Bringing the outside world into long-term care

The ideal relationship between staff and residents of long-term care homes is like that of a family, full of affection and respect. The family spirit at Yucalta Lodge long-term care home in Campbell River has sparked some creative projects like a farmers’ market and a bus stop. The outcome of these activities is not just happier residents and more engaged staff – they can also reduce responsive behaviours for people with dementia while enhancing their quality of life.

A farmers’ market, lemonade stand, a BC Transit bus stop, movie nights, indoor light displays, key wishes program, art decals on walls … all of these initiatives and more have sprung up in just the last three months, led by the enthusiastic staff in the Homestead Cottage and interdisciplinary team of Yucalta Lodge. The staff-led initiatives build on the work started at Yucalta as part of the CLEAR project, an initiative of the BC Patient Safety and Quality Council to help long-term care homes reduce the use of anti-psychotic medications for dementia care.

“The CLEAR project was coming to a close but out of this came incredible staff engagement,” said Yucalta Lodge Manager, Jae Yon Jones. Through that engagement, frontline staff began taking on projects to improve patients’ daily lives. Clinical Nurse Leader Carolyn Tallack helped support staff engagement by guiding them to form a small committee to come up with ideas to present to management." 

Staff engagement and collaboration are part of Jones’ vision for Yucalta Lodge to feel more like a community rather than just a workplace. It also aligns with Island Health’s CARE values of courage, aspire, respect and empathy. “Our Yucalta staff are living examples of what it means to demonstrate these values,” says Jones.

Health-Care Assistant Emily Smith is one of the people who seized the opportunity to find new ways to enrich her residents’ lives. “We’ve wanted to do these things for a long time, and with the CLEAR initiative it was a perfect match,” she explains. “I view the residents as family, so I’m going to take care of them like they’re my family,” says Smith.  “We really love the people we take care of.”

The idea to install a bus stop – complete with a bench, transit sign and schedules – came from Health-Care Assistant Rebecca Hoegler. Being unable to exit the building can cause frustration and agitation for people with dementia. Hoegler’s idea was simple: Give them somewhere to go. “We’re giving them control of the situation in a safe way,” says Hoegler. 
Joanne Amberson, Yucalta Recreation Supervisor contacted James Broadhead, Division Manager for Campbell River Transit, who provided an official bus stop sign and schedules that are setup in a hallway next to a bench. He thought it was a wonderful idea that could be shared with other care homes. 

 “I’ve seen it work already,” says Amberson. “One of the residents decided she was going home because she had to see her mom. Someone said ‘Oh – there’s the bus stop,’ so off she went. She sat there and a few minutes later, a staff member came up and had a cup of coffee with her at the bus stop. They started talking about the mom, changing the flow. The lady calmed down, and then they left the bus stop together holding hands.”

Retaining a measure of autonomy can be important for people with dementia. “If they have a need to go somewhere, don’t take that away,” explains Smith. “Let them go somewhere, and then revamp the situation.”

The success of the bus stop encouraged staff to put forward other ideas, such as a farmers’ market in the cottage courtyard.  “I just thought it would be nice if we could have a couple of tables out there and put stuff out so they could shop and enjoy themselves,” says Smith. Staff and families loved the idea. “Everyone wants to help. It’s gotten much bigger than a couple of tables,” she adds, laughing.
A staff member made a life-size scarecrow, and another enlisted her husband to build a large lemonade stand. Another staff member used her artistic skills to create signs for the market. “Staff are having fun doing these things,” says Smith. 

The farmers’ market will run once a month, allowing residents to enjoy ‘shopping’ without any expense.  Yucalta staff will be able to purchase items also, so the market can be a small fundraiser.
Other projects include installing water tanks filled with multi-coloured jellyfish, music streaming, movie nights, therapy dolls, large body pillows, new nameplates and ‘tree of life’ displays with peoples’ family histories.  Many of the projects are receiving financial support from the Campbell River Hospital Foundation and the Yucalta Lodge Auxiliary. 
The goal is to enrich the residents’ environment, says Hoegler. “It’s bringing the outside world into Homestead. Some of them don’t leave the facility like they used to, so they don’t see the outside world anymore.”

The CLEAR initiative paved the way for these staff-led projects, says Jones.

“We started small and identified a handful of residents and looked at non-pharmacological approaches, and out of that birthed all of these different ideas.”

One successful tool developed during the CLEAR project are activity carts, filled with puzzles, colouring sheets and other simple activities. Volunteers use the materials in the carts to engage with residents.
Music therapy is another program presented to support dementia care. The Campbell River Hospital Foundation has committed to funding that work.  Yucalta Lodge is currently looking for a music therapist. 

Through the CLEAR initiative, they encouraged staff to do simple things that they believed would improve residents’ quality of life. One family member expressed as a key wish that her husband would probably prefer not to have feminine, flowered curtains in his room.

“A housekeeper and the social worker got wind of it and they just went ahead and swapped curtains with another resident’s room who preferred the flowered curtains,” says Jones. “It worked out really well.”

Overall, staff were able to reduce the use of unnecessary anti-psychotic medications among the CLEAR study group by about 3%.  Perhaps more importantly, the CLEAR initiative got them working in a new way, says Hoegler.  

“It’s opening doors to new methods for how to deal with dementia. It’s nice for us to be able to take that and work with it.”

Jones and the other staff at Yucalta believe these projects are only the beginning. Among other things, they are looking at upgrading an outside walkway so residents can safely enjoy walking outdoors, adding a city scene decal to the wall across from the bus stop and purchasing a furry robot seal (PARO) programmed to interact with people who have dementia.  They also want to expand these projects outside the Homestead Cottage to the other two cottages of the care home. Yucalta Lodge cares for 95 residents and a 4-bed Hospice unit.

Jones credits staff like Smith and Hoegler for being a driving influence behind these changes.

“We have some very motivated staff in Homestead and both Rebecca and Emily are leaders in that unit,” says Jones. “I just want to say, wow, you are both amazing! Amazing employees and amazing people.”

Hoegler and Smith brush off the praise. “We’re passionate about our work and we’re also passionate about this project,” says Hoegler.  “I’m happy to come to work every day. What we have going on is pretty special.”


If you are interested in learning how you can support any of the projects at Yucalta Lodge, please contact Jae Yon Jones at jaeyon.jones@viha.ca.

If you would like to learn how you can support these innovative programs and your friends and loved ones living at Yucalta Lodge please contact Stacey Marsh at the Campbell River Hospital Foundation, stacey.marsh@viha.ca  (250) 286-7164 or Georgia Munro at the Yucalta Lodge Auxiliary, gmunro22@hotmail.com.

Watch this video for more information about the CLEAR initiative at Yucalta Lodge.

Watch this video for a look at the bus stop, farmer’s market and other Yucalta Lodge projects.

 

Media Inquiries:
Dominic Abassi
250.755.7966
Dominic.Abassi@VIHA.CA