Group in British Columbia seeks to build smaller, more comfortable long-term care units after COVID-19

VANCOUVER – Rows of rooms line a long, narrow hallway where a large aluminum cart stacked with food trays is parked while front desk staff check in visitors and offer surgical masks.

VANCOUVER – Rows of rooms line a long, narrow hallway where a large aluminum cart stacked with food trays is parked while front desk staff check in visitors and offer surgical masks. At the other end, a large 1980s television set is removed from the building, which itself could be replaced if a rezoning plan is approved.

The nearly 60-year-old Inglewood Care Center, home to 230 residents, is said to have been bulldozed, along with its hospital-like setting, as part of a “12-room household” model of private rooms based on lessons learned from the COVID-19 pandemic.

Chris Russell, administrator of the home, said between 43 and 51 people live on each floor of the center. But a rezoning application is expected to be submitted to the District of West Vancouver in April for a pair of buildings that can accommodate two units, or households, with a dozen residents per floor.

“The big problem is you won’t have that big group dynamic,” he said as he passed a dining hall, the type that would no longer exist as a mass gathering place. in the new house where members of the same household would eat their meals together. .

Baptist Housing, a non-profit provider of senior housing with 21 units in British Columbia, purchased Inglewood in February 2020 with the aim of redeveloping it in line with trends towards fewer residents per unit.

However, the pandemic has forced the organization to reduce the number of people in each household from 23 to 12 in order to reduce the incidence of COVID-19 or other infectious diseases like the seasonal flu, in accordance with guidelines established by authorities. health facilities in British Columbia.

The Health Department said the design guidelines called for 12-18 people per unit, with a toilet in each person’s living space. Owned and contracted home operators can accommodate two people in one bedroom for less than five percent of residents if there are plans to move them to separate bedrooms upon request.

Inglewood has largely escaped the ravages of the pandemic and has had no deaths.

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

Marc Kinna, CEO of Baptist Housing, said Inglewood’s expansion will include independent and supportive housing options for seniors, as well as affordable housing for staff, the vast majority of which commute from outside. from 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 a smaller number of residents does away with large institutional-type facilities.

“The value of a household of 12 is not new. What is new is that places that employed a household model of 12 had much less spread of COVID-19 than places that had communities of 20, 30, 40 residents sharing a space, ”Kinna says.

“Not only did it have socialization and quality of life benefits for getting through a pandemic, you also realized that it has extreme value in saving lives and better protection against COVID or other illnesses that could still be. come. “

Under the proposal, families could safely access Inglewood during an outbreak by taking an elevator to a loved one’s floor, where a visitation room with a plexiglass wall would help reduce the risk infection.

A separate entrance and exit for staff and a room for putting on and taking off personal protective equipment are also part of the 12-person model, which Kinna says will not be more expensive for residents, who pay around 80% of their annual salary. income for long-term care.

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

Pat Armstrong, emeritus emeritus professor of sociology at York University in Toronto, joined international teams to visit long-term homes in Norway, Sweden, Germany, UK and Canada between 2016 and 2018. Their week-long visits to at least two homes in each country were part of a 10-year study that ended in 2020.

“The Swedes and Norwegians were particularly shocked 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 British Columbia. and in Ontario, for example, where up to 32 people are housed together in most homes.

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

Consistency in staffing is a major benefit for staff and residents in smaller homes where employees are offered full-time jobs while many of their counterparts elsewhere have part-time hours and work in multiple locations.

Dr Samir Sinha, director of geriatrics at Sinai Health System and the 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 and higher number of residents per unit.

The pandemic has shown that the Green House approach carries a significantly lower risk of COVID-19 transmission, staff feel better supported, and family participation is valued, he said.

“They tend to provide top quality care, whether or not there is a 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 the baby boomers turning 85 within a decade, Canada will face an unprecedented demand for long-term care, so the work of overhauling the system cannot wait.

Prime Minister Justin Trudeau has vowed to set national long-term care standards and Armstrong, who is on a committee tasked with developing them, said public consultations were due to begin early next year.

“All provinces, territories and the federal government need to work together and say, ‘Enough is enough, it was so deeply horrible that we can never let this happen again,’” Sinha told About the number of deaths from COVID-19 for a long time. long-term care homes.

“While more things have happened, I really hope that at the end of the day, given that out of respect for the more than 15,000 deceased Canadians, we will try to honor their legacy by doing it right for those who do. are left behind and for those who one day may need to live in a long-term care home. “

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

Camille Bains, The Canadian Press

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