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www.oakvillebeaver.com · OAKVILLE BEAVER Wednesday, June 23, 2010 · 10 Is there a long-term solution on the horizon? By Mike Adler and Rob O'Flanagan FOURTH IN FOUR-PART METROLAND SPECIAL PROJECT T he answer to gridlock across Ontario's long-term care system is an injection of new money, elder advocates say. For nursing-home operators, a top priority is the fulfillment of a long-standing promise from the province to fund more staff. Ontario's Health Quality Council, a watchdog agency, sees more assisted-living homes as a potential pressure relief valve for overwhelmed nursing homes. For thousands of Ontario families battling the system's long waiting lists and cumbersome bureaucracy, any relief measure would do. "I think the first thing that is needed are more homes," Denise Riekstins, of Toronto wrote in a typical e-mail response during research for Metroland's special report. "The waiting lists are ridiculous, especially for newer homes. I also think that more thought should go into how to improve home care, maybe make it more affordable, so the person can stay in their home as along as possible. Institutional homes are certainly not like home." Health Minister Deb Matthews says quality improvements are taking hold now in all nursing homes, with a focus on reducing traditional health risks such as falls and bed sores. Efforts to make more home care available as an alternative are in progress under a $1.1-billion program created in 2007. More short-stay beds are being created, to help reduce the number of seniors placed permanently in long-term care. Such "restorative" beds, as Matthews calls them, allow elderly people with short-term needs to be placed temporarily in nursinghome beds to regain their health, and then go home. But what exactly has to happen to produce real change? "I think more time," Matthews said. "I mean, it does take time to change a system." In the meantime, attention has turned to making the nursing home a more palatable choice for the frail elderly, instead of a dreaded "institution of last resort," as the Canadian Health Care Association put it in a 2009 report on long-term care. Christina Bisanz, CEO of the Ontario Long Term Care Association, believes in a conversion that would see nursing homes become a "hub" for all types of care. With the right kind of planning, she says, Ontario's existing 625 homes could feature day programs for the frail elderly, who have dementia or chronic diseases, "to help them to live in the community as long as possible." Bisanz said nursing homes can become "more than just the residence where 24-7 care is given." In some Ontario long-term care homes, that's already happening. At Shalom Village in Hamilton, residents "If we can help people to remain as cognitively well as possible and as physically active as possible, even if they're in a long-term care setting, that still could have benefits not only for the individual, but on the caregivers." Pat Spadafora, director of Sheridan Elder Research Centre Attention has turned to making the nursing home a desirable option for the frail elderly, instead of a dreaded "institution of last resort," as the Canadian Health Care Association put it in a 2009 report on how to refocus long-term care. SCOTT GARDNER / METROLAND WEST MEDIA GROUP PUMPED FOR THE FUTURE: Researchers are looking at ways to incorporate bodystrengthening exercises, music and computer-based brain fitness into daily life in long-term care. Here, a resident of Shalom Village in Hamilton pumps iron. pump iron to help maintain functional mobility. Shalom's health-club concept was originally regarded skeptically by potential funding bodies, said Pat Morden, the home's chief executive. A long-term care home is traditionally viewed as a place of restful care. That's changing. "They barely get in, but they're down there lifting weights. And you see the difference," she said. Experts in the field of gerontology say such workouts help prevent falls and other debilitating mishaps, and can also improve cognitive ability. Benefits flow to the home and the resident. Attitudes about what long-term care settings should be like and what services they should offer are changing rapidly. Researchers are looking at ways to incorporate brain-benefiting music classes and computer games, and body-strengthening practices such as yoga and tai chi, into daily routines to make the final years of life more rewarding, positive and healthier. "If we can help people to remain as cognitively well as possible and as physically active as possible, even if they're in a long-term care setting, that still could have benefits not only for the individual, but on the caregivers," said Pat Spadafora, director of Sheridan Elder Research Centre, part of the Sheridan Institute of Technology and Advanced Learning in Oakville. Under the motto From Lab to Life, the centre forms collaborative research projects in the long-term care field, studying the impact of innovative dance programs aimed at improving mobility, or computer-gaming programs that encourage cognitive health. "If the individual can improve their balance, for example, through our dance program," Spadafora explained, "and their flexibility and their range of motion and their muscular endurance, then maybe they won't need as much physical support from the caregiver to help them get in and out of bed." At Shalom Village, Morden has witnessed the capacity of activities such as music to reactivate mind and spirit. One resident who had a musical background but was debilitated by Parkinson's and dementia began to participate in the home's long-standing drum circle. He hadn't spoken for two years. "He was in the drum circle and he was drumming, and he was sobbing," Morden said. "He just sobbed and sobbed. And then gradually he took over the leadership of the drum circle. That's the magic, to find those moments for people, at some level." Alexa Roggeveen, Sheridan Elder Research Centre's research co-ordinator, said a recent project, funded by Colleges Ontario Network for Industry Innovation, in conjunction with RBJ Schlegel Villages (a nursing-home operator), studied the openness of residents in retirement and longterm care environments to using brain-fitSee Seniors page 11