Peel Manor chosen for specialized unit to help residents with cognitive conditions like dementia

Seven years ago, the Region of Peel began a pilot program with a UK-based organization that transformed part of the Malton Village Long Term Care facility into the first “Butterfly Home” in the province. The pioneering approach created a personalized, “home-like” environment to connect with and care for dementia patients who have unique emotional needs. 

The model, shaped by Meaningful Care Matters (formerly Dementia Care Matters) in Britain, had shown remarkable success in helping those suffering from Dementia, which impacts about a quarter of Canadians over the age of 80. 

Specially trained staff focus on the specific experiences of each patient and use a range of communication approaches to relate to them, with attention to certain feelings expressed by those in their care and emotional responses that can create important connections. 

According to the Region, the initiative has resulted in “improvements in quality of life, increased engagement between those living and working in the home, less use of antipsychotic medication without a diagnosis of psychosis, and positive impacts on workplace culture for staff.” Its efforts received a Quality Award in 2019. 

New funding announced by the province will help expand its efforts to care for the growing number of elderly patients with complex needs in their care. 

On January 29, the Ontario government announced a $5.5 million investment to create three new Behavioural Specialized Units (BSUs) at long-term care facilities in Brampton, Etobicoke, and Timmins. As part of the investment, Peel Manor in Brampton will receive just over $1 million for a 26-bed BSU.

“BSUs offer residents enhanced levels of care that is patient-centred and founded in evidence-based practice. They are designed to provide transitional, specialized support for seniors whose challenging behaviours have become unmanageable in their current setting,” according to the province. 

Provincial officials have failed to adequately fund long-term care facilities for years, and the Region of Peel has been particularly neglected, even though dementia and Alzheimer’s disease together were the second leading cause of death in the Region (for women it was the leading cause of death) in 2012, according to regional government data from a 2019 Comprehensive Health Status Report. 

The effects of this neglect were felt throughout the pandemic when COVID-19 was ravaging retirement and long-term care facilities across Ontario.

Peel Manor in Brampton will be receiving a roughly $1 million investment to build a new 26-bed Behavioural Specialized Unit to care for those with dementia.

(seniorshomecare.com)

“These additional beds will allow seniors with dementia and severe cognitive impairment to move out of hospitals and receive safe, quality care,” Stan Cho, Minister of Long-Term Care, stated in the press release. 

By expanding the amount of BSU beds, more complex Alternate Level of Care hospital patients and community members can be served with care specific to their needs while they are staying in long-term care facilities, avoiding these residents having to face hospitalization, the province says. 

“People with complex behaviours due to cognitive conditions like dementia are often more difficult to place in long-term care homes because of the specialized care required to support them,” the press release explained, sharing that the investments will help to meet the needs of communities who are struggling. 

Kipling Acres in Etobicoke is also getting a roughly $1.1 million investment for a 17-bed BSU and Golden Manor in Timmins will receive $312,800 for an eight-bed BSU. The new units will bring the total number of BSUs to 21 with 398 beds in facilities across the province. 

Just over $3 million will be invested across the specialized care facilities for staff training.

According to the Alzheimer Society of Canada, dementia is a broad term for a collection of symptoms, including memory loss, mood changes and difficulties thinking, problem solving and language, which are caused by a range of impacts on brain function that can be due to abnormal features of aging, diseases, such as Alzheimers, or strokes. Cognitive conditions like dementia are not a normal part of aging and they often result in complex behaviours and require specialized care. 

The additional specialized units will provide “increased staffing, a tailored environment, focused behavioural assessment and enhanced care planning,” the Province announced.

A recent report from Ontario’s Auditor General found the investment may not go far enough. 

According to a December 2023 AG investigation, more that a third of long-term care facilities the AG visited were “denied funding to hire dedicated behavioural support staff.” It also found that while the Province established 307 beds in behavioural specialized units at the time of the report (soon to be 398 with the new additions), the supply was “limited and the admission to these units is generally restricted only to residents with a dementia diagnosis.” 

Data from the Region of Peel show 87 percent of people living in LTC facilities “have a cognitive impairment, including dementia further contributing to the complex care needs of residents,” with 830 residents served across the five facilities based in Peel in need of “increased staffing to meet legislative requirements to support quality care and infection prevention and control measures.” 

Staffing shortages continue to be a critical issue in delivering care to residents across the Region and the province. Between part of 2021/22–22/23, at least a quarter of LTC facilities in Ontario “failed to consistently reach the provincial targets for hours of direct care,” the AG found in its review of staffing levels for nurses and personal support workers.

“Recruitment and retention continue to be a significant challenge in the long-term care sector due to a shortage of health human resources in Ontario,” the report explained. Centres are increasingly reliant on temporary contracts with private, for-profit companies for agency staff who the AG found do not “provide residents with the same continuity of care as permanent staff,” with “mistakes like medication errors” occurring more often among these staff members. 

They are also significantly more costly to hire than permanent staff due to the lack of legislation to cap the amount that agencies can charge long-term care facilities. The AG estimated the average hourly rate for an agency registered nurse was $97.33/hour, 142 percent higher than the average of one directly employed by a facility ($40.15/hour), “with a portion of the difference retained as profit by the agencies.”

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