Spontaneity as a Prescription

Jules Roebbelen • July 9, 2019

Bill Thomas started a new job at a nursing home. He soon identified the “Three Plagues” of nursing home existence as boredom, loneliness and helplessness. Not long after he started his job, staff were encouraged to bring their children to the nursing home after school, and soon they built a garden and a playground in the backyard. They introduced 2 dogs, 4 cats and hundreds of live plants. Soon, they had 100 birds with cages delivered to the home. Every senior who wanted a bird in their room could have one. The changes they saw in the residents were incredible and unprecedented. Residents who hadn’t spoken in years began talking again, first to their birds and then to other people. They offered to take the dogs for walks. People volunteered for plant watering duty. Everyone would share their bird-raising stories at meal times. It was spontaneity, it was out of the routine, and it was working. Life was breathed back into the home. Prescriptions were reduced by half, particularly drugs to help with agitation. Death rates reduced by 15%.

Thomas believed "that the difference in death rates can be traced to the fundamental human need for a reason to live.”

Spontaneity. Breaking the routine is one of the most fundamental points of alleviating isolation and loneliness.


While most nursing homes cannot (or should not) commit to hundreds of plants and animals, there are much more manageable ways to introduce spontaneity to the lives of the residents.


Seniors with dementia have scheduled “play dates” with a children’s day care program in the same building. This offers respite for the day care workers (on both sides) and allows the seniors to exercise their minds, stave off loneliness and just have some fun. Fostering relationships and spontaneity is simply life-giving to the residents who may not have regular visitors. For many, it is the highlight of their week to have a conversation with a silly, energetic three year old. Other programs encourage seniors to read to kindergarten students. Connecting seniors with young children provides health benefits beyond mental stimulation. Not only are the children learning how to read, the seniors truly feel like they have something to look forward to in the day beyond meal times and movie night. They’re given a newfound purpose. A fundamental human need for a reason to live.



Our seniors deserve a greater level of care and connection with other programs. Having a network of care organizations can encourage these beautiful and unconventional partnerships. Organizing a senior’s group to participate in a young children’s program will likely improve the mental, social and physical well being of the residents. Spontaneity, responsibility and general lack of boredom can do a world of difference. We dare you to be spontaneous, and to prescribe it daily.


Crown made of silhouetted people holding hands, yellow background, radiant lines.
By Jeff Doleweerd June 27, 2024
A truly effective central intake hub is not merely a team of staff manually routing referrals behind a veil of complexity; it is an integrated system that dynamically combines public accessibility, algorithmic precision, real-time capacity management, and seamless communication to ensure patients receive timely and appropriate care.
Three people collaborating around a laptop, one holding a mug. Light teal background.
By Jeff Doleweerd May 14, 2024
Access to community healthcare is paramount for individuals across various stages of life — from seniors desiring to age gracefully in their own homes, to new parents seeking care for their infants and individuals in need of mental health and addiction support. Traditionally, when we mention referrals, the image of a physician sending a document to a specialist comes to mind. However, the landscape of healthcare referrals is evolving, and it's time to redefine our approach. Gone are the days when referral management systems solely relied on healthcare professionals. Take Caredove, for example. What was once considered a referral management system has transformed significantly to a multichannel access management platform. Surprisingly, 43% of referral activity now stems from direct public sign-ups. This shift is monumental, with a staggering 70-fold increase in public service requests compared to pre-pandemic levels in 2019. Clinician referrals will be the minority of service requests activity in our platform by the end of 2024. Why this paradigm shift? During the pandemic, communities learned the importance of direct access to essential services. The notion of gatekeeping community services in any manner like specialist services became obsolete. The crisis strengthened the muscles of direct access, emphasizing the significance of preventive health through social and other services that keep people out of hospitals and other care facilities. Moreover, primary care is under immense strain, with 15% of Canadians lacking consistent access to ongoing primary care. In such a scenario, burdening already stretched healthcare professionals with more referral duties is not sustainable. Accessing services directly not only expedites the process but also empowers individuals to take charge of their own health journey. It signifies readiness for change and recovery, without the artificial requirement of seeing a physician solely for a referral. Primary care remains crucial, and it's imperative to equip them with resources available at their fingertips, enabling them to navigate the healthcare landscape autonomously. After all, patients trust their primary care providers, and we should harness this trust. We also need to foster a culture of self-advocacy and consumer empowerment as part of a broader solution. Community agencies are champions of a healthcare system where individuals are empowered to take control of their health, supported by a network of trusted professionals. In an era of putting patients before paperwork, it is time to embrace direct access and take every bit of unnecessary administrative burden off family doctors and nurse practitioners, in the process.
Two people communicating using string phones, standing on separate rooftops over a gap.
May 10, 2024
In the landscape of mental health support, a new trend is emerging: rapid access low-barrier walk-in counseling. This innovative approach is reshaping how individuals access mental health services, providing immediate support without the traditional hurdles of scheduling. At Caredove, we're witnessing the transformative power of collaboration among organizations delivering these services. Let's delve into why this trend is not just groundbreaking but essential. Immediate Suppo rt : Imagine being able to get the help you need right when you need it, without waiting weeks for an appointment. That's the promise of rapid access low-barrier walk-in counseling. It ensures that no one falls through the cracks during times of crisis. Reduced Stigma : By offering low-barrier access, we're sending a powerful message: seeking therapy for mental health concerns is not only acceptable but encouraged. This approach helps break down the stigma surrounding mental health, making support readily available and easily accessible. Increased Accessibility : Not everyone has the means to access traditional counseling services. Some regions have been able to eliminate cost barriers, thereby ensuring that everyone, regardless of financial situation, can access the support they need to thrive. Community Building : Low-barrier walk-in counseling centers can become community hubs, fostering a sense of belonging and support. Preventative Approach : By addressing mental health concerns early and proactively, these services can prevent more serious issues from developing later on. Empowerment : Rapid access low-barrier counseling empowers individuals to take charge of their mental health. By providing immediate support and resources, we're giving people the tools they need to overcome challenges and live fulfilling lives. Cost Savings : While offering these services may seem like a costly investment, it can actually save money in the long run. By addressing issues early, we can reduce the need for more expensive interventions down the line. No physician burden : Rapid access counseling requires no physician referral so does not tap the resources of overextended primary care, or present barriers for unattached patients. Progressive Approach : Embracing rapid access low-barrier walk-in counseling reflects a progressive mindset in healthcare. It's about prioritizing the well-being of all in the community. Stepped Care approach : Rapid access can operate in a stepped care model. During the session, if more specialized services are identified as necessary, individuals can be seamlessly referred to these services by their therapist. Rapid access low-barrier walk-in counseling represents a seismic shift in how we approach mental health support. By embracing collaboration, we can amplify its impact, ensuring that everyone has access to the help they need, when they need it. Together, we're not just changing lives; we're changing the conversation around mental health..
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