Implementing and sustaining evidence-based practices in long-term care.

Teamwork and Creativity in Dementia Care at Bloomington Cove Care Community

By: Jessica Abraham RPN, Behavioural Support Nurse, Janet Iwaszczenko, Executive Director and Sue Bailey RN, RNAO LTC Best Practice Coordinator

Bloomington Cove Care Community, Stouffville

Picture a long-term care home in a rural setting where all residents have dementia.  Bloomington Cove Care Community is this home. “We have been successful because we have fostered a support system that allows for creative approaches in dementia care,” remarks Janet Iwaszczenko, Executive Director of the home.  

“Our home is the first of six to receive funding from Behavioural Supports Ontario in York Region,” Iwaszczenko stated. “Hiring Jessica Abraham, RPN as the behavioural support nurse elevated the program.”  Abraham’s work involves nursing assessment, referral and linkages with both in-house caregivers and outside support professionals. “Her skill and growing knowledge helps us address unique challenges such as admitting younger residents with dementia”, says Iwaszczenko.

Abraham credits strong leadership to be the foundation for their success. She explains how daily risk management meetings and daily huddles support new models of care. 

Their outside supports have included a geriatrician and geriatric psychiatrist from Markham Stouffville Hospital, behavioural therapists from Ontario Shores and Mackenzie Health and a psychogeriatric resource consultant from York Region. LOFT Community Services initiated RPN and PSW behavioural support visits and this continues through Mackenzie Health. 

“Behavioural support RPNs and PSWs attend unit huddles at Bloomington Cove and demonstrate techniques to address responsive behaviours during care. The hands-on learning and on the spot meetings have proven to be an effective way to help us meet resident needs quickly” explains Abrahams.  “Gentle Persuasive Approaches and Sienna Living’s Hush No Rush protocol add to our staff learning and success.”

Conducting a gap analysis with Sue Bailey, RNAO’s Long-Term Care Best Practice Coordinator confirmed the home meets recommendations in RNAO’s best practice guideline Delirium, Dementia, and Depression in Older Adults: Assessment and Care (2016). For instance, Bloomington Cove focuses on each resident’s preferences and needs and offers a choice of activities to support living well with dementia.

Bloomington Cove started a project they call “BUILD”, Building Unconventional Interventions Leading Dementia Care. BUILD focuses on person-centred care values. “We use the following therapies, according to resident preferences: lavender, doll, music, pet, sensory, busy hands therapies, and bright light therapy. Craniosacral therapy treatments have also been used effectively for some residents.” explains Abraham.  “By focussing on residents’ preferences we see a reduced number of aggressive behaviours, less resistance to care, and a decrease in the use of antipsychotics. We also see residents experiencing a return of speech and improved sleep.” 

“The lavender aromatherapy has proven to comfort many residents at bedtime and throughout the night. We first tested a lavender reed diffuser and then we placed little sachets holding lavender buds and oil behind the headboards of participating residents,” describes Abraham. For these residents, the rate of disturbed nights decreased from 35 percent to nine percent over a 21-day trial period. “Lavender therapy and other techniques have proven to be successful and demonstrate our approach to person centered care,” reports Abrahams. 

As the Ontario health care system evolves, Bloomington Cove will gain from its well-established ties with external providers and its person-centered approach to dementia care. “We recently expanded our behavioural support team to include a second RPN,” shares Iwaszczenko. 

- About Bloomington Cove Care Community –
Bloomington Cove Care Community is a 113 bed Sienna Living long-term care home, which includes one respite bed. Located just north of Stouffville, Ontario, in a rural setting, Bloomington Cove cares solely for residents with dementia. 

PDF: Teamwork and Creativity in Dementia Care at Bloomington Cove Care Community