Check out the BSO eNews for June 2012 to connect, share, participate and learn about new resources, project updates, events and stories from the field.
Share with your colleagues
BSO eNews June 2012
The Behavioural Supports Ontario (BSO) Project (BSO) aims to improve the lives of Ontarians with behaviours associated with complex and challenging mental health, dementia or other neurological conditions living in long-term care homes or in independent living settings. To learn more, please visit the project website:


BSO makes a difference!  Seniors accross the province are starting to see changes in how care is provided in long term care homes, hospitals and the community.  Through the Behavioural Supports Ontario (BSO) Project new services, programs and training are now being introduced that provide appropriate care and support for an increasing number of seniors across Ontario, their families and caregivers, who live and cope with dementia, mental illness and/or other neurological conditions.  In this issue, we introduce Take a Closer Look; a regular feature that will highlight, from accross the Province, stories of how BSO makes a difference.

BSO represents a comprehensive system redesign that has successfully broken down barriers, encouraged collaborative work, shared knowledge and fostered partnerships among local, regional and provincial agencies.  The result is a cultural transformation; a new way of thinking, acting and behaving. To date, more than 355 new front-line staff have been hired across the province, over 310 long-term care homes have increased their in-house behavioural supports and upwards of 4,000 new and existing front-line staff have received specialized training in techniques/approaches applicable to behavioural supports.
CONNECT with your colleagues accross BSO.

Connect me to people and groups who are sharing knowledge, working and discussing issues that are important to my work.

Connect with colleagues
to solve problems and overcome challenges now -
Connect with groups to mobilize resources and support meaningful change - Connect with your LHIN Project Lead to learn more about your local BSO Project and how you can get involved - Connect with the BSO Knowledge Integration Coordinator to get answers to your questions about the BSO Project -

SPREAD THE WORD and tell everyone about the great things happening at BSO.

Share your story about the great work your doing and lessons learned 'in the field' and we'll spread the news. 


Recently, the CRO project team asked the LHINs to provide stories of how BSO makes an impact in the daily lives of patients, caregivers and family members alike.  Clearly we've got a lot to talk about... a lot to  share... a lot to be proud of!  Regardless of the story, there was one common denominator - PEOPLE.  A regular feature moving forward, "Spread the Word" looks at how people accross BSO are making a difference and encourages you to do the same.  Here's a sampling...

It’s often said that to truly believe something, you must see it with your own eyes. Suggestively, for family members and health care providers living with and caring for people who exhibit responsive behaviours, this statement holds a regrettably disproportionate degree of truth. In HNHB, Maria is in her 80's and lives in a LTCH. The staff have resigned themselves to understanding she is not a morning person and that it is always going to be a challenge – a struggle, to get her ready for breakfast on time.
One morning, as Maria woke up, the PSW that normally cares for her came into her room as she always does. But this time, she did so with the BSO team. On entering the room, the team greeted Maria who was slowly getting out of bed. Immediately her care worker took hold of her arm and brought her to the bathroom. In no rush, Maria mumbled something under her breath, pulled away from her PSW and sat on the toilet seat in her gown and slippers.  The BSO team motioned to the care worker to retrieve Maria’s undergarments and clothing.  Without hesitation, Maria folded her arms and stared at the floor.
The BSO team took her clothes and gently showed Maria each article one at a time. Not saying a word, she reached out and placed the clothes on her lap, examined her brazier and held it with the hooks facing out. Continuing their use of a gentle approach, the BSO team then approached Maria to help her unfasten the hooks, and within a few minutes she was getting herself dressed; no struggle, no frustration, no aggressive or responsive behaviours. Using a similar approach for toiletry and hygiene care, the BSO team modeled strategies and techniques to help Maria get ready for the rest of her day… that started with breakfast, on time. A somewhat surprised PSW untrained in behavioural supports said “Why does she do that for you and not for me? She must be having a good day.” The next week, the same LTCH sought a referral to the BSO Team for another resident.  Believe it… there is something great happening in HNHB before our very eyes. 

In  September 2011 Fairhaven, an early adopter long-term care home in Peterborough, set out on a transformational journey to forever change the quality of care afforded residents who demonstrate responsive behaviours associated with dementia, mental illness and/or other neurological disorders.  In six months, Fairhaven moved from conceptualization and development, to implementation and success.
Using a BSO standardized behavioural assessment tool and gathering data from resident care plans, residents and family members, it was determined over 50% of residents require support.  Citing the promise of improved quality of life for all residents in the Home, an expected decrease in resident behaviours and a delayed need for more intensive services and support from the integrated health team, it is through a notable commitment to their training and development that new and existing staff are currently operating with enhanced skills, offering them an increased level of confidence in their abilities to manage the road ahead.
Fairhaven represents a snapshot of what is happening across the Central East LHIN where 13 early adopter long-term care homes were engaged early and are now acting as knowledge brokers with their peers.  Over 20 new RNs/RPNs and PSWs have been hired in these facilities; over 800 front line staff have been trained to deal with responsive behaviours and Integrated Care Teams are operating in both LTCHs and the community. 
HQO Update

Improvements through Kaizen Events

The following LHIN groups have made (or will make) a difference by hosting structured quality improvement events (kaizen events) in their local communities. Groups used the events as opportunities to develop tools and processes, to table-top test the tools and processes created during the event and to determine next steps for further testing, learning and refinements in their ongoing improvement efforts.
  • North East (May 9-10):  this 2-day kaizen event focused on creating access and flow of clients to new resources available through the Responsive Behaviour Team and it’s integration with existing services (PRCs, etc.).
  • Central West (May 9-11):  this three consecutive 1-day kaizen eventsfocused on determining how the BSO services across the CW LHIN can best fit and link with the existing pieces. Day 1 day focused specifically on the teams within LTC, Day 2 the teams within community and Day 3 the team’s role with WOHS.
  • South West (May 24-25): this 2-day kaizen eventfocused on determining how the care provided to individuals through the 5 SW LHIN mobile teams can be best delivered by a collaborative care team and where needed smoothly transitioned.

         Upcoming Kaizen Events:

  • Toronto Central (June TBD)
  • Waterloo Wellington (June 19-21)
  • Erie St. Clair (July 12-13)
Groups have successfully kept their client value statements front and centre in their improvement work as they use their client value statement to ground their directions and decisions.

QI Capacity Building

BSO Improvement Facilitators continue to sharpen their QI skills through participation in bbi-weekly webinars including...
  • Applied QI Science  (first Wednesday of every month)
  • Measurement for Improvement (third Wednesday of every month)

Preparations are underway to deliver a two day face-to-face training session for Improvement Facilitators on June 6-7, 2012.
Leveraging synergies between Residents First and BSO

HQO Residents First and BSO staff are working together with LHIN staff to leverage synergies between the two initiatives. 



Alzheimer Knowledge Exchange

Did you know… AKE now has an online subscription feature! This means you can subscribe to specific pages both on the public website and the collaboration space and receive updates when new information is added.  Just visit then click “subscribe to this page” to the right of your screen and go to “edit profile” to choose the frequency of the notifications.

For more information on this feature and the BSO collaboration space tune into the Webinar on Wednesday, June 13, 2012 from 12-1pm by dialing 1.855.450.7670, participant code 2371438, web address
Can’t make it? No problem- the session will be recorded and made available online.

Tips and Tricks from the Provincial Resource Team (PRT)

The Provincial Resource Team hopes the following tips and tricks will help you to make a difference! And don’t forget to check out the many new and useful tools and resources recently added to the Collaboration Space.
  • Consider how environmental design affects behaviour. Check out the Environmental Checklist adapted in the SE, as well as recommended design considerations from the Design & Dementia Community of Practice.
  • As ESC LHIN works to integrate two of their mental health service teams, they will be conducting a Value Stream Mappingexercise to inform this process. Consider how this and other Quality Improvement approaches can continue to support your own implementation activities.
  • If you are running into issues with staff not wanting to leave union seniority for a BSO position- consider a 1 month trial agreementwhere previous position and seniority are held.
  • Check out Changing Directions, Changing Lives: The Mental Health Strategy for Canada.

If there are issues, challenges or promising practices that you would like feedback or advice on please contact us. 

ENGAGE yourself in events, workshops and opportunities to increase your knowledge and mobilize your efforts.

Tell us about events you think others should be engaged in, so we can get them involved in BSO.  


 June 12, Advocacy Centre for the Elderly, 5th ACE Special Lecture featuring Dr.’s Samir Sinha – Care of the Elderly... Could we do better? and Andrea Moser – Long Term Care... are we on the right track?
June 6-7, Improvement Facilitator, face-to-face training.
July 25, CDRAKE featured event, Communicating with Residents with Dementia.

Note: Events may still be in early planning stages. Dates and information are subject to change. Please check the BSO Project Events Calendar for the most current event date information.  

EDUCATE yourself and learn from tools & resources that support your capacity to put promising knowledge into practice.

Send us resources that help you do great work so that we can share them with others. 


You asked and wanted more information about...

Lewy Body Disease
Behavioural Challenges
Demential Knowledge Broker - Responsive Behaviours
Dementia Knowledge Broker - Behavioural Support Systems

Mental Health Commission of Canada – Health Strategy for Canada
Long Term Care Task Force on Resident Care and Safety - An Action Plan to Address Abuse and Neglect in Long-Term Care Homes
CDRAKE Webinar and Events Listing - The spectrum of Lewy body disease: Dementia with Lewy bodies and Parkinson’s 

Copyright © 2012 Behavioural Supports Ontario (BSO) Project, All rights reserved.

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