Differences between an Alternative Home and a conventional CHSLD

• At the alternative home, low-risk medications are kept in the resident’s room rather in a medical cart. This means the nursing assistant does not “make the rounds” to administer medications in the morning. Instead, they visit each room, go to the bedside of those patients who are awake, unlocks the medicine cabinet, and administers the medication.
• In an alternative home, the team of beneficiary attendants can propose to reorganize the schedule for the day’s hygiene care to best suit the needs of each resident. Each room is equipped with a complete private bathroom, meaning that hygiene care can be provided by different attendants, separately and at the same time.
• The team respects the residents’ natural sleep and waking rhythms. At 10:00 a.m. this morning, the pavilion attendant noticed that one of the residents just woke up. They knock at the door before entering and greet the resident. As the resident cannot select their clothing by themselves, the pavilion attendant prepares a set of clothes and informs the beneficiary attendant the resident will be ready to get dressed in a few minutes.
• During a service call, the laundry attendant receives a request from a resident who would like to wear their favourite shirt when their children come to visit the next day. The shirt is in the laundry bag. The attendant will pick up the requested item and add it to a load of laundry so that the resident can have it in time.

• Certain equipment at the alternative home, such as physiological monitoring devices are connected to the Wi-Fi network. This means certain data can be directly updated to the resident’s file daily, making it possible to spot trends. This morning, the nurse increases a resident’s monitoring after noticing a correlation between clinical observations (such as oedema in lower limbs, shortness of breath) and upward trends in the electronic file (such as heart rate and blood pressure).
• Each day, the nursing assistant uses a Wi-Fi-connected physiological monitor to record vital signs. The data is directly uploaded to the resident’s electronic file.
• A beneficiary attendant finds a resident on the floor in the middle of the night during their visual rounds. Watching the last few minutes of the video recorded by the camera in the resident’s room, the nurse sees that the resident tried to get up on their own and tripped on a pair of shoes on the floor near the bed. This observation will allow them to take preventive measures in the future.

• A new resident, who arrived at the alternative home five days ago, is having difficulty settling in to their new environment. A volunteer who has known the resident for over 10 years is there to provide some reassurance. She shares various approaches she uses to dress the resident with the beneficiary attendant. The beneficiary attendant learns that the resident has a very specific routine. For example, she does not accept putting on her left sock before her right sock. This allows the beneficiary attendant to learn the new resident’s complete dressing sequence, helping to reduce her discomfort.
• A new resident is having difficulty adapting. He is always anxious, showing signs of distress and is not collaborative during transitions. The beneficiary attendant speaks with the nurses. Together, they meet with the family and learn about the resident’s life history and lifestyle habits. Then they develop a personalized integration plan that takes into consideration the resident’s discomfort around transitions. Now, team members inform the resident before undertaking a task or intervention, and the resident is much happier.

LUC is 27 years old and lives with an intellectual disability. He has Crohn's disease and has had a stoma for 5 years. Until recently he lived in an intermediary resource, but it can no longer meet his needs. His autonomy has decreased since suffering a head trauma last year. Luc's judgment is poor; he doesn't perceive danger and can be impulsive in certain situations.

Ms. TREMBLAY, 59, has the most rapidly progressing form of amyotrophic lateral sclerosis (ALS). She was an elementary school principal until she was 56 years old. Ms. Tremblay’s right hand and elbow are completely limp and incapable of any active movement. She is fed pureed food, with adapted positioning, supervision during meals and the use of an adapted utensil. She requires significant assistance and the use of a shower chair during personal hygiene. All her cognitive functions are preserved.

Ms. DICAPRIO, 52, was completely independent before suffering a massive stroke in the fall of 2022. She has two teenaged children and a husband, who is a well-known local real-estate developer. Mrs. Dicaprio's motor abilities and her functional capacity remain extremely limited.  Her loved ones want to ensure that she is directed toward a bright, stimulating living environment that is age-appropriate. She suffers from severe aphasia and must use the lift for all transfers.