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WoodGreen Community Services

Building Dementia-Friendly Communities in Toronto:The Home and Community Sector Experience

March 16, 2017




Overview

Introduction to WoodGreen Community Services

What is the Role of Home and Community

System Challenges in Toronto

Community-Led SolutionsSingle Point of Access

Emergency Department Diversion

Education and Training

Blue Umbrella Project

Toronto Intergenerational Partnerships

Looking Ahead: Lessons from Community-Led Solutions




WoodGreen serves 37,000 clients annually in Toronto and offers a range of programming including Immigrant Services, Employment, Child and Youth Programs, Housing and Homelessness Services, and Community Care.

The Community Care Unit works to enable seniors to remain in their own homes for as long as possible, and helps adults living with mental health challenges who face significant barriers including poverty, inadequate housing and social isolation.

Community Care Unit Program Areas

Developmental Services Food Services

Health Promotion Clinics Assisted Living

Mental Health Services Recreation

Respite and Caregiver Relief Social Work

Transportation and Services Crisis Services



What is the Role of the Home and Community Sector in Ontario’s Dementia Strategy?

• Services should reflect the unique needs and choices of people with dementia

• People living with dementia have difficulty finding out what services are available

• Community services that fit people’s existing needs may reduce crisis situations that lead to unnecessary emergency department visits

• Education is needed to help care partners develop knowledge and skills

Highlights from the Ontario Dementia Strategy Discussion Paper


What is the Role of the Home and Community Sector in Ontario’s Dementia Strategy?

• As part of Ontario’s Dementia Strategy, WoodGreen’s Seniors Advisory Council co-hosted a community consultation with the Alzheimer Society of Ontario

• Sixty community members, seniors and caregivers participated on November 9, 2016

• Participants raised the importance of culturally-appropriate care as a way to reduce stigma


Engaging Clients and Caregivers in the Dementia Strategy



What System Challenges are we Facing in Toronto?

• Seniors are the fastest growing population group in Toronto, and are expected to make up 22% of the population by 2041

• In Toronto, 22% of seniors 55+ live alone, and 44% of seniors 85+ live alone, which puts them at higher risk of social isolation and dementia

• It is estimated that 937,000 Canadians will be living with dementia by 2032

Shifting Demographics

Increase in the number of seniors living alone at risk of dementia

Sources: TC LHIN, 2016; Stats Can, 2011; Alzheimer Society of Canada, 2017




• In Ontario, informal caregivers provide 2.9 hours of care for every 1 hour of personal support funded through CCAC or CSS budgets

• In the Toronto Central CCAC, informal caregivers only provide 2.5 hours of care for every 1 hour of personal support, 14% less than the provincial average

• Changes in family structure, demographics, and women’s participation in the labour force will lead to a shrinking pool of informal caregivers

Fewer Informal Caregivers

Fewer caregivers available and lower number of hours being provided

Sources: Preyra Solutions Group, 2017




• The Toronto Central LHIN has fewer LTC beds per senior and the longest wait time in province for seniors waiting at home for LTC placement (243 days)

• In 2016, 63% of LTC residents in Ontario had dementia and 90% had cognitive impairment

• Last year in the TC LHIN, over half of the referrals that were denied were due to behavioural issues

Lack of Long-Term Care

Shortage of long-term care beds and challenges with managing behaviours

Sources: TC LHIN, 2017; OLTCA, 2016


Community-Led Solutions

Single Point of Access

• An integrated single point of access to a continuum of community services

• Effective resource for non-medical emergencies

• Point of access for seniors, families, caregivers, and providers

• Provides information, referrals, over-the-phone crisis intervention, and access to mobile crisis intervention

• Targeted outreach to public/community spaces




Emergency Department Diversion

• Crisis Outreach Support for Seniors (COSS) program serves the whole City of Toronto

• Mobile crisis team is triaged through the Toronto Seniors Helpline

• Outcomes include increased safety for seniors living alone, earlier identification of dementia and reduction in ED usage

• In a survey of clients, 50% indicated that without COSS services they would have sought assistance from the ED or 911




Education and Training

• WoodGreen provides affordable housing for more than 1,000 people in Toronto’s East End

• WoodGreen employees at our housing locations have been trained to recognize signs of dementia, regardless of their role or job function

• Training and education is also provided to tenants to recognize if someone in their building is exhibiting signs of dementia




Blue Umbrella Project

• Reduces stigma through education and training

• Engages people with dementia as both co-facilitators of training and as program evaluators

• Model for engaging private-sector businesses as healthcare partners and community resources

• Successful roll-out across Ontario


Sources: University of Waterloo, 2017

Photo: St. Thomas Times Journal



Toronto Intergenerational Partnerships

• Facilitates partnerships for other community organizations that break down barriers and reduce stigma

• Children and youth provide vital services for seniors, such as security checks, friendly visiting, and program facilitation (volunteer or paid)

• Children and youth gain experience, confidence, knowledge and contribute to community-building


Sources: TIGP, 2016

Photo: TIGP



Looking Ahead

Lessons from Community-Led Solutions

Leverage existing resources to do more with less

Meaningful client engagement

Expand the definition of “care partner”

Create new pathways to reach isolated seniors

Recognize that there is no single solution

Create working partnerships with other agencies


Alzheimer Society of Canada. (2017). Dementia numbers. http://www.alzheimer.ca/en/About-dementia/what-is-dementia/Dementia-numbers

Ontario Long Term Care Association. (2016). This is Long-Term Care 2016. http://www.oltca.com/OLTCA/Documents/Reports/TILTC2016.pdf

Ontario Ministry of Health and Long-Term Care. (2016). Developing Ontario’s Dementia Strategy: A Discussion Paper. https://files.ontario.ca/developing_ontarios_dementia_strategy_-_a_discussion_paper_2016-09-21.pdf

Preyra Solutions Group. (2017). TC LHIN One Community: Highlights from the Analysis to Date. Presentation to the One Community summit, March 3, 2017.

Statistics Canada. (2011). Referenced by Toronto Foundation. Retrieved from: http://torontosvitalsigns.ca/main-sections/demographics/#_edn21

Toronto Intergenerational Partnerships. (2016). Intergenerational Partnerships Annual Report, 2016. http://www.tigp.org/sites/default/files/file_upload_directory/TIGP%20-%20Annual%20Report%202016.pdf

Toronto Central Local Health Integration Network. (2016). Integrated Health Services Plan 2016-2019. http://www.torontocentrallhin.on.ca/resources/reports.aspx

Toronto Central Local Health Integration Network. (2017). Long Term Care Wait Times and Capacity Planning Update. Presentation to the Regional Quality Table, February 28, 2017.

University of Waterloo. Dementia-Friendly Communities - Blue Umbrella Project Update. Retrieved March 2017 from: https://uwaterloo.ca/murray-alzheimer-research-and-education-program/dementia-friendly-communities-blue-umbrella-project-update


References

http://www.alzheimer.ca/en/About-dementia/what-is-dementia/Dementia-numbers

http://www.oltca.com/OLTCA/Documents/Reports/TILTC2016.pdf

https://files.ontario.ca/developing_ontarios_dementia_strategy_-_a_discussion_paper_2016-09-21.pdf

http://torontosvitalsigns.ca/main-sections/demographics/#_edn21

http://www.tigp.org/sites/default/files/file_upload_directory/TIGP - Annual Report 2016.pdf

http://www.torontocentrallhin.on.ca/resources/reports.aspx

https://uwaterloo.ca/murray-alzheimer-research-and-education-program/dementia-friendly-communities-blue-umbrella-project-update