places to flourish

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Places to Flourish. Transforming Practice, Place and Policy for long term care settings Ann Coyle National Planning Specialist for Older People Health Service Executive. Rita. Has been in residential care for three years Makes sure the dog is let out - PowerPoint PPT Presentation

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Page 1: Places to Flourish
Page 2: Places to Flourish

Places to FlourishPlaces to Flourish

Transforming Practice, Place and Policy for Transforming Practice, Place and Policy for long term care settingslong term care settings

Ann CoyleAnn Coyle

National Planning Specialist for Older National Planning Specialist for Older People People

Health Service ExecutiveHealth Service Executive

Page 3: Places to Flourish

RitaRita

Has been in residential care for three yearsHas been in residential care for three years Makes sure the dog is let outMakes sure the dog is let out Takes her time getting up after breakfast in bedTakes her time getting up after breakfast in bed Sorts out the seeds for the gardenSorts out the seeds for the garden Visits Kathleen Visits Kathleen 94, wheelchair bound, in pain, several cancers94, wheelchair bound, in pain, several cancers FlourishingFlourishing

Page 4: Places to Flourish

MickMick

Dense stroke, mostly bed boundDense stroke, mostly bed bound Worked on the building site-early riserWorked on the building site-early riser Politics and sportPolitics and sport Nothing to do except ‘ate and drink’Nothing to do except ‘ate and drink’ Connectivity through care routinesConnectivity through care routines Alone in a busy placeAlone in a busy place CompanionshipCompanionship LanguishingLanguishing

Page 5: Places to Flourish

FlourishingFlourishing

ConnectedConnected ChallengedChallenged ImportantImportant

LanguishingLanguishing

LonelyLonely BoredBored helplesshelpless

Page 6: Places to Flourish

Residential care policy Residential care policy contextcontext

Workhouses, County Homes, Geriatric Workhouses, County Homes, Geriatric hospitals, Community Nursing Units, hospitals, Community Nursing Units, Private Nursing Homes.Private Nursing Homes.

Shift from public to privateShift from public to private Introduction of NHSS and RegulationIntroduction of NHSS and Regulation Quality initiativesQuality initiatives

Page 7: Places to Flourish

ChallengesChallenges

Challenges in public systemChallenges in public system InfrastructureInfrastructure StaffingStaffing

Growth of private sector curtailed by Growth of private sector curtailed by banking crisisbanking crisis

DemographicsDemographics

Page 8: Places to Flourish

Ideological challengesIdeological challenges

Medical model, Medical model, Hierarchical models, Hierarchical models, Segregation Segregation Regulatory modelsRegulatory models

Page 9: Places to Flourish

OpportunityOpportunity

Begin a new dialogue Begin a new dialogue What do you want?What do you want? What do we as a community want?What do we as a community want? What do older people want?What do older people want? What is possible?What is possible?

Page 10: Places to Flourish

International ContextInternational Context

Move to new models of careMove to new models of care More hopeful- FlourishingMore hopeful- Flourishing Smaller Scale- DomesticSmaller Scale- Domestic Care based on relationships/CompanionshipCare based on relationships/Companionship More involvement of residents and familiesMore involvement of residents and families Greater connection to local communitiesGreater connection to local communities

Page 11: Places to Flourish

ModelsModels

Irish modelsIrish models Housing with CareHousing with Care Creating communities within our Creating communities within our

communitiescommunities

Page 12: Places to Flourish

Learning from Irish Learning from Irish ModelsModels

Strong explicit and lived value systemStrong explicit and lived value system Dependency of resident is not a barrierDependency of resident is not a barrier Does not require more staffDoes not require more staff Staff enthusiastic about the changesStaff enthusiastic about the changes Hard workHard work Environment still a barrierEnvironment still a barrier

Page 13: Places to Flourish
Page 14: Places to Flourish

ScaleScale

Economic view 50 bedsEconomic view 50 beds Emerging Evidence Emerging Evidence More direct care with the same number More direct care with the same number

of staffof staff Food and Medication savingsFood and Medication savings Less turnoverLess turnover

Page 15: Places to Flourish

Housing with CareHousing with Care

Many examples internationallyMany examples internationally Shifts the emphasis from hospital to Shifts the emphasis from hospital to

housinghousing More emphasis on autonomyMore emphasis on autonomy Dementia careDementia care

Page 16: Places to Flourish
Page 17: Places to Flourish

Creating Communities Creating Communities within Communitieswithin Communities

Sheridan WyomingSheridan Wyoming Not Public, Not PrivateNot Public, Not Private Developed by a not for profit group of Developed by a not for profit group of

volunteersvolunteers Building developed through combination of Building developed through combination of

state grants, philanthropy and fund raisingstate grants, philanthropy and fund raising Cost paid through state funding systemCost paid through state funding system Small scale living, stand alone- domestic Small scale living, stand alone- domestic

designdesign www.sheridangreenhouse.orgwww.sheridangreenhouse.org

Page 18: Places to Flourish
Page 19: Places to Flourish

Where to?Where to?

Dialogue about policyDialogue about policy Culture shift from care and protection to Culture shift from care and protection to

growth and flourishinggrowth and flourishing Share experiences and learn from each Share experiences and learn from each

other and elsewhereother and elsewhere Involve everyoneInvolve everyone GoodwillGoodwill

Page 20: Places to Flourish

Places to FlourishPlaces to Flourish

A space to develop and share thinking A space to develop and share thinking and knowledgeand knowledge

Evidence of good practice- Evidence of good practice- netwell centrenetwell centre CollaborationsCollaborations Embrace diversityEmbrace diversity

CommunicateCommunicate www.placestoflourish.orgwww.placestoflourish.org

Page 21: Places to Flourish