Carefor’s transformational shift during a time of great change

Steve Perry
CEO

Few aspects of our society evoke the response that healthcare does. It affects us all without regard for age, financial circumstances, skin color or religious beliefs. The creation of a system that satisfies the needs of all who use it is the elusive quest of all who are part of it. Carefor is no exception. While we don’t serve everyone in Eastern Ontario, as one of the largest not-for-profit health and community services organizations within the Champlain Region, our client base is broad and diverse. More than this, the needs of our clients are among the most immediate and complex of anyone in our region. For this reason, the ways in which Carefor has grown and had to adapt in such times of change had to be done with deliberate intention. The costs of not doing so are too great.

Over the past three years as CEO, I’ve been focused on strengthening and positioning Carefor for a transformational shift in how health system partners work together in a new integrated system of care. With this goal in mind, I spent my early days in this role recruiting new leaders, engaging with key partners in the community and across the province and supporting the development of new strategic directions incorporating diverse stakeholder input that will help position Carefor for a successful future filled with growth opportunities and innovation. As a unique and diversified organization, offering a full range of home health and community-based services, and with health system transformation fast-approaching, there was no better time to demonstrate Carefor’s value as an integral partner for Ontario Health Teams.

With the creation of Ontario Health, we quickly mobilized in response to invitations from emerging health teams across the region. Fast forward several months, we are one of 11 convening partners with active contribution in an approved Ottawa Health Team/Équipe Santé Ottawa and a valued partner supporting several other teams in development and on their way towards approval. Reflecting back on this past year, I believe Carefor has experienced more change in one year than it has in its 100+ years of history serving people in our community. As CEO, I could not be more proud of the team at Carefor and our contributions in helping to inform and shape a new integrated, people-centred health care system in our community.

“The best view comes after the hardest climb” has become my living mantra these days. Just as we were settling into a new rhythm with health teams, the COVID-19 pandemic consumed the world’s attention, overwhelmed health systems, crippled the global economy and impacted our physical and mental health over the past number of months. This rate at which this virus has spread forced us all to retract and retreat within our own organizations to protect our people and safely provide much needed care and service to the most vulnerable members of society. In a matter of days, our focus shifted from operational growth and the formation of health teams to supply chain management and procurement of personal protective equipment to keep our staff and clients safe. As we approach the end of our third month of responding to COVID-19, Carefor’s values have been put to the test in this unprecedented time of uncertainty.

·       Partnership. Working with government, funders, system partners, vendors, foundations and donors to ensure we have the right tools and resources to provide continued services.

·       Respect. Respecting the safety and security of our people and those most at risk in this pandemic, our vulnerable seniors and those living with chronic health conditions. 

·       Innovation. Leveraging our creativity and resourcefulness to provide care in new and different ways to support those living with limited means and support systems while in isolation.

·       Responsiveness. Responding without hesitation; thinking fast on our feet and acting quickly to maintain confidence in our people, our systems and our partners.

·       Excellence. Striving for the best, regardless of what curve balls are thrown our way; delivering exceptional quality of care and services and in that vein, continuing to be the provider of choice for people and partners alike.

Guiding the direction in which Carefor operates, these five core values keep me and my team focused and connected to what’s most important while motivating us to sustain, innovate and expand our programs and services in the community. Having said that, leading a team of 1600 health care employees through a global health pandemic is not something I had anticipated in my early tenure as Carefor’s CEO. Over the past three months, I’ve learned more about crisis management and organizational resilience than I’ve experienced in my 20+ years as a leader. Unfortunately, there is no one playbook that guides you when confronted with an unprecedented crisis. While I’ll be the first to admit that Carefor’s response to the pandemic has not been without its challenges,  I believe the secret to our teams’ success in these first three months of the pandemic  can be attributed to: 1) leading with a calm and steady focus; 2) acting quickly and decisively; 3) communicating clearly and often; 4) taking care of oneself and the team; and 5) looking for opportunities to innovate.   

Lead with a calm and steady focus: during times of uncertainty, staff quickly look to their leaders for a calm response and clear plan of action. In the early days of the pandemic, like others in health care, our team launched quickly into emergency response mode with a focus on staff and client safety, while sustaining our business operations. Supported by daily huddles, where we discuss such things as the number of cases of suspected/confirmed COVID-19, staffing availability, program status and closures, isolation of residential clients, etc., our goals were achieved due to creativity, persistence and a “can do” attitude. Well-chaired huddles with a focused structure and action plans enabled us to efficiently and effectively manage incoming public health and Ministry directives to make quick decisions. 

Act quickly and decisively: COVID-19 hit the world hard and fast this past March. With no time to spare, this element of speed drove our team into fight or flight mode as we mobilized to protect our people, our clients/residents and our organization. At the beginning of the pandemic, we spent long days and evenings interpreting public health and Ministry directives, moving people to remote work arrangements with appropriate technology, procuring PPE from diverse sources, setting up safe workspaces at client homes and in clinics, in our hospice and at our retirement facilities. Each of these decisions required quick action, but only after careful review of the evidence and consideration of the implications. With people’s health on the line, the motivation to think quickly, ethically and decisively has never been more important. I am convinced that Carefor had and continues to have low rates of COVID-19 cases among our people due to our early responsiveness, our collaborative approach and our ability to act quickly and decisively in our actions.  

Communicate clearly and often: in the home and community care business, communication can be a real challenge as the majority of staff work remotely, travelling from client home to client home with very little downtime to catch up while in transit. Add to that, many of our staff have multiple employers requiring different information technology and mobile communication tools. Our goal over the past several weeks has been simple – communicate clearly and often. Our communications team was central to our efforts, implementing a multi-pronged approach to getting our key messages to our people in several ways. Using email, video, virtual meetings and an intranet site designed for COVID-19, our staff have received weekly direction, resources and support from their leaders. Although at times staff have sought answers to questions more quickly than we are able to respond to through this pandemic, we have maintained an open, transparent and thoughtful approach to communicating those decisions that have been made in addition to the information and directives available to us from public health, Ontario Health and other credible sources.

Take care of yourself and your team: the physical, mental and emotional toll that COVID-19 has taken on people all over the globe is unprecedented. Moving into week 12 of balancing the significant pressures at work and challenges of home life in this time of uncertainty is draining.  As we hear about restrictions being lifted, there is a degree of fear and concern circulating about a second wave coming this fall. I recognize the toll that this pandemic has had on my own resilience over the past few months. As a leader tasked with taking care of my team, I must make it a personal priority to be that role model that others desire to follow. Practicing self-care is key to managing long-term, high stress situations with a calm, collected and strategic response. My mission at this stage of the pandemic is to support my team by encouraging them to slow down, rest and re-build those energy reserves over the summer months in order to be ready for whatever situation comes our way in the fall.

Look for new opportunities: I love great quotes… one of my favorites is “challenge = opportunity,” so much so that it stays on my office wall as a visible reminder. Short, simple and undeniably true in all scenarios. We know that innovation evolves from times of struggle, strain and testing of societal, workplace and industry norms. Humans are like all other species on this planet; when tested by crisis we generally rise to the occasion and find alternative ways to evolve and grow. In healthcare, we’ve likely witnessed more innovation and change in the last twelve weeks of this pandemic than we have seen in a decade. Despite new partnerships and action teams that have evolved over the past year within emerging Ontario Health Teams, the health system continued to struggle with concepts like true team-based and virtual care. With the emergence of a global pandemic, merely weeks later health care agencies are mobilizing to work collectively to deal with COVID-19 and deliver virtual health care services like never before. In our own organization, we have partnered with aTouchAway by Aetonix Systems Inc. to connect residents with their loved ones, while in isolation. We are preparing to pilot a virtual care and remote home monitoring program for use with clients. Another great example of innovation is our efforts to develop a ‘working from home’ culture at Carefor. As a not-for-profit organization, our mission is focused on providing services at low cost. This has become even more critical as our organization continues to grow. COVID-19 impacted us at a time when we were gearing up to explore new physical space options forcing us to focus on quickly relocating office staff to their homes. Within days, we procured equipment and had people working effectively from the safety and security of their homes. We are now taking advantage of this opportunity to rethink and inform our space plans for the future.

None of these five success factors would be possible without a supportive and engaged board of directors and a strong, dedicated and resilient leadership team; each bringing their own knowledge, expertise and energy to the table. I feel very fortunate that I am surrounded by a group of passionate people who wasted no time mobilizing into action at the first sign that the pandemic would impact us here in Eastern Ontario. Finally I would be remiss not to mention the quality and commitment of our staff at Carefor. Leadership through a crisis is made easier when you’re working with a team that is as resilient, professional and compassionate as Carefor’s.

Climbing this proverbial ‘mountain’ over the past several months has been both challenging and rewarding for us in many ways. My success in leading our team through this first wave of the pandemic is undoubtedly attributed to our steadfast commitment to Carefor’s core values; values that act as our moral compass and guide our efforts forward. However, leading in the face of a crisis requires more than just values, it requires a calm and steady focus, quick and decisive actions, ongoing clear communication, a healthy and mindful approach as well as openness to new opportunities. It also requires a sense of collaboration and teamwork that goes beyond typical levels. Organizational and personal resiliency is the name of this game and will continue to be the goal as we support our people and our clients through this pandemic. As we continue our climb, we must maintain our focus, keep ourselves healthy and take in the view when we reach the summit.   

[Photo Credit: Ashley Fraser/Postmedia]

Helping your loved one at the end of life

Jason Samson
Director, Eastern Counties 

Jason Samson, Director of Carefor Eastern Counties and former manager of Carefor Hospice Cornwall, talks about what people need to know as they support a loved one through the end of their lives.

Time seems to freeze when you learn that someone you love has been deemed palliative. Some will instinctively push the news away. Others will cry, or swing into action. No matter what happens on that day, time and life continues regardless of whether you feel ready to cope.

You and your loved one may have pursued promising treatments and perhaps enjoyed a period of remission from the encroaching illness. At some point, however, further treatments are no longer an option. This is when not only the loved one, but also the primary caregiver, needs support.

Some of the support you need is emotional. The fears and feelings that surface now are better aired than ignored. Some of the support you need concerns practical details. End-of-life care needs to be arranged and funeral plans need to be considered.

Most will need to recognize and deal with anticipatory grief, a grief felt when someone you care about is seriously ill. It is a feeling you will grapple with as you grieve a loss before it completely unfolds.

Depending on the type of illness and the relationship you share, you may feel closer and more determined to make the time you have left count. Perhaps you are terribly anxious about what’s to come or so firmly focused on last-resort treatments that you continue to push away any thoughts of the end. Possibly you long for release or feel guilty and conflicted. In many instances a Social Worker can be of great assistance often recommending that you speak with sympathetic friends or family members, especially those who have weathered similar situations. Joining a support group online or in person and reading recommended books designed for caregivers.

Making time to say goodbye is important. Talking about death is difficult. You may worry that you’ll undercut your loved one’s will to continue or overwhelm them in fear. Speaking about death is not a form of abandonment and it’s normal if your own anxiety, sadness, and discomfort makes your words choke in your throat.

The more important practical aspect of end-of-life planning touches on having a Power of Attorney in place for Personal Care as well as ensuring a signed “Do Not Resuscitate” directive is in place.

Few of us wish to think about these matters at difficult times. But it’s easier to consider many of these issues before they become pressing.

A Power of Attorney for Personal Care helps ensure that a person’s health care wishes and end-of-life concerns are known and respected. This document addresses how aggressively doctors should pursue life-sustaining measures and when quality of life or comfort measures should be paramount in the care provided. The document designates who can speak on your loved one’s behalf and sets forth medical wishes that will guide health care decisions when your loved one becomes unable to make decisions.

Your loved one will need to inform family members. Discuss his/her wishes for end-of-life medical care. This is a difficult topic and it may help to begin by speaking about a recent case in the news or the treatment of someone you know.  It is important to repeat periodically. Have discussions with family and medical staff more than once to be sure wishes are understood. This is especially important as circumstances change.

A do-not-resuscitate order (DNR) informs health care professionals not to attempt cardiopulmonary resuscitation (CPR) if the person’s heart stops beating. This document is written only when these measures are unlikely to revive a dying person or to prolong meaningful life. Generally, during the last stage of a terminal illness, CPR is not very likely to result in successful resuscitation.

It’s very important to discuss the need for a DNR with your loved one and his/her physician. Understand that medical care will still be available your loved one will continue to receive appropriate medical care to treat short-term illnesses or injuries and relieve pain or other troubling symptoms.

It’s worth noting that health care and emergency personnel are required to attempt CPR if there is no DNR, even if the patient has asked family members to request that they forgo this measure.

Keep the original DNR handy. Generally, only originals are valid, so it’s wise to have several originals of a DNR form. Always keep one original handy in the person’s home; the other should be carried by the patient or a caregiver at all times.

Consider the options of receiving Hospice care. Hospice care is a practice, which encompasses physical, emotional, and spiritual needs. It may take place at home, at a nursing home, an assisted living center, or a Hospice residence. When a cure is not possible and aggressive treatment isn’t desired, hospice care offers symptom relief, pain control, and a great deal of support.

The hospice team works with the families and their loved one to develop a personal plan of care. Family, partners, and close friends may be invited to help in many ways, such as by assisting with daily tasks like feeding and bathing and offering comfort by reading, sharing music, holding hands, and simply being present.

Hospice programs vary greatly but generally share similar characteristics in the range of offered services. Hospice staff can administer pain medications, provide nursing care, and offer emotional support. Before and after a death, emotional support is extended to caregivers. Many programs offer bereavement counseling up to a year after a death.

The hospice team is multidisciplinary including specially trained doctors, nurses, personal support workers, social workers, people who offer spiritual care, and volunteers.

It is wise to investigate hospice programs well in advance, as there may be a waiting list for some facilities. Consider what will be expected of you and whether the hospice’s philosophy of care—including use of antibiotics, resuscitation, and hydration—matches that of your loved one and other family members. And ask about support programs for caregivers and availability of inpatient services.

For more information about Carefor Hospice Cornwall, please visit: https://cornwallhospice.com/.

5 tips for coping with loss in a time of isolation

Shannon Ball
Patient & Family Supportive Services Coordinator – Hospice

Under normal circumstances grief can commonly be an intensely isolating experience. Everyone around the world is experiencing such rapid changes affecting their everyday lives and routines, creating a tsunami of collective loss and grief. Experiencing the death of a loved one during these unprecedented times creates a unique and intense grieving experience and requires people to adapt their coping strategies, rituals, and self-care to comply with necessary social distancing.

Here are some tips and tools for coping through this difficult time:

1. Rituals

Rituals which the bereaved normally rely on such as funerals, and visiting loved ones to say goodbye are commonly being taken away from us due to pandemic restrictions. This loss of formal rituals can make the loss of your loved one seem surreal and even more difficult to accept. Remind yourselves that once it is safe to do so you can go ahead with Celebration of Life ceremonies and in-person gatherings. Although postponing these formal rituals is difficult, it is the right and a necessary thing to do. In the meantime, create your own rituals in a safe environment. Alternative options may include lighting a candle in remembrance, writing a letter of the things you did not get a chance to say, planting a memorial tree or asking people on social media to share stories about your loved one. 

2. Support

Support is needed more than ever for those who have experienced a loss. Communicating with others about your grief experience assists you in making sense out of a life that may have ended in a way that doesn’t make sense to you. Expressing the wide variations of emotions that come along with your grief experience is absolutely necessary. Do not bottle things up. Have a plan of who you can reach out to, and schedule regular check-in calls. Understand that people offer different types of support. Reflect on the ways each person in your life is able to support you. Emotional, spiritual, informational, practical and esteem support are crucial in supporting you during the grieving experience.

3. Stress

Everyone is enduring stress and unpredictability during this time. Adding grief on top of already existing stress amplifies these feelings. Give yourself permission to take breaks from your grief to focus on other areas of stress. Financial stress, risk or loss of employment, and keeping you and your family safe all require some of your time and attention as well. At times, you may not be able to grieve in the moment. This does not mean you should ‘push’ your grief away, but rather, to let those surges of grief come, and then let yourself set them aside, too. If needed, give yourself a designated time each day to focus on your grief.

4. Self-Care

Force yourself during these stressful times to make self-care a priority. Try to keep a routine. Incorporate some distractions into this routine. Maintain personal hygiene, try to eat at least 3 nutritious meals per day. Read, listen to music, meditate, cook, and spend some time outside in the sun. Do things that you enjoy and bring a sense of comfort and happiness to you.

5. Mental Health

Check-in with yourself daily to monitor your mental health and wellbeing. If you are finding the feelings of stress, anxiousness or depression too much to cope with on your own, seek the help of a professional. Inform your physician of your concerns, and also connect with a professional therapist, social worker, or virtual grief support group for extra support. Having a professional provide guidance on your grieving process can offer you a sense of stability during this time which feels very uncertain.

Moojan Haidari
Communications & Fundraising Specialist, Ottawa 

According to the Alzheimer’s Society of Canada, over half a million Canadians are living with dementia, and that number is expected to rise exponentially in the next decade.

That being said, what exactly can you do to keep your brain healthy as you age?

As you may know, a healthy brain starts with a healthy lifestyle. Below, our experts in dementia care weigh in on how you can keep your brain healthy, while touching on how it has made a difference in the lives of their clients.

1. Physical Exercise 

Engaging in a variety of physical activities isn’t just a great stress reliever, it also helps to keep your brain working efficiently.

Carolyn Puderer leads Ottawa’s first Young Onset Dementia program in which members participate in regular aerobic exercise, such as swimming, running, and fitness classes.

“Exercise helps pump more oxygen to the brain to feed its cells,” she explains. “Our members find they have more energy and their mood is more positive in the days after attending our program.”

Don’t forget that your heart should be pumping to reap the benefits of physical exercise. Research has shown that aerobic exercise can potentially increase the size of the hippocampus, which is the area of the brain responsible for memory.

2. Mental Stimulation 

Just like how you can work your muscles to get stronger, you can do the same with your brain.

Giving your brain a good workout can improve cognitive function and mental speed by reinforcing existing connections between brain cells – and to do so is quite simple.

Roxanne Dion-Boudreau, Resurrection Lutheran Church Adult Day Program Team Leader, says reading a story or newspaper, word searches, puzzles, playing cards, quilting, and anything else that keeps your mind active and challenged is essential.

“Reduce your TV time and increase your mental stimulation by finding activities that you enjoy and find meaningful.”

3. Healthy Diet 

The phrase “you are what you eat” has been around for centuries, and for good reason. The brain requires a lot of energy to function, which is why nutrition plays a key role in keeping your brain healthy.

While there are countless diets out there, there is one in particular that has been implemented at our dementia programs and at Richmond Care Home, which is a 16-bed home for women living with dementia.  

Program Manager Carole Green recommends following the Canadian Brain Health Food Guide, which is a food diet that helps older adults “preserve their thinking and memory skills as they age.”

The Food Guide recommends increasing your intake of fresh fruits, vegetables, and legumes and reducing red and processed meats.

 Carling Adult Day Program Team Leader Roma Antonello-Harris also encourages clients to follow an anti-inflammatory diet, after scientists found a link between chronic long-term inflammation in the body and the role it may play with brain health. 

“Eat the rainbow,” she says. “Foods that are rich in antioxidants, leafy greens, and healthy fats, such as fish, nuts, and avocados can help ward off building inflammation in the body and reduce what is there.”

4. Socialization 

Cheryl Conway, Carefor’s Carling Adult Day Program Supervisor, can’t stress enough the benefit of staying socially connected when it comes to brain health.

“There is strong evidence that continued social engagement as we age may be as critical to our brain health as physical activity and a healthy diet,” she explains.

“Maintaining social connections can help protect memory and cognitive function. Being part of a social network fends off loneliness, reduces stress levels and improves mental health, all of which may delay the onset of depression and dementia.”

5. Sleep 

Not getting enough sleep is more than just feeling tired. You’ve probably already experienced some of the terrible side effects, such as anxiety, impulsive behaviours, and changing cognition.

Studies show that sleep influences our physical well-being, central nervous system, and our cognition.

Carling Adult Day Program Team Leader Makini Medina encourages people to follow these simple steps to get better shut-eye: “Exercise in the daytime, get natural daylight, avoid napping, keep your bedroom cool, establish a routine, eat a light snack before bed if necessary, and avoid stimulation (TV or exercise) in the evening.”

6. Music 

I’m sure we can all admit to being surprised by remembering lyrics from a song we haven’t heard in years.  

Research has shown that listening to music activates various parts of your brain, strengthening those neural connections. In a way, music is the medicine of the mind, giving your brain a complete workout, which is why Richmond Care Home Activity Coordinator Katie Hamill incorporates music in the daily routine of each resident.   

“When we have a singalong, the whole home is drawn to the living room to participate to the best of their abilities. Some ladies who cannot follow lyric books are able to sing confidently along to beloved songs by memory. Other ladies hum and tap their feet.”

“Our music programming taps into long-held memories and brings a smile to everyone’s face,” she adds.

National strategy will help people living with dementia in Eastern Ontario

For immediate release
June 18, 2019 

Ottawa – Carefor Health & Community Services welcomes the Government of Canada’s release of a groundbreaking $50M national strategy on dementia. As an agency that provides direct support to people across Eastern Ontario who are living with dementia, Carefor understands the growing need for dementia related programs and funding.

An estimated 228,000 Ontarians are currently living with dementia, with that number expected to rise to 255,000 people in 2020 and over 430,000 by 2038. Beyond these numbers, for every person with dementia there are at least two people that provide care to them who are directly impacted by the disease.

As an organization that provides respite, residential and day programs for people with dementia, Carefor is pleased to see caregiver support be a central tenet of the national strategy. “Dementia affects more than just the people living with the disease. It affects families and communities,” says Carefor CEO, Steve Perry. “Increasing supports to caregivers, who are really at the frontline of our healthcare system, will have a direct impact on people living with dementia. Carefor applauds the government for taking this initiative.”

Carefor’s programs for people living with dementia include the Guest House, Richmond Care Home, friendly visiting and adult day programs which can have a wait list of over one year.

About Carefor

Carefor is a local not-for-profit charity that provides home healthcare and community support services across Eastern Ontario. Whether in the home, in the community, at care facilities or one of our clinics, our 1,500 staff are part of the circle of care that is tailored to our clients’ needs. For more information, please visit carefor.ca.

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For more information, contact:

Trevor Eggleton
Communications, Marketing and Fundraising Manager
O: 613-903-6565
C: 613-415-8675
E: teggleton@carefor.ca