My Wishes Project: Using Innovation to Improve the Quality of Life

Health Quality Ontario “End of Life” report tells us that over 20 percent of residents in Ontario long-term care home die each year and that 20 percent will die within a year of being admitted, yet palliative and end of life care processes vary greatly in LTC home settings.

Rosemarie Lindau and April Coulter, Corporate Consultants at Extendicare sought to change this by finding out what the residents of our long-term care homes felt was most important to them in their end-of-life journey.

After researching different survey tools, they adapted an evidence-based program “Go Wish” to a user-friendly LTC tool. “My Wishes” uses cards which are familiar to most residents, to encourage non-threatening discussions about end-of-life

Using LEAN methodology, they tested their tool at Extendicare Port Hope in a small, cozy activity room with 11 residents, 3 family members and the project champions. Rosemarie says, “We found out surprisingly that the residents wanted to talk about death.” Among their goals were to improve the quality of life for a resident and their family at the end of their life and improve resident satisfaction by empowering them to be decision makers in their own care. Improvingly family and staff satisfaction, and including them in this LEAN process would also improve the overall palliative care program.

“For our pilot homes, we spend the bulk of the workshop day providing role playing, and allowing for self-reflection so that when the employees are ready to roll out at the home level they have a greater sense of comfort in asking the questions.”

The experience at Port Hope has informed their other pilot projects in other homes.

“We are very excited about the progress. We are currently in the middle of Phase II – rolling out the “My Wishes” project in 4 owned and 2 Assist homes. We plan to roll out to more homes in the future, and eventually all Extendicare homes.”

The “My Wishes” project is expanding in other ways as well. April and Rosemarie have been presenting to other organizations and will be providing a workshop to the Four Counties Long Term Care Palliative Care Network in the Central East Local Health Integration Network (LHIN).

By Rosemarie Lindau and April Coulter, Extendicare Corporate Consultants, My Wishes project creators