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Opinion: Co-housing and dementia villages: Social innovations offer alternatives for long-term care

Coronavirus has disproportionately impacted the most vulnerable seniors. We need socially innovative solutions to redesign long-term care and help seniors age safely and with dignity
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Canada鈥檚 LTC 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.

COVID-19 has amplified . We need socially innovative solutions to help seniors age safely and with dignity.

From to , to publicly funded , 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 LTC system in Canada, I — all of which are socially innovative.

Here are some solutions that can help when it comes to redesigning the LTC system.

Senior co-housing

One of the goals outlined in the is to help seniors stay active, engaged and maintain their independence. But many seniors struggle — especially affordable housing.

While retirement homes exist, for many — so .

Louise Bardswich is a retired college dean and She and three other women .

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 LTC facility in Ontario — the long stay semi-private option is .

Co-housing can be difficult due to zoning bylaws but legislation put forth in 2019 , named after Bardswich and her fellow co-owners, aims to make it easier for seniors to create co-housing.

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 . These to people who may have a difficult time leaving the home to see a doctor.

JC 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 , Gilbert says there’s been a positive and reduced emergency calls. “We’re seeing people able to cope with their illness much better at home.”

The Ontario Ministry of Health currently funds across every region of Ontario.

Home-based primary care

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

Dr. Nowaczynski explains that that is not possible during an office visit. The level of care he and his team provide and admissions to nursing homes.

According to Dr. 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.

Dr. Nowaczynski estimates that in Toronto there are 100,000 to 150,000 seniors who would benefit from . Between House Calls and other programs, “We’re probably meeting the needs of not even two per cent of that population. So, we are barely scratching the surface and the consequences of that are that there’s a large population of seniors who are receiving inadequate ongoing care.”

Making it . Some countries have even shifted more of their health-care budget to community and home-based care. Denmark spends 36 per cent of its LTC funding on care in designated buildings (like nursing homes), and the rest on home and community-based care.

In Canada, only .

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. 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. .

Providence Living in partnership with Island Health 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, president and 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, family members work together to create a home environment where residents can thrive.

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

Canada’s LTC 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.

The Conversation

Sarah Tranum does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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