The long-term care home is so small, it might be thought of as a big house in the suburbs.
Ten beds, a kitchen and a common living room – This has emerged as a major option to overhaul Alberta’s struggling elderly care system.
Many families of dementia patients are now behind the concept, and last May a government expert panel recommended 10 percent of any new designs using this small concept. That would be 1,600 new beds expected in small-scale facilities by 2030.
They’re hoping for a sign that this family is coming into the county budget on Thursday.
Lisa Ball has an image in her mind for a moment that explains exactly why these tiny homes are needed.
Her father, John Paul, was diagnosed with dementia in his early 70s, a decade before his death. Lisa walked into his long nursing room once to find him naked, terrified in the corner of the bathroom. Three unfamiliar caregivers were trying to push him through his morning routine. His face was just fear and confusion.
“How would any of us feel if someone tried to undress us and we didn’t understand why?” She said.
“Different faces all the time. When you’re in the big facilities, I think they call it rotating employee appointments. Everyone is primed to fail.”
Nursing home around the corner
John was in several different nursing homes before his death, including a small experimental home with just three clients and around-the-clock care staff. Coincidentally, it was at the end of the street from their family home. He and his wife would walk together and stop chatting with the former neighbours. Stress levels decreased in all family members.
But it was not sustainable; Lisa said it closed 10 months after moving in.
“We had a glimpse of when he could do well. It was amazing.”
Advocates say nursing homes with nearly a dozen clients are becoming popular in various jurisdictions, including Saskatchewan, the United Kingdom and Australia. They feel like home, which is best for dementia sufferers. The model also facilitates the creation of safe and accessible outdoor spaces and allows clients to participate in normal household routines, such as baking or cooking dinner.
Fewer employees take on a variety of tasks, so the same person may do some cooking, light housekeeping, and social activities.
They can have a cupcake
Kim Brundrett, who leads the lobby effort with him Calgary Dementia NetworkHe says a house like this would also make moving around easier when it’s not safe to care for someone in their house.
“If you can no longer take care of your wife or mother but they can live on the street and you can go for a walk in a familiar area and the grandchildren can come,” she said. “Maybe she has a little play structure in the back and they could have cupcakes.”
“Less than this: ‘Oh, we’re going to put all the dementias out there and we’re going to lock those doors and we’re not going to interact with them anymore. “
Families of the Dementia Network began lobbying for change last summer after seeing loved ones die or forget their families due to the lockdown and the spread of COVID-19 through large and aging infrastructure. They launched a research project to examine alternatives. Brundrett then met with regional officials in January and was encouraged by their interest.
Her team also hopes to work with Exquisicare, a private company that operates some of the tiny homes already in Alberta. Together, they’d like to see if they can measure benefits such as reduced infections and bed sores, increased mobility and other improved quality of life, which could help Alberta Health organize and direct funding for this approach.
Exquisicare has three 10-bed nursing homes in Edmonton. For Dawn Harsch, a registered nurse who started the company 10 years ago, the key element that Alberta Health needs to change is the funding structure.
The county says change is coming
In principle, seniors who live at home or in a facility can cover their medical needs but pay out of pocket for food and accommodation, in both public and private facilities. But Harsch says it hasn’t been able to access that support for its clients. Its customers stay regressive and die in the same surroundings. But they’re paying for it all — $8,700 a month — in her specially designed, 8,000-square-foot homes in Upper Windermere and Cameron Heights.
“Everything is private. I tried (to get support) and I’m still trying,” she said. “I have always supported that funding should follow the patient where they choose. There should be a choice in where the elderly live.”
The panel of experts that recommended small care homes last May suggested they would also provide better options for Indigenous communities and those living in remote rural areas.
In a written statement, Alberta Health spokesperson Chris Purdue said the Continuing Care System transformation plan will include smaller-scale homes.
“(The shift) includes the expansion of home and community care, a desire expressed by Albertans to review continuing care homes,” he said. “This also includes increasing the number of smaller dwellings that provide continuing care services. We will share specific details with Albertans when they are completed.”
This month the CBC team in Alberta is focusing on family caregivers – husbands, wives, children and others who look after their loved ones. Visit cbc.ca/familycare to read more.