6 ways to improve residential care facilities before you need one

July 13, 2016

What does the future hold for care homes? It’s far from our grandparent’s traditional nursing homes

By Bruce Raber


Having just spent the last few years helping and coercing my parents into leaving their single family home for an independent living apartment for seniors, and subsequently having to move my mom into a different facility with dementia care, the topic of elder care could not be timelier for me.

On June 24, I had the privilege of chairing the Vancouver Health Studio’s annual Client Breakfast. This year the focus was on introducing new approaches to residential living for the elderly. I am of the Baby Boomer generation, which in Canada, like the USA, has some alarming statistics. According to Stats Canada, there are more people now in Canada aged 65 or older than there are children 15 years or younger. And my Baby Boomer cohort group is growing four times faster than any other population group. This will have a tremendous impact on our healthcare system, particularly in how we deliver residential care. And we need to figure this out quickly because in British Columbia, where I live, 13% of our population is 65 or older but in Ontario the same cohort is a staggering 38.5%!

3D model of an elder care facility

Unlike the generation before us, as Boomers retire we will generally be in better health, have longer life expectancy, and more wealth. Consequently, we will have higher expectations for the standard of care quality and environment when we seek residential care.

Over the last 30 years there have been a number of changes and improvements in care delivery models for seniors including:

  • A continuum of care approach which provides stepped care in-situ to allow elders to age-in-place
  • Use of dementia cottages to provide cognitively impaired seniors a comfortable and safe environment in which to live
  • The Eden Alternative®, which prioritizes shared responsibility and partnership between care givers and care receivers to enhance well-being
  • John Zeisel’s Hearthstone approach that builds in memory cues and naturally familiar places, striving strive to create physical surroundings that eliminate sources of frustration and support independent actions and personal choice

Despite these advances, there’s been little innovation in design for senior care, particularly in the last 10 years.

That’s why Stantec provided the forum for what we hope will be the start of a new conversation that reframes elder life as a meaningful stage in human growth and development.

Speakers included Dan Levitt, Adjunct Professor of Gerontology at Simon Fraser University and CEO of Tabor Village in Abbotsford, BC, Jo-Ann Tait, Providence Health Care’s Director of Elder Care, and Robena Sirret, Providence Health Care‘s Residential Redevelopment Clinical Planner. Jo-Ann and Robena, along with Stantec architects Eleonore Leclerc and Ray Pradinuk, presented their journey and findings from their recent visits to 16 residential home care facilities in Switzerland, Germany, the Netherlands, Sweden, and Finland. Jo-Ann commented how “here in Canada we bubble wrap our elderly so tightly to take the risks away, that we squeeze the life out of them.” They shared images and impressions of projects in Europe that demonstrate the value and benefits of care models and facility designs that have switched from a Medical Model to a Social Model; and from ‘least restraint” to ”no restraint” care facilities. Their observations helped form the guiding principles for a new 330 resident dementia care village that Stantec and Providence are working on in Vancouver.

Dan Levitt challenged current societal attitudes toward aging by introducing a new approach to residential living. The conventional narrative of a decline in mid-life and senior enjoyment has been reinforced by the traditional nursing home as the default final destination for frail elders. Dan provided inspiration, insight and a new lens to view housing and care as a spring board for the greatest chapter in life.

If I had to sum up the morning with six takeaways that should be top of mind on your next residential care project they would be:

  1. Residential and dementia care facilities need to support a whole life for their frail elderly.
  2. We need to provide full-spectrum spaces, from tranquil to vital, combined with a social care model that can realize the transformation of the resident back from patient to person.
  3. We need to design private rooms which should be thought of as apartments or homes where the resident can regain the role of host.
  4. We need to look at designing smaller living units, and to create the social spaces of the household where meals are prepared from scratch by staff and even residents.
  5. We need to loosen the “bubble wrap” and consider complete freedom of access to a safe, secure public realm made vital by engaging the surrounding community.
  6. Make direct experience of the changes in outdoor light and weather an inescapable part of daily life for every resident

Of the key principles to be realized, freedom of movement and community integration are most critical. The presentations left me, and hopefully all our guests, with hope that there are better ways of providing care for our elderly, in much more generative and social environments. Perhaps this is one less thing for us Boomers to worry about.

For a copy of the presentations including video highlights, please email bruce.raber@stantec.com

Other blogs by Bruce:

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