RNAO Fellow .

Providing person-centred care to those living with dementia

Cynthia Chovance

Award: RNAO/AMS Fellow

Co-Sponsor: St. Peter's Residence at Chedoke

  • Patient/family/caregiver voices

During her RNAO Fellowship, Cynthia focused on increasing staff knowledge and their ability to provide truely compassionate and person centred care to those living with dementia within a secured unit in a long-term care home. Initial information gathering consisted of a multi-faceted approach that included, but was not limited to:

  • Review of evidenced based articles and Best Practice Guideline
  • Data collected from a variety of internal staff, family/resident surveys
  • Pharmaceutical reviews on the usage of psychotropics and analgesics
  • Observations made on the secured unit

Literature review and experiential review support that all behaviors have meaning. Responsive behaviours are most commonly linked to boredom from lack of stimulation, inappropriate staff approach, non-supportive environments or a lack of care plans that focus on the individuals likes, dislikes and needs.  Findings were presented to the interdisciplinary leadership team and suggestions provided on how to implement new strategies to address the gaps.  Recommendations highlighted the positive changes already in place or in progress throughout the home and expanded on opportunities for changes to support compassionate resident care for those living with dementia in a secured unit.

Changes that occurred prior to, during the fellowship period and currently in progress includes but is not limited to:

  • Volunteers are now trained in Dementia Care by the Alzheimer Society and have implemented Montessori activities
  • Volunteers are given orientation to the secured unit and volunteer hours have increased
  • Living spaces have undergone many changes to provide a better home-like environment including the addition of a bathing suite
  • All staff will be trained on the following techniques: Montessori, Gentle Persuasive Approach (GPA) and Virtual Dementia Training, Pain Screening
  • Staff will have team leaders during each shift to charged with maintaining person centered care and building effective teams
  • Partnering with Alzheimer’s Society for counseling for families and in-house education/support groups

The joint RNAO/AMS Fellowship has allowed the continued development of a healthy workplace environment and a cultural shift that is promoting and supporting compassionate client-centered care.  The interdisciplinary team will continue to enhance the secured unit and then implement successes throughout the entire home.