Dan Levitt has written an article for the Vancouver Sun entitled “Is this the future for nursing homes?”(December 7, 2014). In it he describes his first-hand impressions of an idyllic Dutch town called Weesp which has a neighbourhood designed and built exclusively for people with advanced stages of dementia who can no longer live independently.
He has been interviewed on TV about his visit to Weesp Dementia Village and his observations of how people with dementia are housed, fed and provided a lifestyle which encourages their independence and sense of pride and dignity. Dan Levitt has been working in the field of Senior’s Health Care for many years and he believes that this marvelous new program in the Netherlands points the way to the future for here in Canada. It’s all about dignity.
Residential care now gives elderly a sense of purpose
For the first time, by 2017, Canada will be home to more people older than 65 than children under 15. The demographic shift has already been marked by an increase in the prevalence of chronic diseases, resulting in the larger number of long-term care residents with multiple complex diagnoses.
At the same time, the rising tide of dementia is impairing the ability of many Canadians to live independently. The baby boom cohort exhibits stronger preferences for independent living arrangements, greater autonomy, and choice in services than previous generations.These forces create an urgency for innovation in how seniors age.
The good news is the paradigm shift has begun, as the culture within senior care living communities fundamentally changes. Residential-care facilities are no longer the nursing homes of yesteryear, as innovations in the care of the elderly have ushered in a new era in which choice, purpose and service are paramount.
Families are more involved as partners in the delivery of programs and services to loved ones. An example is family councils, which support families dealing with the loss experienced when a loved one lives in a residential care facility. Through this council, a complaint process exists to resolve issues on an individual basis, and to identify concerns that have an impact on more than one family and resident. The council is also a place for staff recognition programs, established to compliment employees who go the extra mile.
Family councils organize education sessions for families on the issues they face. Families offer caregiver support to each other — the elephant in the room — as there is a perceived gap in subsidized support for informal caregivers. In addition, at Tabor Village in Abbotsford, the family council led two consecutive annual fund-raising dinners, to improve programs and services transforming an institutional style multi-purpose room into a living room, and changing a basic outdoor space into a therapeutic garden.
Seniors in long-term care facilities are increasingly involved in choice, and have progressively more responsibility. Residents have rights and responsibilities to articulate their privileges and obligations. Seniors living in care facilities have lost much of their independence, and basic quality of life indicators often focus on food. Seniors are now involved in the dining experience choosing menu items, recommending recipes, and deciding on the way the dining rooms are decorated. Through the resident council, seniors directly determine how programs and services are enhanced to better meet their needs.
A more robust government funding formula has increased direct care hours and enabled a more diverse care team, in addition to nurses and care aides, who shoulder most of the heavy care. Seniors benefit from recreation staff, music therapists, social workers, chaplains, occupational therapists, physiotherapists, and mobility aides. The hope is a more diverse staff mix will lead to better health and better health outcomes.
As seniors are increasingly tech savvy, the expectation that long term care facilities will offer high speed Internet access is the new norm. Smart phone apps have been designed to enable seniors to measure their vital signs and extend their independence. The aging population will benefit from new practices, knowledge and products that have an impact on care delivery, quality of life and wellness, transforming the journey of aging.
New technology has been integrated through collaborative approaches to enhance the lives of seniors. Pharmacy services, electronic health records, point of care assessment touch screen tablets and global positioning systems provide a needed solution to reduce the stress when a senior with dementia wanders away from a long term care community.
Regardless of the innovations in long-term care facilities, seniors — especially aging baby boomers — want to stay at home as long as possible and have new expectations of what home care should be, ensuring they can age in place. Likewise, baby boomers will expect residential living environments to have a workforce highly customer service oriented; engaging programs and specialized services for seniors with advanced dementia; values that uphold health safety and dignity, and space for couples who desire privacy for intimate encounters, to name a few.
Society cannot build enough residential care facilities and there is not enough government funding available. An obvious truth that is either ignored or going unaddressed is that all the programs and services that baby boomers will need is unsustainable given the current delivery model and tax base. The big question to answer is: who will pay for increased costs to meet the increased demands?