A Department Risk Assessment was previously conducted for Huron Lodge. The final report dated, July 7, 2018, identifies managing employee scheduling due to employee absenteeism as a Critical Risk. The addition of Part-time Nursing Records positions would mitigate this risk.

THERAPEUTIC RECREATION AIDES (TRA) – 2 FTE (1 Full-time, 2 Part-time)

Therapeutic Recreation Aides (TRA) are responsible for the stimulation and engagement of residents at Huron Lodge. Therapeutic Recreation Aides are trained to deliver dementia appropriate therapies such as Snoezelen and Montessori based approaches. As Huron Lodge residents are experiencing more dementia and sundowning symptoms, additional part-time staff are required for evening and weekend direct care. Sundowning is a term used to describe behaviours that occur during the late afternoon or evening hours. These behaviours can include confusion, anxiety, aggression, agitation, or restlessness. The addition of 2 part- time TRA’s will allow for the provision of this care during weekend and evening hours.

Huron Lodge is moving towards a version of the “Butterfly Model of Care” for the dementia area of the home. The dementia care area is home to 32 residents whose needs are extremely complex and require a dedicated full-time Therapeutic Recreation Aide to provide therapeutic interventions. The Butterfly model is based on a person-centred philosophy that recognizes that individuals have unique values, personal history, and personality, and that each person has an equal right to dignity, respect, and to participate fully in their environment. Services and supports are designed and delivered in a way that is integrated, collaborative, and mutually respectful of all persons involved, including the person with dementia, family members, caregivers and staff.

A full time TRA is required in this home area as part of the care team to engage and support residents in meaningful activities, which is even more critical due to COVID visitation restrictions. When residents are engaged, there are fewer opportunities for responsive behaviour towards other residents and staff members.

KITCHEN STAFF – 1.5 FTE

As noted with the increase in the Case Mix Index (CMI) for Huron Lodge, the resident population needs have increased drastically. The Resident Bill of Rights must be followed which translates into the development of individual menus to meet complex clinical requirements, prevent allergies, and respect religious and cultural diversities.

Huron Lodge must align with hospital guidelines for therapeutic diets and textures. Hospitals have adopted the International Dysphagia Diet Standardization Initiative (IDDSI), which is a world-wide program that has substantially increased the types of diet textures and fluid consistency that must be prepared and provided for the residents. This has had a great impact on the regular therapeutic diets and has increased food preparation and production time, and staffing requirement within the department to prepare the required diets and textures. The addition of the 1.5 FTE will decrease the Corporation’s significant risk by providing the staff required to properly adhere to the guidelines.