Mary is sitting on the couch in the common area of the supportive living facility. Worried and agitated, she asks where her husband is. The nurse, like all of Mary’s caregivers, knows Robert passed away years ago. She also knows that Mary’s dementia triggers frustration, sadness and confusion when someone brings up his death.
“Robert is at work right now,” she reassures Mary. “He’ll be back in a little while. Let’s watch a show and have lunch while we wait for him.”
This is Mary’s reality – her husband is still alive and at work.
Is there a way to reduce the confusion and suffering experienced by people living with dementia and improve their quality of life? The answer is yes.
Two years ago, caregivers at Lifestyle Options Retirement Communities might have brought Mary back to the present. Nowadays, they take a different approach.
In summer 2015, clinical lead and director of care Jennifer Chan, RN, led a project to implement this new approach at Lifestyle Options Retirement Communities – Whitemud in Edmonton. General manager Renate Sainsbury will take over the project lead as Chan moves into a new role.
The Butterfly Homes Model® focuses on offering emotional care to patients, and understanding and respecting the reality of people who have dementia. Dr. David Sheard first introduced this model of dementia care in the United Kingdom.
Butterfly homes aim to move from traditional institutional and utilitarian settings toward the look and feel of a home. Jennifer’s team began with painting the facility walls in bright, cheerful colours and removing clinical signs that said things like “Wash your hands.”
Staff also traded their scrubs for everyday outfits: “This is home to the people living here. When we come in here in our street clothes, we could be their neighbour or their friend,” says Jennifer.
“I have noticed a difference in how the nurses and staff relate to the residents,” says Bonnie-Lee Clarke Olive. “The Butterfly program gives the staff permission to show affection, hug a resident and take the time to interact with them on a personal and individual level. That was not always the case prior to the Butterfly project.”
Mealtimes are now served family-style, and staff take their meals with the residents. People with early stages of dementia are even able to serve themselves, make toast and help set the table -- all small activities that make the facility feel like a home.
Under the Butterfly model, all staff – including cleaning staff – acknowledge residents when they enter their room, whether it’s a simple greeting and small talk, or sitting down to begin a conversation.
Jennifer says person-centered care is all about emotional intelligence.
“It’s how you respond to people around you. Providing care is easier when you have a meaningful relationship with the residents,” says Jennifer.
So if a member of the housekeeping staff enters a room to tidy up, they may engage the resident and lose time cleaning in favour of time spent talking.
“The difficult part of getting staff buy-in was to let them know that this is okay,” says Jennifer. “Of course, a minimum level of cleanliness and tidiness will always be maintained. But let me ask you – is your home always meticulously clean? No, neither is mine! Most homes aren’t. We need to remember that this is someone’s home.”
Before implementing the model, the home scored between six and seven on the Butterfly homes tool, which scores facilities between one and 10 – with one being the best.
“When we first started, the tool showed a lot of resident time was spent in a state of boredom and the mealtime experience was horrific. It broke my heart,” says Renate.
But after they introduced the Butterfly model, they scored a one, the highest quality of life possible. As a result of the new model, they were able to:
“Usually, we think dementia is the end of the road,” says Renate. “But we’ve learned people can still live a beautiful life with dementia. Our hope is that the Butterfly Homes Model® will be available in all supportive living and long-term care sites in the future. We’re feeding their spirit now; that’s the huge difference.”
There are currently six Butterfly homes projects in Alberta. More information can be found at dementiacarematters.ca.
By Crystal Komanchuk, Communications Coordinator