The quality of care in Ontario's nursing homes is paramount for residents and their families. The Long-Term Care Homes Common Assessment Project (LTCH CAP) has been playing a prominent role in addressing this key priority. In partnership with the Ministry of Health and Long-Term Care, the Ontario Long-Term Care Association and the Ontario Association of Non-Profit Homes and Services for Seniors, the Project has been facilitating and supporting the implementation of a standardized and automated common assessment instrument known as the Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0). Almost three years into this initiative, long-term care homes are seeing the quality of life of their residents significantly enhanced by this interdisciplinary assessment.

Long-term care homes in Ontario use a variety of methods to capture residents' abilities, preferences and care needs when they create care plans. While standards are often very high, the lack of consistency and ability to gather standardized, evidence-based clinical information makes it difficult to compare and improve the quality of care between homes. It also restricts the ability for homes to exchange information efficiently with health agencies. The RAI-MDS 2.0 addresses these needs by producing consistent and detailed resident information that is analyzed using scientifically proven decision frameworks.

Already being used in 20 countries and several provinces and territories in Canada, Ontario is now amongst the leaders in using the full RAI-MDS 2.0 approach to create in-depth care plans. By incor-porating each resident's strengths, preferences and needs into the assessment from all aspects of the care team involved, the results enable an in-depth care plan that is tailored to the resident.

Currently, 35 percent of Ontario's long-term care homes have implemented or are in the process of implementing RAI-MDS 2.0. During this process important benefits have already become evident within the homes. Care team members are empowered by a more comprehensive picture of the resident, helping them investigate and resolve potential concerns earlier.

"You develop a keener sense of the resident. I thought I knew the residents but now I know more about their abilities and limitations," explains Andre Charron, a Registered Practical Nurse at Perley Rideau Veterans' Health Centre. "The tool allows you to look deeper than what you physically see. Your assessment is better because it is based on a holistic approach. I find myself asking 'why is that?' more often."

While care-staff have reported many benefits to common assessment, the results it is producing has touched the lives of residents and their loved ones.

One resident at Bonnechere Manor in Renfrew entered the home after suffering a severe stroke accompanied by left side weakness. After having been transferred a number of times between hospitals before arriving at the home, he was not happy with being placed in a long-term care home and showed signs of profound depression. He required extensive assistance with dressing and personal hygiene. Triggers within the RAI-MDS indicated that this resident had the potential for increased independence.

A further assessment was requested and goals were set up for him. The care team followed procedures which were posted in his room, and he received increased physiotherapy to strengthen his right leg. His program of anti-depressants was continued. Just three months later, the resident began showing improvements in washing, dressing and general mobility. His deep sense of loss of his past life had diminished. His condition improved so dramatically that he underwent a CCAC (Community Care Access Centre) assessment, and moved to a retirement home next door.

His family was also thrilled with this transformation, and appreciated how the RAI-MDS process encouraged involvement from family members. "My brother felt that someone was finally paying attention to him," explained the resident's sister, who is also a member of the local Family Councils' Committee. "I noticed small improvements, he could walk on the carpet or out on the deck and he was able to dress himself. I was told what was being done and when I knew about his depression I could watch out for signs of it and tell the staff."

With the benefits to residents care in long-term care homes increasingly evident, families can look forward to playing more of a role then ever before in providing their loved ones with the quality of life they deserve.

Submitted by the Long-Term Care Homes Common Assessment Project (LTCH CAP), a project initiative of the Continuing Care e-Health Program. For more information, contact the Project Support Centre at 1-866-909-5600 or ltchproject.moh@ontario.ca.