Social innovation leads to co-housing and dementia villages 

By Sarah Tranum

To help seniors age safely and with dignity we need innovative solutions. From co-housing to community paramedicine programs, home-based primary care to publicly funded dementia villages, there is hope on the horizon.

As a social innovation designer, I study complex challenges with the aim to find the common approaches needed to solve issues, not just manage the symptoms.

Recently, to better understand the challenges of Canada’s LTC system, I interviewed stakeholders involved in a range of approaches that were attuned to individuals’ needs at different stages of aging—all of which are socially innovative.

Here are some options that I believe can help:

Senior co-housing
One of the goals outlined in the National Institute on Ageing’s National Seniors Strategy is to help seniors stay active, engaged and maintain their independence. Despite this, many seniors struggle to find suitable housing—nevermind affordable. While retirement homes exist in many communities, for a lot of older adults the monthly fees are simply out of reach. Which leads us to looking at why some seniors are choosing co-housing.

Meet Louise Bardswich, a retired college deanwho co-owns a home in Port Perry, Ont. She and three other women pooled their resources together to build and share.

Their wheelchair accessible home features design elements that will allow them to age in place—like barrier free bathrooms, a spacious kitchen and a guest room that can be used for a live-in care provider in the future. The housemates pool their resources to cover costs and Bardswich estimates her ongoing monthly costs at $1,100.

While $1,100 is not affordable for everyone, it’s considerably less than the cost of room and board at a LTC facility in Ontario where the long stay semi-private option is almost double at $2,280.04 per month.

Co-housing can be difficult due to zoning bylaws but legislation put forth in 2019 called the Golden Girls Act, named after Bardswich and her fellow co-owners, aims to make it easier for seniors and their families to create co-housing.

Community paramedicine programs
An integral part of supporting older adults who wish to continue living safely in their homes is ensuring that they have access to the services they need. One innovative example is community paramedicine programs. These programs use existing trained emergency medical personnel to provide primary health care to people who may have a difficult time leaving the home to see a doctor.

JC Gilbert is the deputy chief in charge of operations at the County of Simcoe Paramedic Services. In the five years since the launch of Simcoe’s programs, Gilbert says there’s been a positive impact on patients’ overall well-being. It’s also reduced emergency calls. “We’re seeing people able to cope with their illness much better at home.” The Ontario Ministry of Health currently funds the development of community paramedicine programs across every region of Ontario.

Home-based primary care
House Calls is a primary health care practice for home-bound seniors living in Toronto, led by Dr. Mark Nowaczynski and SPRINT Senior Care.

Dr. Nowaczynski explains that seeing people at home gives health practitioners the ability to gain a more holistic understanding of a patient’s health and well-being that is not possible during an office visit. The level of care he and his team provide can prevent hospitalizations and admissions to nursing homes. According to Dr. Nowaczynski, House Calls serves 450 seniors with an average age of 89. “We make it possible for our patients to live out their days at home and die at home,” he says.

Dr. Nowaczynski estimates that in Toronto there are 100,000 to 150,000 seniors who would benefit from home-based primary care. Between House Calls and other programs, “We’re probably meeting the needs of not even two per cent of that population. So, we are barely scratching the surface and the consequences of that are that there’s a large population of seniors who are receiving inadequate ongoing care.”

Making it possible for people to age at home has been shown to reduce the reliance on the healthcare system and be cost effective. Some countries have even shifted more of their health care budget to community and home-based care. Denmark spends 36 per cent of its LTC funding on care in designated buildings (like nursing homes), and the rest on home and community-based care.

Dementia villages
Communities of care designed to give their residents freedom and choice within a safe and supporting environment, the first dementia village in the world opened in 2009 in the Netherlands. The Hogeweyk is an intentionally designed village with 23 houses for 152 seniors living with dementia. The village has a bar, restaurant, theatre, grocery store, streets and gardens for residents to use and enjoy. It is publicly funded and runs on a budget comparable to conventional nursing homes.

Providence Living in partnership with Island Health will soon be opening Canada’s first publicly funded dementia village care model in Comox, BC. With construction starting this year, it will feature smaller households that support freedom of movement, access to nature and connection with the community.

Candace Chartier, president and CEO of Providence Living, explains that this village concept is not just about the physical design but encompasses a shift in the model of care in which residents, staff and family members work together to create a home environment where residents can thrive. “The challenge is to make this the new standard of care instead of a patchwork that results in wait lists, drives up health care costs and creates confusion for everyone.”

Long-term care in Canada can become a human-centred system that helps seniors get the care they need. But first, we need to make humane, dignified care for seniors a top priority.  

Sarah Tranum is an Associate Professor for Social Innovation Design in the Faculty of Design at OCAD University. This article was republished from under Creative Commons licence.

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