From cohousing to dementia villages, here’s how we can put humanity back at the centre of senior care.

Sarah Tranum January 23| The Conversation

Sarah Tranum is an associate professor of social innovation design in the faculty of design at OCAD University.

Canada’s LTC can become a seamless, human-centered system that helps senior citizens get the care they need. (Shutterstock)

[Excerpt] COVID-19 has amplified existing cracks in the long-term care system in Canada. We need socially innovative solutions to help seniors age safely and with dignity.

From cohousing to community paramedicine programs, from home-based primary care to publicly funded dementia villages, there is hope on the horizon.

As a social innovation designer, I study complex challenges with the aim to find the common approaches needed to solve these issues and not just manage the symptoms.

To better understand the challenges of the long-term care system in Canada, I interviewed stakeholders involved in approaches attuned to individuals’ needs at different stages of aging — all of which are socially innovative.

Here are some solutions that can help when it comes to redesigning the long-term care system.

Senior cohousing

One of the goals outlined in the National Institute on Ageing’s National Seniors Strategy is to help seniors stay active, engaged and maintain their independence. But many seniors struggle to find suitable housing — especially affordable housing.

While retirement homes exist, for many the costs are out of reach — so some are choosing cohousing.

Louise Bardswich is a retired college dean and co-owns a home in Port Perry, Ontario. She and three other women pooled their resources to build a shared home.

Their home features design elements that will allow them to age in place — like wheelchair accessible bathrooms, a spacious kitchen and a guest room that can be used for a live-in caretaker. The housemates pool their resources to cover costs; Bardswich estimates her monthly costs at $1,100.

While $1,100 is not affordable for everyone, its considerably cheaper than a long-term-care facility in Ontario — the long-stay semi-private option is $2,280 per month.

Community paramedicine programs

An integral part of supporting older adults to continue living safely in their homes is ensuring that they have access to the services they need. One innovative example is community paramedicine programs. These programs use existing trained emergency medical personnel to provide primary health care to people who may have a difficult time leaving the home to see a doctor.

J.C. Gilbert is the deputy chief in charge of operations at the County of Simcoe Paramedic Services. In the five years since the launch of its community paramedicine programs, Gilbert says there’s been a positive impact on patient’s overall well-being and fewer emergency calls. “We’re seeing people able to cope with their illness much better at home.”

Home-based primary care

House Calls is a primary health care practice for home-bound seniors living in Toronto, led by Dr. Mark Nowaczynski and SPRINT Senior Care.

Nowaczynski explains that seeing people at home gives health practitioners the ability to gain a holistic understanding of a patient’s health and well-being that is not possible during an office visit. The level of care he and his team provide can prevent hospitalizations and admissions to nursing homes.

According to Nowaczynski, House Calls serves 450 seniors with an average age of 89. “We make it possible for our patients to live out their days at home and die at home,” he says.

Dementia villages

Dementia villages are communities of care designed to give their residents freedom and choice within a safe and supporting environment.

The first dementia village in the world opened in 2009 in the Netherlands. The Hogeweyk is an intentionally designed village with 23 houses for 152 seniors living with dementia. The village has a bar, restaurant, theatre, grocery store, streets and gardens for residents to use and enjoy. It is publicly funded and runs on a budget comparable to conventional nursing homes.

Providence Living, in partnership with Island Health, will open Canada’s first publicly funded dementia village care model in Comox, B.C. With construction starting this year, it will feature smaller households that support freedom of movement, access to nature and connection with the community.

Candace Chartier, CEO of Providence Living, explains that this village concept is not just about the physical design but encompasses a shift in the model of care in which residents, staff and family members work together to create a home environment where residents can thrive.

These examples show potential for the future of long-term care in Canada. The challenge is to make them the new standard of care instead of a patchwork of services that result in waitlists, drive up health-care costs and create confusion for seniors and their caregivers.

Canada’s long-term care can become a human-centred system that helps seniors get the care they need. But first we need to make humane, dignified care for seniors a top priority. 

Four Ways to Fix Canada’s Long-Term Care System