials for Indigenous Community-Based Care
About this Webinar
This webinar outlines the development of six culturally relevant fact sheets on dementia and dementia care that can be used by Indigenous family caregivers, health care providers, as well as other organizations interested in the promotion of dementia awareness and care in Indigenous communities. The fact sheets bridge essential biomedical knowledge deemed important to convey and Indigenous understandings and explanatory models of the illness. The development of culturally appropriate health promotion materials for Indigenous communities is not simply a cut and paste process where mainstream materials are adapted through changes to imagery but not meaning. Rather, the production of culturally-based materials requires grounding in Indigenous knowledge of specific illnesses and community based models of care.
This integrated webinar event is brought to you by brainXchange in partnership with the Alzheimer Society of Canada and the Canadian Consortium on Neurodegeneration in Aging (CCNA).
This webinar has been identified as a resource that supports Indigenous culture in long-term care by the Ontario Caring Advisory Circle.
Ontario Caring Advisory Circle
About the Circle
The Ontario Caring Advisory Circle (OCAC) guided the identification and development of culturally appropriate resources to support Indigenous residents in long-term care homes between April 2018 and March 2020. Membership of the OCAC was comprised of up to 11 members with wisdom and expertise in long-term care and Indigenous culture. Members were a mix from northern and southern regions of Ontario.
The OCAC created a five-pillar approach to their terms of reference. These five pillars formed the foundation of the work and represented the commitment, interest, and duties of the advisors.
Pillar One – Ensuring a cultural lens in all Ontario CLRI activities
Pillar Two – Identifying resources to fill gaps
Pillar Three – Ideas for education and training
Pillar Four – Identifying research projects
Pillar Five – Guidance for stakeholder outreach
History
The initial gathering of the OCAC took place on April 24, 2018 at the Toronto Birth Centre. At this gathering, the OCAC came together to plan their shared vision for the work ahead. Through process and spirit, the group’s terms of reference were birthed. The OCAC met several times a year via video/teleconference or face-to-face.
Since culturally appropriate imagery is important to the OCAC, the names of Indigenous artists living in Ontario were put into a hat during the October 24, 2018 face-to-face gathering at the Thunder Bay Art Gallery. Robert Kakegamic’s name was drawn and he was contacted to design and paint the OCAC’s logo to represent their spirit. Robert continues the Woodland School of Art tradition while including cultural values and old legends in vivid colours as part of the new way of presenting and expressing Indigenous identity. Robert lives in Sandy Lake, Ontario, a Swampy Cree-Ojibwa First Nations community.
The Inconvenient Tooth: Exploring challenges and best practices in the management of daily mouth care for older adults in LTC
Saint Elizabeth First Nations, Inuit and Métis Program
About the Program
The Saint Elizabeth First Nations, Inuit and Métis Program provides virtual education at no cost to health care providers working in First Nation communities. Their national knowledge exchange network includes online courses, webinars, community forums and 24/7 access to peers and experts. They also partner with communities and organizations to better understand gaps and barriers to care and support improvements through action-based research.
This program has been identified as a resource that supports Indigenous culture in long-term care by the Ontario Caring Advisory Circle.
Ontario Indigenous Cultural Safety (ICS) Training
Indigenous Cultural Safety (ICS) Training is an interactive and facilitated online training program for all professionals working in the Ontario health and social service systems administered by the Indigenous Primary Health Care Council, who is working in partnership with Indigenous partners in Ontario to develop ICS training that is specific to Ontario.
The training addresses the need for increased Indigenous cultural safety within the system by bringing to light the service provider bias and the legacies of colonization that continue to negatively affect service accessibility and health outcomes for Indigenous people.
Anti-Indigenous racial discrimination and bias have profound negative impacts on the health and wellness of Indigenous communities in Ontario. The Ontario ICS Program is focused on supporting Indigenous Health transformation as part of the overall health and social service systems transformation underway in Ontario. The goal is to improve Indigenous healthcare experiences and outcomes by increasing respect and understanding of the unique history and current realities of Indigenous populations.
This program has been identified as a resource that supports Indigenous culture in long-term care by the Ontario Caring Advisory Circle.
A Guide for Planning and Providing Francophone LTC Services
About the Guide
This guide provides practical advice and tools for how to plan, develop and deliver LTC services for Francophones in the GTA and across Ontario and Canada. The guide is intended for all those involved in planning, advocating for, and providing Francophone health services in Ontario, particularly the LHINs, FLHPEs, FLHNs, health service providers, particularly LTC home administrators and boards, all staff of LTC homes, and Francophone community leaders.
Although the guide is geared toward designing and delivering LTC services in French, the information and tools would be beneficial for other community and residential care models for Francophones as well as services for seniors from other language minority groups.
The development of this guides was a collaborative effort between the French Health Network of Central Southwestern Ontario, Entité 4, Reflet Salvéo, Bendale Acres, the City of Toronto and other regional partners.