Innovations In Care
In 2019, Henley House in St. Catharines became the first privately held long-term care home in Ontario (and only the second Home overall) to receive the distinguished Butterfly Model of Care accreditation for dementia care.
The Butterfly Model of Care was developed by Meaningful Care Matters™ (formerly Dementia Care Matters™), an international transformative support and culture change organization based in the United Kingdom with more than 20 years of experience in this field. The Butterfly Model focuses on delivering emotion-focused care that connects with people in a dignified, human way. It addresses the holistic needs of the individuals and supports quality of life for each person living with a dementia across the whole of their lived experience.
Butterfly Model of Care
Focusing On Feelings
The Butterfly Model of Care uses a feeling-centric approach to care that centres on eight key components:
BEING person centred involves helping staff to shift their focus from only doing ‘tasks’ to being able to reach people on the inside.
ENABLING quality of life starts with really seeing, hearing, feeling the lived experience of people. This also involves measuring the minute by minute experiences of people and being determined to improve the moment.
INSPIRING leadership means guiding people away from detached management to a new professionalism of attached leadership. Attached leadership is where people lead from the heart and not just by the hand.
NURTURING staff’s emotions in dementia care, recognises the need to support people's emotional labour. This centres on fostering positive team relationships while requiring the development of an emotion led organisational strategy.
GROWING training that works signals a move away from tick-box courses and awareness level competency training. The new focus is on the development of people's emotional intelligence through reflection, modelling and coaching.
ACHIEVING real outcomes is all about focusing on policies, procedures and systems as the secondary focus. Balancing and measuring quality of service and quality of life as the primary goal becomes the new focus.
SUPPORTING staff in dementia care to modernize and to restore compassionate cultures of care is critical. This involves staff being developed to merge clinical best practice with the new focus of staff knowing how to lead and personally model person centred care and relationship focused support.
MATTERING in a dementia care home involves centring on the core skills in staff of Feel, Look, Connect and Occupy while creating culture change through developing a community based on Share, Reach, Relax and Matter.
Achieving 12 Clear Outcomes
In Butterfly Care Homes a wide range of quality of life and quality of service outcomes are focused upon:
1
A house model – breaking the care home up into domestic scale, recognizable houses – in imaginative low cost ways
2
Creating housekeepers – transforming outdated ways of working as domestic and catering staff into housekeepers being the heart of the home in each house
3
Removing us and them – clearing away the boundaries and barriers that separate us from feeling people's lived experience and providing an environment, a ‘look’ that emphasizes the quality and value of close relationships
4
Removing controlling care – enabling staff to understand how each moment in the day is an opportunity and choice to turn a potentially controlling or neutral task orientated response, into one that is a real, positive, social, shared connection
5
Removing central dining rooms – preventing the ‘herding’ of people from one room to another and creating in lounge/diners a positive, engaging, social occasion where food preparation, visual choices, sensory stimulation and social connections turn the mealtime experience into a key part of social interaction in the day
6
Matching – preventing people experiencing unnecessary stress by being all muddled together at different ‘points’ of a dementia, by grouping people together in ‘houses’ at a similar point of experience. This gives both people living there the best chance to thrive and have a sense of well being, while enabling staff also to really provide specialist skills to people in focused groups
7
Relaxing the routines – freeing up the staff team, by giving them permission to be with people, while fostering team work to still flexibly also achieve the discreet running of the home
8
Filling the place up – turning the home into an engaging place with loads of opportunities to reminisce, touch, feel, carry objects and be engaged in domestic living. This requires an over exaggerated ‘staging’ bringing items of ‘stuff’ closer to people
9
Enjoying mealtime experiences – training staff how to sit and ‘be with’ people sharing a meal, while keeping the conversation going by rehearsing conversation topics and introducing memories and placing engaging items on the table, in pockets etc. to talk about
10
Turning staff into butterflies – helping staff to draw on a wide variety of ways to engage and occupy people in the moment, from staff wearing ‘activity’ belts’ and connecting with people, to lifting the atmosphere with short minute by minute ‘activities’
11
Feelings before behaviours – providing a set of ‘recipes’ for staff on the meanings behind behaviours. Training staff on approaches which acknowledge that people living with a dementia rely less on facts, logic and reason and, therefore, put more trust in feelings
12
Measuring well-being – giving staff practical tools to increase people's well-being and decrease ill being. Helping staff to see that quality of well-being is the primary indicator of good quality dementia care
The Internal Transformation
The introduction of the Butterfly Model of Care requires radical changes in staff roles, training, day-to-day operations as well as to the physical design of the Homes - a process that takes more than a year to plan and implement.
It involves committing to a series of transformations that includes shifting from:
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doing detached management to being an attached leader
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over emphasizing physical care to prioritizing emotional care
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providing sterile, clinical, hotel environments called ‘units’ to creating busy, filled up, engaging places that feel like ‘home’
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focusing on task orientation to being comfortable with a relaxed, freed up atmosphere
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purchasing training on dementia care awareness about ‘others’ to developing learning about being person centred in ourselves
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running a home for people to involving people in the running of their own home
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emphasizing separateness in how a building and ‘we’ look, to appearing more informal, best friends and family like
This was truly a transformative experience for Primacare, one that led to a complete cultural change in our organization that affected all of us very deeply. It was a lot of hard work but our care teams met that challenge head on. And when you see the impact it has on our residents and the joy it gives family members and staff, it’s all worth it, each and every day.
The Results
“I’ve learnt that people will forget what you said, people will forget what you did but people will never forget how you made them feel.”
- Maya Angelou
The Butterfly Model of Care is all about going back to the real essence of care. Butterfly Care Homes are focused on ensuring that the real feeling of mattering is within the veins of their model of care and the heart of compassion is their core priority. When things come together, it works. Butterfly Model of Care homes can be real homes, places to be celebrated, where there are passionate leaders, heartfelt staff, engaging environments, true family involvement and people really living.
