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Toronto city council to look at new Butterfly nursing home care program that is a success in Peel Region
April 24, 2019
Moira Welsh

Toronto is being asked to transform its 10 city-run nursing homes into places of warmth, friendship and fun by implementing a new long-term-care model that is taking hold in Peel Region.

Councillor Josh Matlow, the city’s seniors advocate, said he will present a motion Monday asking council to direct the city’s top long-term-care bureaucrat to adopt the same Butterfly program that Peel used to create a homier, happier life for residents in the Redstone dementia unit at Malton Village.

Peel regional council recently voted to expand the program to dementia units in all five of its municipal homes. Matlow said he wants the program in every Toronto nursing home unit -- not just those for people with cognitive decline.

“I have visited many different long-term-care facilities, public or privately run, and obviously some are far better than others, but what they all share is an institutional environment,” Matlow said. “There’s so much more we can do as a society to ensure that seniors live in places that feel like homes.”

Peel’s yearlong experiment with the British-based Butterfly program, the first in Ontario, was documented in a Star investigation called The Fix.

Residents who previously spent their days staring at the floor or watching TV soon came back to life. Workers spoke about falling in love with jobs that provided a sense of purpose. Year-end data showed staff sick days dropped dramatically, saving that one unit a “conservative” estimate of $50,000 a year. There were also declines in resident antipsychotic drug use, falls and depression, all of which save money in the overall health-care system.

The move to transform Toronto nursing homes is applauded by geriatrician Dr. Samir Sinha, author of Ontario’s seniors strategy and co-chair (with Matlow) of an “accountability” group that advises the city on its seniors agenda.

“Here’s the opportunity -- the city of Toronto runs the largest network of municipally funded homes in Ontario,” said Sinha. “As a taxpayer, as a citizen of Toronto, I want to make sure that the homes I am funding are providing the best possible care.”

Sinha and Matlow said the 60 experts in the accountability group -- created by Matlow to challenge the city to do more for seniors -- are pushing Toronto to follow Peel’s lead.

Redstone’s transformation captivated industry leaders. Dozens visited when the pilot finished in the spring. One private chain, Primacare Living, will bring the program to its homes in September; Peel says others are seriously considering it.

In Toronto, Mayor John Tory read The Fix and sent a letter to Reg Paul, general manager of long-term care, asking him to “examine the feasibility” of bringing it to Toronto.

“We must not leave any stone unturned in looking for the best available means of caring for (seniors with dementia),” Tory wrote in late June.

Matlow’s motion -- if successful -- directs staff to get the job done. He’s hoping it passes without delay, since this is the last council meeting before the fall municipal election.

The motion would also require the general manager to join Matlow on a tour of the Redstone unit; give a progress report on transformation to councillors at the first meeting of the community development and recreation committee in early 2019; and, one year after implementation, give the same committee a report on financial impacts and potential savings.

Matlow said he’s optimistic councillors will vote in favour of the motion, “if the mayor and council are sincere about improvements for our long-term-care homes.”

Nancy Polsinelli, Peel Region’s commissioner of health services, said she’ll be watching with fingers crossed.

“How courageous of them,” Polsinelli said on Friday. “I completely commend them. Being courageous is knowing that we are a village and we are all working together in creating a revolution.”

Polsinelli said she has a list “as long as my arm” of homes that are interested in Redstone’s success.

“It is coming alive. I am seeing it,” she said.

Sinha said the story of Redstone’s transformation “sparked” a movement for change from the 60 seniors experts in Toronto’s accountability group.

“What I love about the Butterfly initiative is that it gives us a really good example of something we can do with respect to the care we provide,” Sinha said.

Toronto’s 10 city-run homes have 2,641 residents and 3,300 full- and part-time staff. If the city adopts Butterfly, it could influence other facilities to create their own full-scale transformations. In addition to the 10 municipally run homes, there are dozens of private and non-profit nursing homes in Toronto, housing thousands of residents.

Sinha said he was especially interested in the impact the Butterfly program had on Peel’s staff. At Redstone, workers who were once forced to race from task to task are now allowed -- actually, expected -- to take the time to sit and chat with residents, give hand massages and eat together at long, family-style tables.

Happier staff, with fewer sick days and lower turnover, will lead to cost savings -- a key consideration, Sinha said.

“Where we directly see the benefit is in terms of improved staffing costs. Improved morale and less time off sick translates into more intangibles like better resident well-being.”

If the Butterfly program comes to Toronto, there would be costs for the yearlong staff training and renovations. Peel Region is adding extra staff to its dementia units.