Long-term care residents at the city-run Garry J. Armstrong Home say they are benefiting from Ottawa’s new focus on person-centred care.
Upon her arrival at Garry J. Armstrong, resident Judy Allen said her transition to long-term care after living in a private long-term residence had its challenges. However, the shift to person-centred care (PCC) has made her daily life “really much better.”
So how did the improvement happen?
In general, there are many different moving parts in making a long-term care home more ‘person-centred’.
Individualized care
The PCC model is part of the city’s strategic plan for long-term care, which Allen claims has kickstarted a freer environment for her and her neighbours. For example, the new plan allows for slower-paced mornings, with less scheduled times and more freedom to partake in individual activities such as games, puzzles and increased outdoor access.
Viviane Robinson, who has been at Garry J. Armstrong for five years, says access to individual activities and projects has been a positive change. Because she uses a wheelchair, she is increasingly dependent on staff and having her own time alone is her favourite part of the day.
More welcoming environment
PPC is an integrated approach that attempts to strengthen resident comfort and safety. According to a city report, “person-centred (PCC) models of care shift decision-making closer to residents, focusing on relationships, home-like environments and bringing choice, autonomy and purpose to the lives of residents.”
The implementation of PPC in long-term care relies on enhanced staff training and knowledge. At Garry J. Armstrong, staff members Bintu Kallon and Mercy Amos-Alphaeus are ambassadors for the program, recognizing that residents on each floor have specialized needs and cognitive abilities. They help in decision-making by encouraging resident input into activities, such as hosting special dinners and community events.
“The patient population of (for example) Floor Seven, they are very cognitive, and you can have a dialogue with them, and they can tell you how they want things done,” said Kallon.
On this level (otherwise known as neighbourhood Seven) at Garry J. Armstrong, residents partake in surveys and discussions that allow for customized change to their living environment.
“They did a wonderful job; they hosted a dinner for 25 of us down in the atrium. It was just gorgeous. It was a five-star meal,” said Allen about a recent event.
The city began the PPC pilot program in May 2023 in parts of the city-run LTC homes Garry J. Armstrong and Peter D. Clark. According to a report submitted to a recent City Council meeting, there were improvements to resident quality of life, to family engagement and in staff satisfaction. The report also noted some areas for improvement as the initiative is expanded.
Infrastructure changes and resident participation
In 2015, Ontario introduced a long-term care manual containing the design standards and practices that every home needs to follow to ease interdisciplinary care for residents dealing with a range of needs and disabilities.
Through these resources, service providers are expected to provide a comfortable and enjoyable experience including co-design and family engagement that ensures that those closest to residents can help shape the place that their family members will call home.
In some cases, residents have become involved in designing environments. At Garry J. Armstrong, Kallon claims that since the implementation of PPC residents have more autonomy. Kallon pointed to some changes made recently in a common room.
“Once the project commenced, we had a meeting where we took the input on what they wanted,” she said.
“They voted on it, each person voted on it. And now, they’re going to be voting on the colours chosen for the dining room and each part of the living area.”
Health and safety
The PPC model also draws from other fields, including design and architecture, but with a focus on ensuring a space does not become too clinical. According to Chantal Trudel, associate professor in Industrial Design at Carleton University, the push for safer, more viable independent living for residents relies on some pretty complex methodologies including workplace, assistive technologies (such as dementia care monitoring), activity services, scheduled recreational therapy and outdoor access, which aids in strengthening patient protection from infection, for example.
“It’s not a clinical environment. Residents who live in long-term care, this is their home. The clinical aspects of infection management role are crucial while balancing a very person-centered environment,” Trudel explains.
Linda Garcia, professor in the Interdisciplinary School of Health Sciences, and Director of LIFE Research Institute at the University of Ottawa, says the key when transferring an individual into LTC from acute care in a hospital is connection. Physical space should accelerate social connection opportunities for residents, improving their mental health and allowing for the growth of physical, mental and spiritual relationships.
Garcia also specializes in the social and physical environment that impact individuals with disorders such as dementia. She says stimulating environments and well-trained staff that recognize resident capabilities as well as their functional limitations are critical.
“If I’m 85 years old and have dementia and you’re wanting to design a new coffee shop for me, you need to understand that I’m going to need to see some contrast. You want to maximize my eyes and my ears because my brain is starting to have issues with cognition. I always come back to three things: Do you have a safe place to live? Do you have something meaningful to do? And do you have someone to love?”
The city is planning on expanding the PPC model in 2025, with an emphasis on educational growth and improvement.
