Changing standard practice in long-term care improves quality of care and quality of life
Loch Lomond Villa is located in New Brunswick, a maritime province known for its fishing and forestry. The area also holds the distinction of having the highest percentage of aging people across Canada, with the total number of New Brunswick seniors expected to nearly double over the next 15 years. This demographic reality has been a driving force for this hidden gem of a nursing home to become a global leader in person-centered long-term care.
The home opened its doors in 1973 to care for the area’s senior population. The mission remains the same, but in recent years Loch Lomond Villa has undergone a true reawakening in how this work is carried out. “Today, the people coming to live at Loch Lomond Villa are sicker and frailer with more complex chronic conditions,” explains CEO Cindy Donovan. “The demands of families are different. They want to be a part of the care circle, so we have had to change to fit all this. But we have also had to change because the millennials being hired work differently, which ultimately affects how we provide care and services to our residents.”
The Planetree Difference: From Unmanageable Initiative Overload to a Singular Vision
The team at Loch Lomond Villa responded to these changing times with a multitude of initiatives. Despite all this activity, however, there was something holding the organization back from fully meeting the evolving needs of its residents, families and staff. The missing piece was a solid foundation that would unite all the disparate efforts toward a singular vision.
The missing piece was Planetree. Implementing Planetree’s construct for caring – with an emphasis on creating structures to promote partnership, introducing practices to promote quality of care and quality of life, and individualizing care to align with each resident’s preferences, priorities and wishes – was undertaken not as yet one more priority to juggle, but rather as a new way of life for Loch Lomond Villa.
“Planetree is a belief system that starts from the inside and radiates outward, to the benefit of all. It makes us who we are, touching all areas of life at the Villa, including the work environment, operations, leadership, expertise, innovation and services.”
- Cindy Donovan, CEO, Loch Lomond Villa, Inc.
Why this Gold Certified Nursing Home Rejected the Notion of Creating a Home-Like Environment
In 2010 – the same year Loch Lomond Villa first partnered with Planetree – construction began on a new 100-bed nursing home to replace part of the original structure. “The Village,” as it was called, opened two years later as a physical embodiment of the values of person-centered care. Steered by the voices of those who lived and worked there, the emphasis of the design and décor was on creating an environment that would decrease anxiety and confusion while encouraging independence, relationship-building and a prideful sense of ownership in the community.
The goal was not to create a “home-like” environment, but to build spaces where residents genuinely feel at home. This has been accomplished by integrating connections to the outdoors, introducing a “door step model” into each resident’s room and incorporating a variety of destinations to encourage social interactions. A family suite in each house accommodates families overnight. State-of-the-art technology safeguards keep residents safe while preserving their sense of freedom.
How Partnering with Residents and Families Dramatically Reduced Residents’ Use of Antipsychotic Drugs, Dietary Supplements and Bed Alarms
Creating a community where people feel at home requires far more than physical changes. Guided by Planetree’s Person-Centered Care Certification criteria, consistent assignment of residents to caregivers was instituted to breed greater familiarity. Individualized care plans were developed to optimize autonomy and choice. The integral role of family in residents’ lives was honored by providing opportunities for family to participate in their loved ones’ care as Care Partners.
Rigid institutional schedules for meals, bathing and sleep were dismantled, paving the way for much greater choice and self-determination for residents in how their days unfold. This not only has improved residents’ quality of life, but has enhanced their overall health and well-being. For instance, now that residents are provided much greater flexibility around meals and mealtimes, use of dietary supplements has gone down drastically – 43% in three years. This, in turn, translated into cost savings that were re-invested in programming to further enhance residents’ quality of life and the community experience. Similarly, taking a more personal (versus institutional) approach to care has resulted in fewer residents on antipsychotic medications and 60% fewer bed alarms.
Even the way of speaking about residents has changed. Institutional language that unintentionally reduced residents to a diagnosis or care plan requirements has been eliminated in favor of language that honors those who call the community home.
The Planetree Culture Attracts Top Talent
Planetree has unleashed a new level of caring and creativity among staff. Those who just a few years ago defined their role strictly by the tasks expected of them are now eager to contribute to the community in ways that transcend any specific job description. Even more profound has been the growing sense of personal accountability for meeting individual residents’ needs. On-the-spot problem-solving to enhance residents’ quality of life has changed the dynamic of Loch Lomond Villa not only as a place to live, but as a place to work. Staff work across departments to do what is right for the resident, whether it be adjusting the height of a kitchen table to enable a resident in a wheelchair to continue baking or ensuring opportunities for individuals to continue connecting with their community.
This empowering work environment, Donovan believes, will be a critical differentiator for Loch Lomond Villa in the coming years. The same demographic shift creating greater demand for senior services is also driving up the retirement rate and staff vacancies across the region. Offering up a work experience that yields joy and pride in work has established Loch Lomond Villa as a place the next generation of employees will want to work, positioning the organization for success in an increasingly competitive employment market. Indeed, recently hired employees have consistently identified the community’s culture as what drew them to Loch Lomond Villa.
“Planetree has taken us to that next level. Our staff were so proud to receive the Gold Certification and to work in a place that strives to have that high standard of person-centered care. I think it is important to be Certified so that nationally, internationally, government-wise, they know we’re not just saying it, we’re actually being measured against person-centered standards.”
- Cindy Donovan, CEO
Setting a New Standard in Long-Term Care
As the first long-term care community in the province to achieve Gold Certification through the Person-Centered Care Certification Program, Loch Lomond Villa has become a shining example of what is possible in long-term care. It has become a place people want to call home. Today, Loch Lomond Villa is first choice for individuals selecting a nursing home in the area.
What began as a personal re-awakening about the need to transform the culture of one home has sparked a re-imagining of how we care for the aging population that extends far beyond Loch Lomond Villa. Advocacy efforts at the local and provincial level have drawn on the Loch Lomond Villa’s experience to demonstrate the power of person-centered care to produce measurable improvements in quality, safety and resident and staff satisfaction.
