Navigating The Labyrinth For Optimal Care

1. Navigating The Labyrinth For Optimal Care Kristie Clark, R.N., MScN, Clinical Nurse Specialist RGP – Middlesex/London Robin Coatsworth-Puspoky, R.N., MScN, Clinical Nurse Specialist RMHC - London

2. Declaration of Conflict of Interest • Both Robin and Kristie work in the field of geriatrics and have consults with residents who are experiencing behaviour and mood symptoms. • This research is not privately funded and no apparent conflict of interest was identified through the ethics application.

3. Other Members of the Research Team • Dr. Lisa Van Bussel, Geriatric Psychiatrist • Anne Jarvie, R.N., MScN, Clinical Nurse Specialist RPP • Lynda Parker, MSW, RSW, Social Worker RGP • Leslie Post, MSc.PT, Physiotherapist RGP • Cheryl MacDonald, BScOT, Occupational Therapist RGP • Dr. Dorothy Forbes,PhD, Assistant Professor, The University of Western Ontario • Dr. Iris Gutmanis, PhD, Director Evaluation and Research, SGS • Sherri Groulx, RN, RMHCL Discharge Liason Team • Kelly Simpson, M.A., Education Coordinator, SGS • Donna Scott, RN, BScN, Best Practice Guidelines Coordinator, SW

4. Purpose of Presentation To share our plan of how we are going to develop resources that meet the needs of LTC providers who are caring for residents with mood and behaviour symptoms and that incorporate the National Guidelines for Seniors’ Mental Health The Assessment and Treatment of Mental Health Issues in Long Term Care Homes (Focus on Mood and Behaviour Symptoms).

5. Background • High prevalence of mental health disorders among LTC residents (Borson & Fletcher, 1996; Moylan & Carr, 2005) • Concern re: accessibility and availability of external resources when dealing with challenging resident behaviours (MOHLTC, 2007) • Lack of knowledge of existing resources and poor linkages b/t health sectors was noted as a barrier to optimal care (MOHLTC, 2007)

6. Background Continued • RGP team was experiencing a high number of referrals from LTC homes that was related to mood and behavioural issues. • Recognized that the recommendations in the CCSMH guidelines addressed a lot of these issues.

7. Focus Groups • To gain a better understanding of care providers’ perspectives on what behavioural issues are occurring in LTC settings in Middlesex London. • Explore care providers’ needs in LTC to effectively respond to identified behavioural issues. • Examine how LTC staff would like information and/or education on available resources disseminated.

8. Methodology - Recruitment • All LTC homes in Middlesex/London will be invited to participate in focus groups. • Directors of care and administrators will be approached. • Recruitment flyers • Staff meetings • Overhead announcements

9. Methodology – Focus Group Format • 3-8 participants/group • 2-3 research staff • Onsite at LTC homes • Letter of information and confidentiality addressed • Demographics collected verbally • Question Guide Format

10. Data Collection & Analysis • Focus groups to be recorded • Field notes • Transcript-based analysis using a thematic approach. • Results shared with all participating LTC homes • Results used to help resource development

11. Potential Outcomes • To have an increased understanding of LTC staffs’ needs for responding to residents’ behavioural and mood symptoms. • Development of resources that incorporate the national guidelines recommendations and that meet the needs of LTC healthcare providers. • Improved care for residents experiencing behavioural and mood symptoms.

12. Conclusion • Ethics has approved our project. • We are at the recruitment phase of this project and are looking forward to sharing our experiences and findings with you next year.

13. Questions? Comments! Feedback  They always say time changes things, but you actually have to change them yourself - Andy Warhol