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Nursing home chain starts big shift toward new care model

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The floors are clean, the walls are an inoffensive shade of beige and the staff work to keep the elderly people who live here safe from harm.

By Ontario government standards, the dementia unit inside the Henley House long-term care home in St. Catharines gives good care, its managing director says.

At Peel’s Redstone dementia unit, Chelsea Martens sits with Piotr (Peter) Wojcik while he peels an orange. The Butterfly program says touching food, peeling fruit and vegetables in advance of meals helps people with dementia start thinking about food and eating. As a result, people who might not otherwise eat stay nourished.
At Peel’s Redstone dementia unit, Chelsea Martens sits with Piotr (Peter) Wojcik while he peels an orange. The Butterfly program says touching food, peeling fruit and vegetables in advance of meals helps people with dementia start thinking about food and eating. As a result, people who might not otherwise eat stay nourished.  (Randy Risling / Toronto Star)

And now, she can’t wait to see it dismantled.

“There’s going to be a very, very big shift in the way we provide care,” said Jill Knowlton, of Primacare Living.

Instead of one big unit of 25 people, the home will be broken into two small, cosier living spaces for people with moderate and severe dementia. Workers will be trained to express empathy and spend time chatting, playing cards or dancing with people living in the home, rather than rushing from one task to the next. Walls will be painted in fuchsia, tangerine or neon green to help people navigate the hallways.

Inspired by the changes at Peel Region’s Malton Village, which used the British-based Butterfly Program to turn a drab dementia unit into a place of warmth, energy and friendship, Primacare will also add the program to its homes in Brampton and London and a new home to be built near Hamilton.

Read more:

The Fix: How one Peel nursing home took a gamble on fun, life and love

Henley House long-term care home in St. Catharines is the first home in the Primacare Living chain to implement the Butterfly Model.
Henley House long-term care home in St. Catharines is the first home in the Primacare Living chain to implement the Butterfly Model.  (Handout)

“The scourge of dementia is old news — now is the time to do something about it,” Primacare president Matthew Melchior said at the launch of the Butterfly program in St. Catharines last week. “Standing still is stagnation. The status quo is not the answer.”

Peel’s Malton Village was the first in Ontario to implement the full Butterfly program, which focuses on social and emotional happiness for people with dementia. In Alberta, the program is used in six seniors’ homes (five assisted living and one long-term care.) It is used in 23 homes in the U.K., three in Australia and one in the United States. Peel’s year-long pilot ended last spring and after seeing the results, Peel Regional councillors voted in favour of adding it to its four other long-term care homes.

Candace Chartier, CEO of the Ontario Long Term Care Association, which represents mostly for-profit long-term care homes like Primacare, told the St. Catharines crowd, “This is something that is going to change the lives of every person in this room and the staff members, volunteers and every resident and every family member that come through the doors.

“I’ve had the chance to look at the Butterfly Model…it truly is what the future of long-term care is, what senior care is,” Chartier said. She later told the Star that Ontario’s plans for 30,000 additional nursing home beds should follow new care models instead of replicating the current designs that place large groups of people in one living space.

The Butterfly program is one of several models that focus on sweeping culture change, easing workers out of a traditional style of care that, in Ontario, is dominated by schedules, routines and hourly documentation. The Green House Project and Eden Alternative — both created by American geriatrician Dr. Bill Thomas — share similar philosophies that favour small homes, social interaction and friendships between staff and people in their care.

Knowlton, of Primacare, said the company spent two years researching ways to improve, despite already adding extra staff and training programs. Primacare signed a contract last spring with Dementia Care Matters, the Butterfly model owner, after seeing the program’s impact on people living in Peel’s Malton Village.

Peel’s experiment with the program was documented in a 12-month Star investigation called The Fix. Starting in March of 2017, the process began slowly, but people who previously spent their days staring at the floor or watching TV came back to life. Workers spoke about falling in love with jobs that provided a sense of purpose. Peel said staff sick days have dropped by 75 per cent.

Critics say the program does not have peer-reviewed academic research to back its claims. Peter Bewert, CEO of Dementia Care Matters (owned by the Salvation Army Australia), said he welcomes independent research. Peel Region is in talks with the Centre for Elder Research at Sheridan College to begin a detailed evaluation.

The story of Peel’s experience showed the highly regulated and regimented nursing-home industry that change is possible, said Lisa Levin, CEO of Advantage Ontario, which represents non-profit and municipal homes.

“It created such a buzz,” Levin said. “Almost everywhere I went, people were asking me about this. It really has had quite an effect. A number of our members are looking at transformative care — I wouldn’t be surprised if all of them are looking at it.”

There’s a widespread belief in the industry that the Ontario health ministry could help homes improve care with a staffing boost and changes to ease some regulatory requirements. Officials have not said if they intend to do so. Levin said she believes the new government knows the system needs innovation.

Ten people live in each side of the St. John's Green House Project home in Penfield, N.Y., a ranch style nursing home focused on emotional and social connections.
Ten people live in each side of the St. John’s Green House Project home in Penfield, N.Y., a ranch style nursing home focused on emotional and social connections.  (Randy Risling/Toronto Star)

For now, Levin said Peel’s experience shows that homes can begin moving forward with changes to create a relaxed homier setting.

“What’s happening now is that people are realizing they can make a difference. They can change — I call it a transformation. That it is within the means of our homes, and our government.”

In the City of Toronto, which operates 10 long-term care homes, general manager Reg Paul is examining a variety of emotion-centred care programs. Last summer, city council voted unanimously to ask city officials to report back in early 2019 on recommendations for a pilot project.

Toronto’s Paul said city homes have fewer than average incidents (like falls, use of restraints or anti-psychotic medication) but added, “I believe that we have to continue to evolve.” Dr. Samir Sinha, co-chair of Toronto’s seniors’ accountability group, said Toronto homes are improving but he’s still advocating for changes created by programs like the Green House Project or Butterfly. The changes at Peel, for example, showed that staff and residents benefited, he said. “It allows people to blossom,” said Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals.

Last year, the Star visited a Green House nursing home in a suburban neighbourhood in Penfield, N.Y. There were two separate units of 10 people each, with open-concept kitchens, long family-style tables and cosy living rooms, operated by St. John’s long-term care, a non-profit organization.

After seeing improvements in Penfield, St. John’s decided to turn its traditional 400-bed nursing home in nearby Rochester into smaller homes. St. John’s spokesperson, Nate Sweeney, said the staff turnover rate in its Green House homes is 10 per cent, compared to 35 per cent in the traditional-style of care. Sick days are 75 per cent fewer than in traditional units, reducing overtime costs, he said.

Peel is reporting the same drop in staff sick days. It also found an increase in resident and staff satisfaction and a decrease in antipsychotic medication and falls, but a spokesperson said Peel wants to do an in-depth evaluation and measure numerous outcomes, with Sheridan College.

“I believe it will stand up to the rigour of research,” said Mary Connell, Peel’s Butterfly project manager and a registered nurse who will oversee the program’s roll-out in Peel’s five homes.

Moira Welsh is a Toronto-based investigative reporter. Contact Moira at mwelsh@thestar.ca Follow her on Twitter: @moirawelsh

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Nostalgia and much more with Starburst XXXtreme

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Get a taste of adventure with Starburst XXXtreme based on the legendary NetEnt Game. The nostalgic themes are sure to capture fans of the classic version as they get treated to higher intensity, better visuals, and features. The most significant element of the game is its volatility. Patience will not be an essential virtue considering the insane gameplay, and there is a lot of win potential involved. It retains the original makeup of the previous game while adding a healthy dose of adrenaline. 

Starburst Visuals and Symbols

The game is definitely more conspicuous than before. The setting happens over a 5-reel, 3-row game grid with nine fixed win lines, which function if a succession from the left to the right reel is present. Only those players that that attain the highest win per bet line are paid. From a visual standpoint, the Starburst XXXtreme slots illustrates lightning effects behind the reels, which is not surprising as it is inherited from the original version. Available themes include Classic, Jewels, and Space. The game is also available in both desktop and mobile versions, which is advantageous for players considering the global pandemic. According to Techguide, American gamers are increasingly having more engaging gaming experiences to socialize to fill the gap of in-person interaction. Starburst XXXtreme allows them to fill the social void at a time when there is so much time to be had indoors. 

Starburst XXXTreme Features

Players get to alternate on three features which are Starburst Wilds, XXXtreme Spins, and Random Wilds. The first appears on reels 2,3, or 4. When these land, they expand to cover all positions while also calculating the wins. They are also locked for a respin. If a new one hits, it also becomes locked while awarding another respin. Starburst XXXtreme offers a choice between two scenarios for a higher stake. In one scenario with a ten times stake, the Starburst Wild is set on random on reels 2,3, or 4, and a multiplier starts the respin. The second scenario, which has a 95 times stake, starts with two guaranteed starburst wilds on reels 2,3, or 4. it also plays out using respin game sequence and features. The game also increases the potential with the Random Wilds feature to add Starburst Wilds to a vacant reel at the end of a spin. Every Starburst Wild gives a random multiplier with potential wins of x2, x3, x5, x10, x25, x50, x100, or even x150.

The new feature is sure to be a big hit with the gaming market as online gambling has shown significant growth during the lockdown. AdAge indicates the current casino customer base is an estimated one in five Americans, so Starburst XXXtreme’s additional features will achieve considerable popularity. 

What We Think About The Game

The gambling market has continued to diversify post-pandemic, so it is one of the most opportune times to release an online casino-based game. Thankfully Starburst XXXtreme features eye-catching visuals, including the jewels and space themes. These attract audience participation and make the gameplay inviting. The game also has a nostalgic edge. The previous NetEnt iteration featured similar visuals and gameplay, so the audience has some familiarity with it. The producers have revamped this version by tweaking the features to improve the volatility and engagement. 

That is characterized by the potential win cap of 200,000 times the bet. Starburst XXXtreme does not just give betting alternatives for players that want to go big. The increase of multipliers also provides a great experience. If the respins in the previous version were great, knowing that multipliers can go hundreds of times overtakes the game to a new level. 

Players should get excited about this offering. All of the features can be triggered within a single spin. Whether one plays the standard game or takes the XXXtreme spin route, it is possible to activate all of the features. Of course, the potential 200,000 times potential is a huge carrot. However, the bet size is probably going to be restricted and vary depending on the casino. It is also worth pointing out that a malfunction during the gameplay will void all of the payouts and progress. Overall, the game itself has been designed to provide a capped win of 200,000 times the original bet. 

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Anglais

‘We’re back’: Montreal festival promoters happy to return but looking to next year

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In downtown Montreal, it’s festival season.

In the city’s entertainment district, a musical act was conducting a sound check on stage Friday evening — the second day of the French-language version of the renowned Just For Laughs comedy festival. Tickets for many of the festival’s free outdoor shows — limited by COVID-19 regulations — were sold out.

Two blocks away, more than 100 people were watching an acoustic performance by the Isaac Neto Trio — part of the last weekend of the Festival International Nuits d’Afrique, a celebration of music from the African continent and the African diaspora.

With COVID-19 restrictions continuing to limit capacity, festival organizers say they’re glad to be back but looking forward to next year when they hope border restrictions and capacity limits won’t affect their plans.

Charles Décarie, Just For Laughs’ CEO and president, said this is a “transition year.”

“Even though we have major constraints from the public health group in Montreal, we’ve managed to design a festival that can navigate through those constraints,” Décarie said.

The French-language Juste pour rire festival began on July 15 and is followed by the English-language festival until July 31.

When planning began in February and March, Décarie said, organizers came up with a variety of scenarios for different crowd sizes, ranging from no spectators to 50 per cent of usual capacity.

“You’ve got to build scenarios,” he said. “You do have to plan a little bit more than usual because you have to have alternatives.”

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MELS new major movie studio to be built in Montreal

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MONTREAL — MELS Studios will build a new film studio in Montreal, filling some of the gap in supply to meet the demand of Hollywood productions.

MELS president Martin Carrier said on Friday that MELS 4 studio construction will begin « as soon as possible », either in the fall or winter of next year. The studio could host productions as early as spring 2023.

The total investment for the project is $76 million, with the Quebec government contributing a $25 million loan. The project will create 110 jobs, according to the company.

The TVA Group subsidiary’s project will enable it to stand out « even more » internationally, according to Quebecor president and CEO Pierre Karl Péladeau. In the past, MELS Studios has hosted several major productions, including chapters of the X-Men franchise. The next Transformers movie is shooting this summer in Montreal.

Péladeau insisted that local cultural productions would also benefit from the new facility, adding that the studio ensures foreign revenues and to showcase talent and maintain an industry of Quebec producers.

STUDIO SHORTAGE

The film industry is cramped in Montreal.

According to a report published last May by the Bureau du cinéma et de la télévision du Québec (BCTQ), there is a shortage of nearly 400,000 square feet of studio space.

With the addition of MELS 4, which will be 160,000 square feet, the company is filling part of the gap.

Carrier admitted that he has had to turn down contracts because of the lack of space, representing missed opportunities of « tens of millions of dollars, not only for MELS, but also for the Quebec economy. »

« Montreal’s expertise is in high demand, » said Montreal Mayor Valérie Plante, who was present at the announcement.

She said she received great testimonials from « Netflix, Disney, HBO and company » during an economic mission to Los Angeles in 2019.

« What stands out is that they love Montreal because of its expertise, knowledge and beauty. We need more space, like MELS 4, » she said.

There is still not enough capacity in Quebec, acknowledged Minister of Finance, the Economy and Innovation Eric Girard.

« It is certain that the government is concerned about fairness and balance, so if other requests come in, we will study them with the same seriousness as we have studied this one, » he said.

Grandé Studios is the second-largest player in the industry. Last May, the company said it had expansion plans that should begin in 2022. Investissement Québec and Bell are minority shareholders in the company.

For its part, MELS will have 400,000 square feet of production space once MELS 4 is completed. The company employs 450 people in Quebec and offers a range of services including studio and equipment rentals, image and sound postproduction, visual effects and a virtual production platform.

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