The Northern Way of Caring in a Geriatric Special Care Unit

Gregory Marr, BSc, MHA, CHE

Manager, Residential Programs

Joyce Bangira, RN, BScN

Clinical Care Coordinator, Gateway

Special Care Unit

• 14 Long Term Care Beds

• Secure Wing

• Advanced Dementia

• “Behavioural Unit”

Common

Areas

Resident Rooms

Tub Room, Supply

Resident Rooms

Special Care Unit

Although home to 13% of Gateway’s population:

• 72% of aggressive incidents

• 42% of minor and moderate harm

“Transition unit” with an average length of stay of 24 months

Strategy

1. Consistent and appropriate staffing levels

2. Consistency in clinical practice and care delivery

3. Geriatric Interdisciplinary Team

4. Interdisciplinary pre-admission huddles

5. Supportive environment

Staffing Levels (previous) LTCA 1

(8hr)

LTCA 2

(4.75 hr)

LTCA 3

(8 hr)

LTCA 4

(4 hr) 0645

1845

1845

0800

1445

2245

1600

2000

24 hours

LPN 2

(12 hr)

0645

LPN 1

(12 hr) 0645

1445 1245

LTCA 5

(8 hr)

2245

0645

Staffing Levels (new) LTCA 1

(12 hr)

LTCA 2

(12 hr)

LTCA 3

(4 hr)

LTCA 4

(12 hr)

0645

1845

1845

0730

1730

2130

1845

0645

24 hours

LPN 2

(12 hr)

0645

LPN 1

(12 hr)

0645

1845 1930

Geriatric Interdisciplinary Resource Team

• Long Term Care Aides, Licensed Practical Nurses, Registered Nurses, Recreation Therapy, Geriatric Psychologist, Geriatric Psychiatrist, Families

• Creative collaboration and care planning

6 Month Results

• 50% decrease in aggressive incidents

• 3 Transitions off of the wing

“Because we are always the same people working

together and because East Wing is a small unit, we are

like a work family”

“The fact we only do care when they are ready for care allows us to do care

more often an without any aggression”

What’s Next?

• Conducive Environment