BC Group seeks to build smaller, more homelike long-term care units

Rows of rooms line a long, narrow hallway where a tall aluminum cart with food trays is parked while reception staff search visitors and offer surgical masks. At the other extreme, a large 1980s television is being removed from the building, which could be replaced if a rezoning plan is approved.

The nearly 60-year-old Inglewood Care Center, home to 230 residents, would be demolished, along with its hospital-like setting, as part of a “home of 12” private room model based on lessons learned from COVID-19. pandemic.

Chris Russell, the house manager, said that between 43 and 51 people live on each floor of the center. But a rezoning request that is expected to be filed in the West Vancouver District in April calls for a couple of buildings to accommodate two units, or homes, of a dozen residents per floor.

“The bottom line is that you won’t have that large group dynamic,” he said, passing a dining room, the kind that would no longer exist as a mass gathering place in the new home where members of the same household would eat together. .

Baptist Housing, a non-profit provider of senior housing with 21 houses in BC, purchased Inglewood in February 2020 with the goal of rebuilding it in line with trends toward fewer residents per unit.

However, the pandemic forced the organization to reduce the number of people in each household from 23 to 12 to reduce the incidence of COVID-19 or other infectious diseases such as seasonal influenza in accordance with the guidelines established by health authorities in British columbia

The Health Ministry said the design guidelines call for 12 to 18 people per unit, with a bathroom in each person’s living space. Operators of own and contract housing can accommodate two people in a room for less than five percent of the residents if there is a plan to transfer them to separate rooms upon request.

What people are reading

Inglewood largely escaped the ravages of the pandemic and had no fatalities.

More than 15,000 people have died during the pandemic in nursing homes across the country, the highest proportion among the 38 member countries of the Organization for Economic Cooperation and Development.

Marc Kinna, CEO of Baptist Housing, said the Inglewood expansion would include some independent and supportive housing options for seniors, along with affordable housing for staff, the vast majority of whom travel from outside the West Vancouver area. .

The new buildings would incorporate aspects of the so-called Green House model in the United States, where a home environment for fewer residents eliminates large institutional-type facilities.

“The value of a home of 12 is not new. What’s new is that places that used a model of 12 home had much less spread of COVID-19 than places that had communities of 20, 30, 40 residents sharing a space. “. Kinna said.

“Not only did he have the socialization benefits and quality of life benefits to get through a pandemic, but he also realized that it has extreme value in terms of saving people’s lives and providing better protection against COVID. other diseases that could still happen. ” come.”

As part of the proposal, families could safely access Inglewood during an outbreak by taking an elevator to the floor of a loved one, where a visiting room with a Plexiglass wall would help reduce the risk of infection.

A separate entrance and exit for staff and a room for donning and doffing personal protective equipment is also part of the 12-person model, which Kinna said won’t cost more for residents, who pay about 80 percent of their annuity. long-term care income.

Baptist Housing would negotiate a new agreement with Vancouver Coastal Health to help pay for the increased cost of the new building. The budget for the entire project is estimated at $ 583 million, with an expected contribution of approximately $ 15.5 million from BC Housing and $ 13 million from Canada Mortgage and Housing Corp.

Pat Armstrong, a distinguished professor emeritus of sociology at York University in Toronto, joined international teams to tour long-term homes in Norway, Sweden, Germany, the United Kingdom, and Canada between 2016 and 2018. His week-long visits at least two households in each country were part of a 10-year study that was completed in 2020.

“The Swedes and Norwegians were especially surprised to see our large units,” Armstrong said of researchers from countries where eight to 12 older people typically live in a long-term care unit, compared to BC and Ontario, for example. where up to 32 people are housed together in most homes.

There are no Green House models in Canada, but some aspects have been implemented in parts of the country, including one known as the Eden Home in Halifax and another called the Butterfly Home in the Peel region of Ontario, he said.

Consistency in staffing is an important benefit to both staff and residents in smaller homes where employees are offered full-time jobs, while many of their counterparts elsewhere have long hours. part time and work in multiple locations.

Dr. Samir Sinha, director of geriatrics at Sinai Health System and University Health Network in Toronto, said that in addition to adequate staffing, smaller homes need adequate government funding, beyond the traditional formula for the current number, highest residents per unit.

The pandemic has shown that Green House’s approach led to a significantly lower risk of COVID-19 transmission, that staff felt better supported and family involvement was valued, he said.

“They tend to provide superior care, pandemic or non-pandemic,” said Sinha, who is also director of health policy research at the National Institute on Aging at Ryerson University in Toronto.

He said that with baby boomers turning 85 in a decade, Canada will face an unprecedented demand for long-term care, so the work to reshape the system can’t wait.

Prime Minister Justin Trudeau promised to set national long-term care standards and Armstrong, who is on a committee to develop them, said public consultations were expected to begin early next year.

“All provinces, territories and the federal government must work together and say, ‘Enough is enough, this was so deeply horrible that we can never allow this to happen again,'” Sinha said of the number of deaths from COVID-19. in a while. term care homes.

“While some incremental things have happened, I really hope that ultimately, given the fact that out of respect for the more than 15,000 Canadians who died, we will try to honor their legacy by doing well for those left behind and for those who one day they may need to live in a long-term care home. “

This Canadian Press report was first published on December 31, 2021.