The Act and Beyond: Law and culture change

by Family Councils Ontario

Law and culture change: what’s the connection?

Culture change is an often discussed concept in the Long-Term Care (LTC) sector. Organizations across the world, including governments, are making efforts to change the culture of aging and LTC into one where everyone thrives and people are at the centre of the work. FCO believes strongly in the culture change movement and the value of putting residents and families at the centre of the system.

To fully understand the process and impacts of culture change in LTC, we need to answer the question “what do we mean by ‘culture’?” The culture of an organization- or system- is defined as "the set of values, beliefs, shared assumptions, behavioral norms and patterns of interactions that, together, characterize" it (Arora and Baronikian, 2013). Culture, therefore, is not something concrete, something that can be prescribed, or something that can even be quantified. We know it exists because we can feel and experience it in action. So then, how does culture change relate to something that can be prescribed and quantified: legislation?

One of the biggest changes to LTC culture is the still ongoing shift from an institutional to social model of care. This change is exemplified in the Long-Term Care Homes Act, from the preamble through to the last section of the law. One of the most impactful changes to the legislation governing Long-Term Care (the Long-Term Care Homes Act replaced three pieces of legislation: the Nursing Homes Act, Homes for the Aged and Rest Homes Act and the Charitable Institutions Act, and the regulations under those Acts) is the emphasis on mutual collaboration and respect amongst residents, their families and friends, Long-Term Care Home licensees, caregivers, volunteers, the community, and governments. One of the most obvious aspects of this change is the inclusion of Family Councils in the Long-Term Care Homes Act.

What are some of the reasons that FCs were included in the LTCHA as never before?

  • Give families a stronger collective voice
  • Recognize the value and impact of family involvement in LTC
  • Increase the powers of Family Council
  • Support culture change

Constructive family involvement in LTC is both a driver and a product of culture change. The formation of Family Councils in Long-Term Care Homes began years before the Long-Term Care sector was focused on culture change. Family caregivers, and especially Family Councils, have been part of the driving force that insisted that care focus on each residents’ needs and that family caregivers be considered part of the team of care. Family Councils were among the pioneers of culture change, putting into practise the elements of social models of care through their involvement in Long-Term Care. The inclusion of Family Councils in the Act demonstrates a recognition by government and the LTC Sector of the important role families play in the changing culture to one of resident and family centred care.

This month we’ll be exploring various aspects of the legislation impacting Long-Term Care and their connection to Family Councils.

For previous posts on the Long-Term Care Homes Act, read the archives.

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