DEMENTIA CARE AND ORGANIZATIONAL CULTURE: CHALLENGES IN LONG TERM CARE

Abstract

<p><strong>ABSTRACT </strong></p> <p>In the current climate of downsizing and cost cutting within the health care system in Ontario, the Long Term Care (LTC) sector is faced with the present and future challenge of providing care for a growing population of people afflicted with dementia. LTC facilities are generally regarded as a suitable location for people with dementia experiencing behavioural disturbances to live out the last years of their lives. Critics, advocates and researchers are concerned with the capacity of facilities to meet the complex care needs of this vulnerable population. Confronted by barriers such as staff shortages, increased workloads and acuity of resident care facilities are struggling. The purpose of this study was to explore what characterizes a LTC facility that allows the staff to receive and respond well to the care needs of their residents experiencing behavioural disturbances, to better understand the organizational culture and practices that distinguish them from facilities that are not as successful in their efforts to provide resident-centred care.</p> <p>A small qualitative study of specialized geriatric outreach case managers working within a number of different LTC facilities was conducted using personal interviews to draw forward their experiences and observations. This group of professionals was uniquely positioned to witness the organizational cultures and practices within facilities associated with good and responsive care. Analysis of their accounts suggests that an organizational culture within a LTC facility that is able to create an environment that builds capacity among the staff to provide responsive care, was resident-centred, had an inclusive work culture, provided support and work flexibility was better able to be responsive to the needs of residents with dementia experiencing behavioural disturbances. The findings also revealed the importance of not losing sight of the impact front-line staff can have on making changes and pushing back against the current social policy agenda and constraints in LTC.</p>