April 7, 2020

Relationship and stimulation are the heart of Sunnyside Home’s new model of dementia care. The long-term care home on Franklin Street North in Kitchener is training in the “Butterfly Approach” taught by U.K. company Meaningful Care Matters.

“It’s just not right that (older people who) served us so well and brought us up and fought in wars … end up starved of connection and emotional well-being,” said Sally Knocker, a trainer with Meaningful Care Matters, who introduced the model during a presentation at Sunnyside Jan. 15.

The Butterfly Approach, which was first implemented in a U.K. care home 25 years ago, seeks to improve the emotional health of residents with dementia by teaching staff to bond with them in a home-like environment. This means slowing down, focusing on relationships before tasks, sharing meals and ditching the scrubs. It also means livening up the lived environment and presenting objects and activities that stir memories and engage residents.

Daren Felgate, a Meaningful Care Matters consultant, said in an interview, “I think the challenge is (staff) understanding that being loving towards people and being with people is not a bolt-off to doing activities and providing meal times. It’s the core of it, it’s the whole thing.” It takes time to develop that attitude, Felgate said. “My optimism about it is that I think the (Sunnyside) team get(s) that.”

The Butterfly Approach has already been implemented in some homes in Alberta and in the Region of Peel. The City of Toronto gave the model a pass last year, though. Researchers the city hired to analyze “person-centred” care models such as the Butterfly Approach were cautiously positive about the various approaches, but indicated there wasn’t enough scientific evidence yet to endorse one. They told the city, “The mixed evidence does not lead to a recommendation for a single model but rather to a strategy to learn from all the models, adapting promising practices to specific homes and their populations.”

In a 2018 report, the Region of Peel noted positive measures, such as the number of residents taking antipsychotic medication without psychosis falling to “21.7 per cent, compared to 41.2 per cent at the start of the pilot” in its Malton Village home.

‘Go-with-the-flow feel’

Peel workers have complained of understaffing under the new paradigm leading to exhaustion, though the region noted a decline in sick time during its pilot (the Region of Peel added 24.3 full-time-equivalent positions in long-term care in 2019).

And the Meaningful Care Matters presenters acknowledged the emotional care of staff as an area for improvement in their practices.

Felgate said, “This is (what) I worry about a lot. We’re still working on ideas and materials. Because often you’re asking people to be themselves at work and it’s exposing them to a lot of emotion. And where do they go with that?” He said support needed to be provided.

But he also expressed the positive vision of the project.

“My hope is in 12 months somebody come(s) back and staff are more relaxed, you see people sharing meal times, it’s like a go-with-the-flow feel for the day, feels a lot more spontaneous.”

Sunnyside serves 236 long-term care residents. The Ontario Long Term Care Association says 64 per cent of the province’s long-term care residents have dementia.

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