How to Build Collaborative Partnerships Between Developmental Service Agencies and Long Term Care Homes Three Models from Three Regions Karen Belyea, Executive Director, Total Communication Environment Terry Elliot, Program Director, Mary Centre Sandy Stemp, Chief Operations Officer, Reena

Presentation Overview Introductions –Health Care Facilitator Video Reena – Toronto, York region Mary Centre – Peel Total Communication Environment – Ottawa Questions and Answers For more discussion and connections ….

Seniors Health Knowledge Network Applied and became a community of practice in 2008/2009 –Aging and Developmental Disabilities Community of Practice Provincial Network of interested individuals Please join Knowledge to Action Project

History/Background

Locations Supported by Developmental Services Individuals stay in their current locations for as long as they are able Variety of locations including group homes, triplexes, condos, apartments The tipping point for individuals requiring referral to LTC similar to those in the general community

Aging at Home Does not mean never moving to a Long Term Care Home Means maximizing the resources in the community to live as independently as possible for as long as possible – preventing premature admission to a hospital or Long Term Care. This is the same for all seniors in Ontario Many initiatives by the LHINs to promote Aging at Home

Family Homes Most individuals with developmental disabilities live at home with a family caregiver Many different reasons why referral to LTC is needed May or may not be connected to the developmental services system

Reena Social Service agency in North Toronto and York region –Funded – Ministry of Community and Social Services Supporting Individuals with Developmental Disabilities by providing: –Day Supports (over 100 individuals) –Residential Supports (308) From SIL to Elderhomes –Outreach and Respite Options (at least 300 at any one time)

Reena and Aging Reena has been involved with Aging projects since Formed the Ontario Partnership on Aging and Developmental Disabilities – Co-lead of the Seniors Health Knowledge Network, Aging and Developmental Disabilities Community of Practice

Reena Demographics 2013 and 2023

Reena and Aging Oldest individual at Reena was 89 years old Oldest individual currently is 87 years old Oldest individual with Down Syndrome is 67 yrs 53% of our residential clients are over the age of 50 years Currently supporting 11 individuals living in Long Term Care homes

Cummer Lodge

Toronto Municipal Home for 42 years 391 beds, 4 respite Known to support individuals with dementia and challenging behaviour 92 behavioural beds – 8 beds for individuals with behaviours that no one else can support (special project with the LHIN) Specialized skills in supporting individuals with Huntington’s disease (9 persons at present)

Supporting Individuals with a Developmental Disability In the past have admitted individuals with developmental disabilities Partnership with Reena began in 2000 when an individual with Down Syndrome and dementia was admitted Invited to a conference on Aging and Developmental Disabilities Became a member of OPADD Currently Cummer supports 14 individuals with a developmental disability

Current Situation

Current Context 6 Reena clients living at Cummer Lodge –10 individuals who transitioned from Reena to Cummer –6 who have passed away –2 individuals who came from facilities Has evolved from a few hours a week visiting to 3 staff

Facilities Initiative LTC protocol was developed by MCSS and MOH-LTC for the facility project but also covers community agencies LTC protocol spoke to the developmental services agencies remaining involved and providing enhanced supports within LTC –Staffing, Equipment, Private Room, Special Needs - other costs that are not covered e.g. medication not covered by ODB

Facilities Initiative Because of the relationship between Reena and Cummer – MCSS choose the two organizations to transition 2 individuals from a facility to a LTC home. This increases community capacity for the future –The funding remains in this model and others can access these same supports in the future

Cluster Support Model Support and Assist with behavioural needs –Using past knowledge and strategies to develop a support plan –Utilizing behaviour therapist from Reena to come into the Long Term Care Home – assess and develop programs and/or strategies –Acting as a support to the Cummer Lodge team Continue to support with banking, assisting with purchasing items - personal needs

Cross Sector Training Cummer offers Reena staff a thorough orientation Orientation covers amongst other things, Policies and Procedures, feeding, lifts and transfers Reena staff share their expertise in the developmental sector with LTC home staff Cummer staff share their expertise in the LTC/Seniors sector with the DS staff Cummer and Reena staff attend OPADD/TPADD workshops (e.g. U-First)

Other Elements to Consider

CCAC Recognize their critical role in the transition of individuals Relationship building with CCAC is key Need to have a champion within CCAC who is sensitive to the issues of Aging and Developmental Disabilities, understands the limitations on the system and how to help

Role of Family Consent by Substitute Decision Makers –For the application to LTC –For the admission to the LTC home –For care decisions –Some manage finances – others it will be managed by the LTC home or PG&T – or agency that has continual involvement –Crucial involvement prior to choosing a LTC home and continuing through the process

Public Guardian and Trustee CCAC may communicate with the PG&T before admission to LTC Substitute health care decisions In some cases Finances & Estates Invited to Care Conferences

Challenges Flow of Communication Consent and who to contact when an agency is involved – information sharing –DS agency must fully understand who is the SDM and who makes health care and financial decisions prior to admission to LTC Staff training for both DS agency and the LTC home – requires time & money Defining staff roles and shifting roles Finances – things that are not covered by MOH- LTC such as medication not covered by ODB

How you can Implement a Collaborative Model

Building Relationships Important to recognize differences and challenges Recognize we speak different languages –Need to define our terms and be nonjudgmental with how we describe people and support Openness and willingness to work together Try to look beyond barriers

Tips for Success Develop good communication processes –Regular Team meetings with all players Constant evaluation – partnership is constantly evolving Willingness to work through challenges Open minded Good staff orientation and education Understanding the “other” system is key