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Places to Flourish

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

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Places to Flourish

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  1. Places to Flourish Transforming Practice, Place and Policy for long term care settings Ann Coyle National Planning Specialist for Older People Health Service Executive

  2. Rita • Has been in residential care for three years • Makes sure the dog is let out • Takes her time getting up after breakfast in bed • Sorts out the seeds for the garden • Visits Kathleen • 94, wheelchair bound, in pain, several cancers • Flourishing

  3. Mick • Dense stroke, mostly bed bound • Worked on the building site-early riser • Politics and sport • Nothing to do except ‘ate and drink’ • Connectivity through care routines • Alone in a busy place • Companionship • Languishing

  4. Flourishing Connected Challenged Important Languishing Lonely Bored helpless

  5. Residential care policy context • Workhouses, County Homes, Geriatric hospitals, Community Nursing Units, Private Nursing Homes. • Shift from public to private • Introduction of NHSS and Regulation • Quality initiatives

  6. Challenges • Challenges in public system • Infrastructure • Staffing • Growth of private sector curtailed by banking crisis • Demographics

  7. Ideological challenges • Medical model, • Hierarchical models, • Segregation • Regulatory models

  8. Opportunity • Begin a new dialogue • What do you want? • What do we as a community want? • What do older people want? • What is possible?

  9. International Context • Move to new models of care • More hopeful- Flourishing • Smaller Scale- Domestic • Care based on relationships/Companionship • More involvement of residents and families • Greater connection to local communities

  10. Models • Irish models • Housing with Care • Creating communities within our communities

  11. Learning from Irish Models • Strong explicit and lived value system • Dependency of resident is not a barrier • Does not require more staff • Staff enthusiastic about the changes • Hard work • Environment still a barrier

  12. Scale • Economic view 50 beds • Emerging Evidence • More direct care with the same number of staff • Food and Medication savings • Less turnover

  13. Housing with Care • Many examples internationally • Shifts the emphasis from hospital to housing • More emphasis on autonomy • Dementia care

  14. Creating Communities within Communities • Sheridan Wyoming • Not Public, Not Private • Developed by a not for profit group of volunteers • Building developed through combination of state grants, philanthropy and fund raising • Cost paid through state funding system • Small scale living, stand alone- domestic design • www.sheridangreenhouse.org

  15. Where to? • Dialogue about policy • Culture shift from care and protection to growth and flourishing • Share experiences and learn from each other and elsewhere • Involve everyone • Goodwill

  16. Places to Flourish • A space to develop and share thinking and knowledge • Evidence of good practice- • netwell centre • Collaborations • Embrace diversity • Communicate • www.placestoflourish.org

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