From “The Forgotten Frontline: homecare during the pandemic”:
“This pandemic has shone a light on the extent to which, so few people understand what homecare is. For too many there is still an outdated image of homecare as ‘mopping and shopping,’ as a set of practical activities designed to make people feel better but not much more than that. As almost like an added luxury! The truth could not be further than that”.
Every day on the radio and in social media we hear about the importance of supporting all health care workers providing care, whether this is in the home, retirement residence or long-term care home. “We have your backs” we keep hearing everyone say, but this is not the case for all workers.
On April 25th, the Ontario government made the following press release: “Ontario Supporting Frontline Heroes of COVID-19 with Pandemic Pay – Government Recognizes the Dedication and Sacrifice of Frontline Workers”.
It went on to say: “This increase will provide four dollars per hour worked on top of existing hourly wages, regardless of the qualified employee’s hourly wage. In addition, employees working over 100 hours per month would receive lump sum payments of $250 per month for each of the next four months. This means that eligible employees working an average of 40 hours per week would receive $3,560 in additional compensation. Those eligible to receive the payment will be staff working in long-term care homes, retirement homes, emergency shelters, supportive housing, social services congregate care settings, corrections institutions and youth justice facilities, as well as those providing home and community care and some staff in hospitals.”
But, the policy excluded anyone that was not contracted directly by the government. Despite the fact that most “home care” in the community is delivered by private contractors, the government decided to exclude a large portion of this health care workforce. Perhaps the many smaller providers lacked necessary political influence or more to the point private caregivers were not considered heroes or anything close?
We believe that excluding a great many people from this important gesture is discriminatory and a human rights issue. It has also insulted a great many workers and upset many families.
The government is excluding important people who are providing care to persons in long term care, in retirement residences, and in the home and the community, contrary to the public statement and promise made. The following is from one of our caregivers:
“…in April the Premier of Ontario announced a $4/hr increase on salaries of all frontline workers…it mentioned staff working in facilities, long term care and nursing homes….I agree with the Premier. Healthcare workers are first and foremost deserving of the recognition and financial reward. Now here’s the tricky question: do we as Mosaic frontline workers and PSW’s qualify for the increase? As I read the announcement there’s a line there that says and I quote….”as well as those providing home and community care and some staff in hospitals”…. unquote. I am hoping that it included privately operated healthcare providers. That added incentive will surely boost our financial situation especially at this time, amid the pandemic where commodities, rent and everyday expenses are on the rise.”
We know that our caregivers are making personal sacrifices and taking risks to provide care in the community each and every day. The personal sacrifices they are making include sleeping apart from family, taking extra precautions to avoid contracting the virus and in many instances accepting reduced hours because of the need to avoid multiple person contacts. Many health workers have underlying health conditions, yet society expects them to continue to turn up.
The personal support and nursing care that excluded care workers provide is mostly within personal and intimate space. Many will be going into known higher risk environments such as nursing homes and retirement residences. But home and community care is not without risks: homes may receive a number of visitors including health care workers from private contracted agencies who may visit multiple people and environments on a daily basis. Our frontline staff are not just responsible for providing personal care but social and emotional supports and in the current climate are often the first point of call for monitoring visitors into the home.
The care that these health care workers provide is important to a great many families as public health only provides a limited amount of care. Most of the care provided by public health is task based and of limited duration and is insufficient to keep many persons safe in their homes. Many of the issues we see with care in the home and the community are similar to those we see in long term care. Personal support work and nursing in the community is seen more as a set of rudimentary tasks that have little value. As the quotation at the start of this article says “The truth could not be further than that”. The following is from one of our PSWs currently in a long term care environment:
“It’s hard working in the LTC, even if you’re dealing with only one client….I want to highlight the PSW working one on one. We are not dealing in physical care alone. We are working on the most important aspect, the EMOTIONAL part, which I think is the most important to be taken care of. We deal with their emotions, we talk to them, we laugh with them, we stay by their side where nobody else is with them in a situation they are now.”
Without the care provided by this excluded workforce many more human beings may need to move into long term care homes at a time when it is least feasible to do so and to receive levels of care that have long been recognised to be insufficient.
But excluding the many health care workers who work in private care impacts not only a much more vulnerable work force but also the families for whom the cost of care is itself a sacrifice.
Many of our families have decided to chip in and pay the extra fee themselves. While some families may be able to do so others will not have the financial leeway. We know that families are torn between wishing to support their care providers and being able to provide care in the first place and feel the dilemma intensely. We should not be placing families and caregivers in this situation.
Many of those we speak to believe that the government is supporting all who provide care in long term care, retirement residences and home and community. Not so. There appears to be a distinction between first class citizens who are heroes and other much deserving, apparently second class citizens, who are not worthy of being spoken of in the same breath.
We believe in all caregivers and we also believe in the families they serve. We should not divide and differentiate between what are first and foremost important relationships in difficult times.
Amidst the Coronavirus storm we have managed to piece together a summary of the recent 6th Annual Conference of the European Society for Person Centered Healthcare in London, UK, from 27th to 28th February of this year.
What a conference! Speakers and delegates from around the world, and well engaged panel discussions that overflowed into the breaks and far beyond..
Person centeredness has many perspectives and many disciplines. Whether you are an academic, a physician, a person as a patient, a patient organisation, an administrator, a social worker or home care provider, we all have input into how person centeredness is being shaped.
The central theme of the conference was one of collaboration, or as it was referred to by Dr Amy Price and others in their talks, co-production. Creating a system that can deliver person centered care requires us all to work together, to make sure that all our perspectives are shared and incorporated in the system itself. Everyone is a person, each with valuable perspective and knowledge, each with human rights and sensitivities.
The 2020 conference addressed many of the inputs, conflicts, trends and components of person centered care.
Myriam Dell’Olio (and co-workers) noted that “that while there is surging interest in person centered care, feedback from persons as patients finds that “healthcare professionals are not delivering or implementing… in a meaningful way”.
Dr Michelle Croston, a senior lecturer and advanced nurse practitioner, discussed what it meant to be person centered in the care of people living with HIV. She referenced a Wellness Thermometer that had been developed to assess the wider social and emotional and spiritual wellbeing of persons in addition to clinical and biological concerns – the inserted link refers to a previous presentation on the Wellness Thermometer.
Dr Jeremy Howick talked about the use of positive expectations, empathy and placebos in addressing some of the many ailments that clinical method seems unable to address and a link to one of his and other co-workers papers is provided. Lower back pain is one such area of attention. A UK BBC2 documentary programme did a study on placebos with the help of Dr Howick and found some interesting results.
We then considered the impact of robots, nursing culture, spirituality and artificial intelligence with presentations by Professor Marilyn Ray, Colonel (Ret.) and Colonel Dr Marcia Potter of the US Air Force. The US Air Force through the work of Dr Ray (her Theory of Bureaucratic Caring) and others has helped develop person centered care processes within the US forces medical system, addressing the interaction of formal structures and the needs of the person.
The conference was well represented by “patient” groups: The Patient’s Association (UK), Melanoma UK, Cannabis Patient Advocacy with its mental health focus, Genetic Alliance UK (Rare Diseases) and the Brittle Bone Society, and last but not least Parkinson’s Concierge, a dynamic duo, both living with Parkinson’s and both engaging widely in addressing the many aspects of the disease. The patients organisations discussed many of the barriers they face in helping the needs of persons as patients be recognised, but they also discussed the many ways they are working with health systems and other organisations.
We had a talk from a director of patient engagement at a UK National Health Service Trust (Co-production) that illustrated how bringing in patient engagement within hospitals can significantly reduce complaints and enhance person as a patient satisfaction.
We had a talk from Grace Meadows, program director Music for Dementia 2020, on the importance of music for those living dementia from the perspective of “doing with” as opposed to “doing to”. This was followed by a presentation by Samantha Hughes, a doctoral student, on some important results from one of the longest running studies on social prescribing in the UK. Social aspects of social prescribing and the need to provide ongoing social opportunities beyond the often short periods of these interventions were highlighted results.
Day two started with our own “Jane Teasdale’s” keynote presentation on some of the many complexities of home care, then moved to a presentation on behavioural science and how this impacts decision making for clinicians and persons as patients. Next, Dr. Rajni Lal, a Specialist Registrar in Geriatrics, talked about the decision making process for older people undergoing surgery and how older adults’ priorities often conflict with prescribed surgeries.
We had presentations on quality of life decision making and some of the ethical dilemmas posed by the cost of medical treatments, by Dr Vije Rajput, and a talk from Denmark on some of the pitfalls in assessing infant social withdrawal. This was followed by a light-hearted presentation on Frohlich groups, which is a form of acting therapy for both clinicians and patients.
Dr Bruno Kissling, a Swiss doctor then presented on a person centered framework of interaction for both doctor and patient, addressing trusting relationships, active listening, patient reflection and the consultation as an interactive process, with both doctor and person as patient as experts at “eye level”.
The conference also addressed the importance of digital and data solutions, from pharmaceutical companies reinventing themselves to software developers (RemindMeCare/ReMeLIfe,Simon Hooper) engaging fully with the social and emotional space of the person living in the care home. We had an especially interesting talk from Dr Bharat Tewarie who presented on how artificial intelligence and big data could be used to inform decision makers of human needs, wishes and priorities in health care.
A special thanks to the European Society for Person Centered Healthcare, in particular Professor Andrew Miles and Sir Jonathan Ashbridge for organising and running this highly focused, incredibly detailed and informed set of presentations and discussions.
It is not uncommon to see someone strolling past with a cane, having to rely on it for balance and stability. But don’t be surprised if you see someone zip past you on the street, propelled by specialized walking poles. This is exactly what participating in a fitness activity called Urban Poling (aka Nordic walking) looks like. Just think of cross-country skiing (minus the skis) in an urban setting!
ACTIVATOR poles are a specialized kind of walking pole designed by a Canadian occupational therapist specifically for rehabilitation and active living. It continues to gain popularity among people looking to prevent falls by staying active. One of these individuals is Bob Lewis, who describes himself as follows:
I am 61, overweight and have Type 2 diabetes and [have] twisted my ankle a few times. Now, with the ACTIVATOR poles, I have no problems with balance, sore feet, or going downhill. I enjoy walking because I don’t have my fears of injury.”
Interestingly, perhaps the most valuable aspect of the poles is that they have a look and feel that represents active living in a way that traditional assistive devices, like canes, do not. Fourteen years since the development of the Activator Poles, many have embraced it as just that – a tool to promote active living. Letty Kurucz agrees with this perception of walking poles. She recalls that when her orthopaedic surgeon recommended a cane for her painful knee joint, she felt depressed and discouraged, perceiving herself as disabled at the age 42 and unable to be actively manage her weight. She felt helpless until she saw someone urban poling. At that moment, she recalls that one word came to mind: “Ability.”
You might be wondering about the benefits of walking with these specialized poles? That’s what Urban Poling Inc. founder and occupational therapist Mandy Shintani wondered after a neighbour from Sweden attributed the health of Scandinavians to their culture of walking and in particular, Nordic walking. Mandy was surprised to find independent research studies showing numerous benefits of pole walking in key factors related to preventing falls (as of December 2019, there are 280+ listed on PubMed!). For example: improving core strength, stability, posture, balance and also confidence for walking. Walking with poles offers these benefits because it engages approximately 90% of a walker’s muscles. Walkers actively swing their arms and shoulders while pressing down on the ledge of the poles’ handles with each step. Doing so contracts the core ab muscles giving the walker a full-body workout.
Conditions like osteoporosis, Parkinson’s, ABI and MS typically produce a stooped posture and a shuffling gait pattern, which are two factors that increase the risk of falls. ACTIVATOR poles support good posture by providing bilateral support while encouraging the walker to stay upright and lift their feet.
Unfortunately, wintertime presents more challenges for walking due to rough and slippery roadside conditions. As a result, many older adults sometimes report feeling trapped in their homes. While walking on ice is not recommended, there are a few strategies for walking more safely in the winter. For example, taking off the rubber tip from the ACTIVATOR poles and using the carbide steel tip underneath, and also walking with supportive footwear and good treads.
With safety in mind, Mandy developed the ACTIVATOR poles with several features to improve balance and weight-bearing capacity. To learn about the research on the patented ACTIVATOR Poles and the walking technique designed for improving balance, go to www.urbanpoling.com
Whether you love walking and are looking for a way to make the most out of your walks or seeking a solution for fall prevention for your clients, one thing is for sure: adding a set of specialized poles to your walk might just be the answer!
For more information contact:
Dolly Mehta, BSc, MSc, MMgt, Health Promotion and Sales Manager, Urban Poling Inc.
T: 416.319.1900 | T: 1.877.499.7999 | F: 604.990-7715 urbanpoling.com
Health Promotion, Urban Poling Inc., 416-319-1900 www.urbanpoling.com
Urban Poling is excited to be partnering with Mosaic Home Care Services in hosting a free round-table discussion on Winter Walking Safety on January 28 @ 10:30 am at the Armour Heights Armour Heights Presbyterian Church (Community Café)! Please join us to learn all about valuable winter walking and fall prevention safety tips while walking with poles.
Diana Oliver, Managing Director of Urban Poling, will be sharing the benefits of this easy and fun activity and will have informative handouts available for all interested participants.
Be sure to come out and discover the proven benefits of pole walking and experience first-hand why Nordic walking is becoming increasingly popular. After all, 4 points of contact with the ground are better than 2, so it won’t take long for you to see how our one of a kind poles can help maximize your safety and boost your confidence while walking in the winter and all year round.
Whatever your age or fitness level, our poles can help you take a confident and safe step forward. We look forward to seeing you at this fun, informative and interactive event where we will all learn to way our way to better health, one step at a time. All are welcome!
Here are some pictures from our Winter Holiday Celebration headlined by Ori Dagan.
“Award-winning jazz singer, songwriter and recording artist Ori Dagan is taking jazz to new and exciting places. His rich baritone voice and impressive abilities as an improviser produce an instantly recognizable sound. In live performance, he surrounds himself with Canada’s finest musicians, performing an engaging mix of material which is always fresh and in the moment.“ https://www.oridagan.com/bio
You can also follow Ori on Twitter: he gets around Toronto, performing at a wide range of eclectic venues. https://twitter.com/oridaganjazz
And the Testimonial:
Christmastime is such a special time of the year and we are so grateful that you, on behalf of Mosaic, provided an opportunity for many of us to join together to celebrate a festive event at Shops on Steeles which was accompanied by live entertainment and good food. We are very appreciative! Thank you.
Sincere thanks and praise for all of the organizers who contributed and worked hard to make the event successful.
This festive celebration brought people together at the mall and helped everyone get into the holiday spirit. I personally loved the Christmastime gathering.
Here are possible thoughts for next year’s celebration. Maybe engage attendees with spirited Christmas carolling and even have someone read the the Night Before Christmas’ poem, maybe by the senior below.
Hope your Christmas is filled with joy and the new year brings only good things to you, your family and Mosaic.
Supporting identity and its opportunity for expression may be a better way of looking at falls risks.
Person centered home care requires sensitivity to the character, identity, wishes and abilities of the person:
Much care provision is still overly focused on completing set tasks, on illness, “age” and the many risks posed by daily living. Person centered home care is dependent on close collaborative relationships sensitive to the person, their preferences, their social and emotional needs and capacities.
Capacities include a person’s mental, physical, spiritual, social and emotional assets and their desire to express them through daily activities, interests, social networks and community. At Mosaic we emphasise what we can do to help the person to express independence and control, and to live meaningfully in their home and community.
Best practises should look at opportunities to develop and maintain physical ability, creative skillsets and social networks at levels meaningful to the person. One important way to do this is to incorporate simple strength and balance exercises into daily life. Research shows that exercises emphasising basic physical strength can support independence and reduce the need for home care supports. We would also emphasise the importance of providing opportunities to continue to do things that might otherwise be done unnecessarily by care providers. Care services should also look to engage family, friends and community, in keeping with the person’s wishes and preferences.
While professional providers of home care services must be aware of medical needs and circumstances to safely provide care, we believe that we have to engage from the person up in order to give voice to and actualise the capacities and identities of persons living in our communities. Home care is not about the loss of identity but the continued support of its expression in daily life.
November. It’s the one month of the year that seems dreary. The days are shorter. The leaves have fallen and the grass is brown. And the cold wind and rain seem to blow right through you. It’s time to cozy up!
Pull out the soft blankets and candles (battery-operated candles are fine). If you have a fireplace consider yourself lucky and use it! Some call this Hygge which is the Danish word describing a feeling or mood of coziness and contentment. It is a lifestyle, not just an evening/weekend/seasonal thing.
And while updating your home is one way to enjoy the month, getting out of your home and being active and around family and friends is also part of Hygge and is important to avoid becoming isolated.
There are so many opportunities to attend interesting events that it’s easier than ever to stay connected, even during the nasty weather. Pop in to your local library to see what programs they have. Guaranteed they have a knitting and crochet group, a puzzle or adult colouring program or perhaps a book club or authors talk is more your style.
At Mosaic, our Community Resource Centres offer a number of programs that are open to the community to attend. We have a drop-in knitting and crochet group that meets weekly and the participants work on their own projects or help with charity knitting. This year, the group is working on hats and scarves for the Out of the Cold program. It is amazing what a small group of people can do to remember those in our community that may be struggling to make ends meet this season.
If knitting isn’t your “thing”, come out to a Mosaic Community Table Talk! Held in various locations for anyone to attend, join us for interesting discussions. The coffee is on us!
Every year on November 11th, we take time to remember soldiers who fought in wars past, as well as current soldiers and those training for the future to keep our world safe. We invite you to attend a Remembrance Day Ceremony at The Shops on Steeles at 404 at 10:30am on November 11th, 2019.
Hygge, knitting for charity, Community Table Talks and Remembrance Day ceremonies are all ways to get involved in your community. You can also stay involved by helping the people closest to you. Perhaps offer to do some yard work for someone who is not able to do it themselves. Offer to pick up some groceries or simply call someone you haven’t spoken to in a while. These are all ways of remembering people in our lives who may not be family, but are somehow connected to us. We refer to this as being a part of a Compassionate Community.
Should you find that a neighbour, friend or family member requires more support, whether this be cooking, cleaning or personal support, Mosaic Home Care is just a call away.
For information on our programs and services visit us at www.mosaichomecare.com or call 416.322.7002 or 905.597.7000.
You don’t need to be a musician to benefit from music therapy.
My name is Dorothy Davies and I am an accredited music therapist with advanced training in Neurologic Music Therapy. In this article, I will be answering some common questions related to music therapy, including:
● Do I have to know how to sing or play an instrument?
● Is music therapy the same as music education or performance?
● What is music therapy?
● Who is it for?
● What areas can be addressed?
Do I have to know how to sing or play an instrument?
No, the focus of music therapy is not on musical skills or expertise. Rather, music is used as the primary tool in order to address clinical, non-musical goals.
Is music therapy the same as music education or performance?
No, music education (lessons) focus on the development of musical skills, techniques, and expertise. Music performance focuses on the implementation of those skills for entertainment purposes.
What is music therapy?
Music therapy is a therapeutic service provided by an accredited music therapist (MTA), in which music is used as the primary tool in order to address clinical, non-musical goals. These may include development and/or training within cognitive, motor, speech/language, social, behavioural, emotional, and mental health domains.
Neurologic Music Therapy (NMT) is a specialized area of music therapy that requires additional training. It is a research- and evidence-based system built on how music perception and music production influences the brain. Music-based exercises aim to address functional, non-musical goals in 3 main areas: motor, cognition, and speech/language.
Did you know that music can be harmful if not used properly?
Accredited music therapists are trained to use music clinically and intentionally in order to support clinical goals and overall health and well-being.
For example, if not carefully delivered, music can bring up trauma for some clients, which requires proper support in response. If not carefully delivered, music can also overstimulate some clients.
Who is it for?
Music therapy has the unique ability to benefit people of all ages and abilities. This includes toddlers, children, adolescents, adults, and elderly individuals. Some examples of client populations that can benefit from music therapy include:
● Brain injury
● Parkinson’s Disease
● Palliative care
● Speech disorders
● Developmental disabilities
● Autism spectrum disorder (ASD)
● Down syndrome
● Attention deficit hyperactivity disorder (ADHD)
What areas can be addressed in music therapy?
Music therapy can address goals related to cognition, motor, speech/language, developmental, social, behavioural, emotional, and mental health.
● Exercises can aim to train and/or rehabilitate functional abilities. These may include:
○ Cognitive goals related to memory, executive functions, and attention
○ Motor goals related to gait, balance, range of motion, gross/fine motor skills, strength, and endurance
○ Speech/language goals related to retrieval and production of functional phrases, speech intelligibility, articulatory control, and respiratory capacity
● Exercises can aim to enhance learning and education
● Exercises can aim to teach appropriate social behaviour and conduct
● Exercises can aim to reduce feelings of depression and anxiety and encourage self-expression and self-exploration
● Music therapy services can also be provided through adapted music lessons, where learning of musical skills are paired with therapeutic goals
Music therapy services can be offered on an individual or group basis.
In summary, music therapy is a unique form of therapy that can address people of all ages and abilities on their journey of realizing potential and shaping health through music.
If you have any questions, please visit www.cornerstonemusictherapy.com for more information.
For specific inquiries, please email me at firstname.lastname@example.org.