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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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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
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
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
FlourishingFlourishing
ConnectedConnected ChallengedChallenged ImportantImportant
LanguishingLanguishing
LonelyLonely BoredBored helplesshelpless
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
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
Ideological challengesIdeological challenges
Medical model, Medical model, Hierarchical models, Hierarchical models, Segregation Segregation Regulatory modelsRegulatory models
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?
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
ModelsModels
Irish modelsIrish models Housing with CareHousing with Care Creating communities within our Creating communities within our
communitiescommunities
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
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
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
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
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
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