CSA Z2004:24, Mental health and well-being in long-term care (LTC) and assisted living (AL) settings

Table of Contents

• CSA Z2004:24, Mental health and well-being in long-term care (LTC) and assisted living (AL) settings 1
• Standards Update Service 3
• Technical Committee on Home and Community Care 10
• Subcommittee on Mental Health and Well-Being in Long-Term Care and Assisted Living Settings 13
• Preface 15
• SDG Foreword 16
• 0 Introduction 17
• 0.1 General 17
• 0.2 Overview 17
• 0.3 Background 19
• 0.4 Users 19
• 1 Scope 19
• 1.1 General 19
• 1.2 Exclusions 20
• 1.3 Terminology 20
• 2 Reference publications 20
• 3 Definitions and abbreviations 24
• 3.1 Definitions 24
• 3.2 Abbreviations 27
• 4 Guiding principles 27
• 4.1 General guiding principles 27
• 4.2 PCC 27
• 4.2.1 General 27
• 4.2.2 PCC principles 28
• 4.3 EDI 28
• 4.3.1 General 28
• 4.3.2 EDI principles 28
• 4.3.3 Human rights 28
• 4.3.4 Discrimination and stigma linked to mental health 29
• 4.4 Cultural safety and humility 29
• 4.4.1 General 29
• 4.4.2 Addressing the call to action from Honouring the truth, reconciling for the future 29
• 4.4.3 Cultural safety and humility principles 30
• 4.4.4 Cultural support 30
• 5 Organizational commitment to mental health and well-being 30
• 6 Quality improvement 31
• 6.1 Quality improvement process 31
• 6.2 Alignment 31
• 6.3 Quality improvement process elements 31
• 6.4 Applying the quality improvement process 31
• 6.4.1 General 31
• 6.4.2 Steps 32
• 6.4.3 Quality indicators 32
• 6.4.4 Evaluations 32
• 7 Workforce 33
• 7.1 General 33
• 7.2 Mental health and well-being of workers 33
• 7.3 Workforce practices 33
• 7.3.1 General 33
• 7.3.2 Recruitment 33
• 7.3.3 Continuity of care 33
• 7.3.4 Workforce ratios 33
• 7.3.5 Skills and occupational mix 33
• 7.3.6 Models 34
• 7.4 Work environment 34
• 7.4.1 Psychological health and safety in the workplace 34
• 7.4.2 Accessible mental health support 34
• 7.5 Worker training 34
• 7.5.1 General 34
• 7.5.2 Content of training 34
• 8 Design of the LTC and AL setting 35
• 8.1 General 35
• 8.2 Building design elements 35
• 8.2.1 General 35
• 8.2.2 Basic design attributes 35
• 8.2.3 Ambiance 37
• 8.2.4 Environmental attributes 38
• 9 Recreation therapy programs and activities to foster social connectedness, mental health, and well-being 39
• 9.1 Offering recreation therapy programs and activities 39
• 9.1.1 General 39
• 9.1.2 Content of the recreation therapy program 39
• 9.1.3 Development of the recreation therapy program 39
• 9.2 Resident input into the recreation therapy program and activities 39
• 9.3 Types of therapy interventions and activities offered 39
• 9.3.1 Range of activities 39
• 9.3.2 Culturally appropriate therapy interventions and activities 40
• 9.3.3 Internal and external activities 40
• 9.4 Accessibility 40
• 9.4.1 General 40
• 9.4.2 Adaptability to individual strengths and abilities 40
• 9.5 Resources 41
• 9.5.1 General 41
• 9.5.2 Coordination of outside resources 41
• 9.6 Implementation and communication 41
• 9.7 Evaluation 41
• 10 Optimizing mental health and well-being through relationships within LTC and AL settings 42
• 10.1 General 42
• 10.2 Optimizing mental health and well-being of residents by building relationships with workers and volunteers 42
• 10.2.1 Promotion strategies and planning to support the mental health and well-being of residents 42
• 10.2.2 Supporting mental health and well-being of residents through shared knowledge and understanding 42
• 10.3 Optimizing mental health and well-being of residents by building relationships with families and care partners 43
• 10.3.1 Implementing practices to engage and involve families and care partners 43
• 10.3.2 Building relationships between workers, and residents, families, care partners, and communities that promote mental health and well-being of residents 43
• 10.3.3 Resources to support the mental health and well-being of families and care partners 44
• 10.4 Building relationships among residents to support their mental health and well-being 44
• 11 Support for residents with mental health conditions 44
• 11.1 Addressing mental health needs 44
• 11.1.1 General 44
• 11.1.2 Specialized mental health resources 45
• 11.1.3 Planning 45
• 11.1.4 Continuation of services 45
• 11.1.5 Workforce training 45
• 11.1.6 Models for providing specialized mental health care 46
• 11.1.7 Specialized mental health resources as essential workers 46
• 11.2 Mental health assessments 46
• 11.3 Care plans 46
• 11.3.1 General 46
• 11.3.2 Care plan development 47
• 11.3.3 Care plan content 47
• 11.3.4 Treatment approaches 47
• 12 Critical incident management 48
• 12.1 General 48
• 12.2 Management by the workforce 48
• 12.3 Support 48
• 12.4 Processes and protocols 48
• 13 LTC and AL considerations for younger residents 49
• 13.1 General 49
• 13.2 PCC principles for younger residents 50
• 13.3 Transitions 50
• 13.4 Rehabilitation program 50
• 13.5 Workforce and care relationships 51
• 13.6 Activities and community participation 51
• Annex A (informative) — Lighting levels to promote mental health and well-being 52
• A.1 General 52
• A.2 Daytime lighting 52
• A.3 Evening lighting 52
• A.4 Nighttime lighting 52
• Annex B (informative) — Examples of activities offered within a recreation therapy program 53
• Annex C (informative) — Non-pharmacological treatment options for dementia, delirium, and depression 54
• C.1 Non-pharmacological treatment options for changes in mood, personality, or behaviour in dementia 54
• C.2 Non-pharmacological treatment options for delirium 56
• C.3 Non-pharmacological treatment options for depression 57
• Annex D (informative) — Additional context on younger residents 58
• D.1 Background 58
• D.2 Length of stay 58
• D.3 Characteristics of younger residents 58
• D.4 Needs of younger residents 58
• D.5 Additional articles related to younger residents in LTC and AL settings 59
• D.6 Innovative practices 59
• Annex E (informative) — Bibliography 60