A touch. A word. A pair of pants or a doll. These may be simple things to us, but for someone who suffers from dementia or other cognitive diseases of the brain they can be triggers for aggression or articles of comfort. This is the reality faced by those who care for some of the most challenging residents at Caressant Care in Bourget. Fortunately, the home also has a remarkable program with remarkable staff who help residents struggling with conditions such as dementia, Alzheimer's, schizophrenia, bi-polar, personality disorders and other challenges cope every day so that they can enjoy quality of life.
Behaviour Supports Ontario or BSO is not unique to Bourget or to Caressant Care. While this feature focuses on the BSO program at Bourget, we recognize and appreciate all those who help residents through their BSO program in their homes across Caressant Care.
At Bourget, the program is used to support virtually every resident at Bourget and is led by PSW Dayna McMahon, who we met in the March issue of Caressant Care Connections. Dayna champions the behavioral support program at Caressant Care Bourget and is instrumental in ensuring all residents are getting the referrals and follow ups that they need completed.
"We use a tool called 'getting to know me' that helps us understand our residents better," says Dayna. "It is a survey type tool that residents and their family members fill out to tell us about themselves including what their likes and dislikes are, what they did when they were younger. We then use this information, as well as other input, to develop personalized care plans for each resident." Care plans are placed on BSO summary boards so that staff can see and respond accordingly to each of the resident's needs.
A resident's personal history can help Dayna and the BSO team unlock buried memories. One such resident was an indigenous person from up north. Staff helped him develop a board about his home and his traditions and he really enjoyed the experience because it helped connect him to his past. This is work that Dayna has been doing for the past four years though she hasn't been doing it alone. She is part of an interdisciplinary team that also includes monthly visits by BSO Geriatric RN Mirelle Desnoyer from nearby Hawkesbury General Hospital.
She helps Dayna and the BSO team Bourget with a resident-centered approach to care and behaviour management. The team is also helped by Dr. Lisa McMurray, a geriatric psychiatrist from the Royal Ottawa Hospital who consults on some of the more challenging cases.
"Our main priority is to help residents live a good quality of life as safely as possible given their cognitive challenges and we always try and use non-drug therapy first to see if it decreases unwanted behaviours," says Mirelle. "Then we re-assess as needed and do lots of family consultations as well to really understand what is going on with a resident, what the triggers are and how we can avoid them."
Dayna recalls an incident where a resident had become extremely agitated because he was being given a pair of pants he didn't like. The pants were discarded and a notation in the care plan was made for future reference to avoid upsetting the resident in future about pants of a certain colour and texture.
Through Dyana's and Mirelle's BSO leadership, and the one-to-one care Dayna helps provide, the home has been able to reduce the number of episodes of escalation and hospital transfers due to behavior-related issues.
As part of the PSO program, Bourget has two cats that are life-like therapeutic toys that help calm residents. The "animals" purr and move like a real cat and residents love to take them for strolls in their arms. Some residents enjoy doll therapy where they get to dress them up in clothes while others benefit from putting together puzzles. Residents who become agitated are often provided weighted blankets that help to calm them.
On Wednesdays, residents with dementia participate in the Montessori program that helps them keep their minds active by doing sorting activities such as placing colour chips in the correct coloured bin. There are also group therapy classes that Dayna leads to encourage others to help each other.
Mirelle says Bourget is her favourite place to visit because of the people there from residents to the staff. "They are very open minded about approaches to care and are flexible and willing to try something new to help their residents."