COVID-19 cases in long-term care inspire redesign, reform of institutional-style homes

Some private operators of personal care homes want the province of Alberta to consider making them part of the public system that takes care of our aging population.

Karen Cazemier, who runs Community Care Cottages in Alberta, is convinced smaller home settings are better for seniors’ overall health and mind.

“We grow up in homes and we live in family settings so it works because this is natural to what we are used to living in,” Cazemier said.

Community Care Cottage.The type of home is referred to as a personal care home. With spaces for between 10 and 12 residents, the seniors live together with around-the-clock care. But because it’s a private facility, residents’ payments aren’t subsidized by the province.

“Why are families forced into paying out of pocket for a scenario that’s a better option for them?” Cazemier said.

None of Community Care Cottages’ homes had a single case of COVID-19, and operators say they rarely even have flu outbreaks.

Main living room at Community Care Cottage.
Main living room at Community Care Cottage. Jill Croteau/Global Calgary

Blaine Ringham’s stepfather, Julius Molnar, lives at one of the homes in Red Deer.

“When the rest of the world was just starting to get interested in a virus, they had already locked down the home as a precaution and took steps to make sure no one went in, and the safety level was better than you could do in a big facility,” Ringham said.

READ MORE: Alberta families desperate for changes to long-term care after COVID-19 outbreaks

He prefers this style of home rather than larger long-term care homes.

“(My stepfather) has improved dramatically in this style of care,” Ringham said. “The option of the smaller home has so many benefits I prefer never to move him, but the cost might force us into moving him.”

Blaine with his stepfather Julius.In the larger public long-term care facilities, families pay for accommodation, and the province pays for the health-care costs. But in a private setting, families pay for it all.

“We stopped institutionalizing everyone in our society and now we (are) institutionalizing our seniors, and other options need to be talked about,” Ringham said.

The operators of personal care homes in Alberta want the provincial government to consider making them a part of the public system. Other provinces support such care homes financially.

“Saskatchewan has over 120 personal care homes; so does Manitoba and B.C. This concept of personal care homes is not an novel idea, but it’s novel in Alberta,” Cazemier said. “I would challenge the UCP government; on page 74 of their platform document, they ran on a platform that said they would allow and promote personal care homes, and I’m looking forward to them delivering on their promise.”

An Alberta Health spokesperson said Alberta’s continuing care system is a mix of public, independent and non-profit operators and is funded according to the needs of residents.

They didn’t reply to direct questions about the personal care home model.

Bedroom in Community Care Cottage.Andrea Klooster runs Harmony House in Red Deer. She is a registered nurse and fears her personal care home is on the brink of closure. She hasn’t taken a paycheque since the pandemic started and has been asking the province for support.

“They said, ‘Absolutely not. There is no money for private nursing homes, and you’re on your own,’” Klooster said. “‘But we are there for you if they need to move to another facility.’”

Bill Stephenson has been a resident there for almost four years.

“It’s homey; you don’t feel like you’re being assembled in a warehouse waiting to die,” Stephenson said.

Watch the other installments in Global News’ continuing coverage of the LTC crisis

Jill Griffith’s father, Marvin Bishop, also lives at the home. She’s spent time lobbying the government to consider putting these homes into the public system.

“We will all be seniors, so there needs to be more invested, more time, more love, more care,” Griffith said. “That’s what I say about Harmony, it’s a model of senior care that I wish for every family that has to put their loved one in senior care.”

READ MORE: ‘From here to the box’: Seniors voice terrifying concerns on long-term care amid COVID-19

With many seniors on waiting lists for public long-term care homes, families don’t understand why this can’t be financially supported. Larry Schulhauser’s father, Gerry, is content at Harmony.

“He has a smile on his face, and I said: ‘Dad, you being looked after?’ He said: ‘Yes I am!’” Schulhauser said.

“He loves this place. He’s happy here, and this is what’s important to me.”

“A senior is just you and I with more wrinkles and more care needs. They are us — just older,” Cazemier said.

Many are calling for the current design of most of the long-term care homes in this country to change. Margot Schulman created a design company and has dedicated her entire career to redesigning and reforming the current system.

Margot Schulman
Margot Schulman. Jill Croteau/Global News

Schulman said too many of them are built with efficiency in mind and not enough focus on quality of life for seniors.

“We need a complete overhaul of this existing system and, financially, we just continue to pump money into the system that is broke,” Schulman said. “It’s time to create a new model.”

Alberta Health didn’t reply to questions about reforming the LTC system.

READ MORE: Long-term care facilities are the only option for many. What happens when they fall short?

After suffering a serious brain injury, Margot’s brother David needed a long-term care home. Over the years, Margot watched him share spaces with 40 different roommates, with over 1,000 care aides. She knew what needed to be different.

“The space and the buildings are old, the basic physical surroundings are just absolutely depressing, and they don’t have to be,” Schulman said.

She is creating a human-centred model, with functional homes that reflect the character of the people who live there.

Margot and her brother David.”All the research that we’ve done, we need to have consistent care partners who actually get to know and understand a person’s history,” Schulman said.

People thrive in smaller home settings with familiar surroundings, particularly those with dementia. She’s created a model that mirrors dementia villages in places like Europe.

“I am in awe that we are designing these massive structures if we know our client has a memory issue,” Schulman said.

Surveys from families across the province support the concept to transform traditional institutional-style homes. The Health Quality Council of Alberta advocates for better seniors’ homes. CEO Andrew Neuner said there are opportunities to improve based on feedback from families and caregivers.

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“There have been a variety of reviews, and we have made recommendation and we have yet to see action,” Neuner said. “We monitor long-term care and a variety of measures that bring a better perspective.”

“There are opportunities to improve and some operators do extremely well, but there is a chance to learn from others.”

Dr. Carole Estabrooks, director of Translating Research in Elder Care, said the pandemic has raised the conscience of Canadians to want better care.

“We were holding it together with goodwill and caring and a lot of duct tape,” Estabrooks said. “There were warning signs.

“Nobody is proud of what’s happening. So, let’s mobilize it into action and let’s do better by our old folks. I can’t imagine Canadians don’t want to do better,” Estabrooks said.

The hope is once there’s a transformation of the physical surroundings, it will inspire stronger connections between workers and residents.

“That’s really what it’s about. How do we spark joy, how do we have meaning, how do we create autonomy, safety, security, in our spaces and in the community for seniors,” Schulman said.

© 2020 Global News, a division of Corus Entertainment Inc.

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