Five years ago, William Osler Health System (Osler) set out to make a profound change in how patients with dementia receive care within an acute care hospital environment. In February 2023, Osler's Acute Care for the Elderly (ACE) Unit at Brampton Civic Hospital was Accredited with Level 1 Distinction by the United Kingdom-based consultancy, Meaningful Care Matters (MCM). Osler's ACE unit is the first acute care health hospital system in the world to implement The Butterfly ApproachTM.
Developed by MCM, The Butterfly Approach is an emotion-based, person-centred model of care for patients living with dementia, which recognizes that a patient's emotional needs are just as important as their physical needs. Implemented in a number of Long-Term Care (LTC) homes globally and in Canada, Osler believed this ground-breaking program could also greatly benefit patients in hospital.
“Since implementing this approach on our ACE Unit, we have seen an increase in patient and family satisfaction, staff and physician engagement and also staff retention," said Patricia Geerlinks, Osler's Director, Women's & Children's Programs, also Director, Seniors' Health, until April 2023. “Since initiating the program, the team has observed fewer patient falls, an improvement in patients' dementia-associated behaviours, and a reduction in their functional decline."
Stepping into Osler's ACE Unit, the environment is vastly different from a typical hospital unit. Beige hospital walls have been replaced by vibrant colours. Large vinyl wall decals convey the experiences of everyday life and provide orientation, way-finding and stimulation to patients living with dementia.
“Dementia can affect a person's ability to judge spatial relationships between objects or to see subtle colour differences – this can lead to expressive behaviours," said Dr. Sudip Saha, Osler's Medical Director of Seniors' Health and Division Head of Geriatric Medicine. “Bright colours and wall decals help patients navigate through the unit, creating a setting that is more appropriate, accessible and enjoyable for people living with dementia,"
While environmental transformation is a key element of The Butterfly Approach, an equally important aspect is the relationship between the patient and their health care team.
“ACE Unit staff receive extensive training in emotion-based, person-centred care, and every interaction with the patient is seen as an opportunity for positive, meaningful care that takes into account who the patient was before they developed dementia," said Chanese Lambert, Osler's Clinical Services Manager, Seniors' Health. “Team members are recruited with as strong a focus on emotional intelligence, as their qualifications and years of experience."
Upon admission to the ACE Unit, patients are assessed for both their medical history and personal history, allowing the care team to better understand who they were before they became a person living with dementia.
“If we are able to recognize what a patient needs and anticipate it in advance, then we'll greatly minimize them feeling emotionally distressed, reducing the onset of responsive behaviours, as well as the use of pharmacological interventions," noted Geerlinks.
In Osler's catchment area – spanning Brampton, North Etobicoke and surrounding communities – the population growth rate is three times the provincial average. Projections indicate that there will be an 83 per cent rise in the seniors' population nationally in the next eight years.
“Dementia is one of the biggest health care challenges of our time and, in the absence of any curative or disease-modifying treatment, we must think of other ways to support patients with dementia by incorporating new methodologies like The Butterfly Approach to ensure we continue to provide excellent care," said Dr. Saha.
Osler will be closely monitoring the impact The Butterfly Approach has on patients within an acute care hospital environment with the hope to expand to other areas.
“This entire experience has been transformative, not only for the patients in our care and their families, but also for the staff and physicians who care for them," said Geerlinks. “Osler and the ACE Unit are trail blazers and I hope that we can be the spark that ignites the flame of a necessary paradigm shift in dementia care, not just here in Canada, but around the world."