February 19th, 2020

The future of dementia care

By Lethbridge Herald Opinon on September 5, 2019.

Innovative care models show

the way forward

If it takes a village to raise a child, what about a village to care for a senior with Alzheimer’s disease?

That very idea pioneered in the Netherlands has been gaining followers around the world. And a Canadian long-term care home designed to look and feel like a charming village rather than an institution opened last month in Langley, B.C., near Vancouver.

The “villagers,” who are living with dementia, live in small groups in cottage-like homes where they can help staff prepare meals, walk freely around the paths and gardens of the fenced property and pop into the community centre, post office or general store.

It’s not quite real, of course, but the idea is that mimicking parts of a previously remembered life and creating a more normal daily routine will keep residents happier and more settled, as well as safe.

That’s far preferable to keeping residents safe and calm by limiting their independent movement and pumping them full of powerful drugs, which too often is how it’s done in a traditional long-term care home where staff are run off their feet.

The village concept, along with a planned high-tech dementia and Alzheimer’s home in Hamilton and the British-based Butterfly program of emotion-focused care that some long-term care homes in Ontario have already adopted, all challenge us to think differently about what care can and should look like.

More than 420,000 Canadians aged 65 and older have been diagnosed with dementia, which includes Alzheimer’s disease and other brain disorders, according to the federal government. And the Alzheimer Society of Canada has long warned that the number of cases is set to double over the next 15 years.

With that tsunami of need coming our way, these innovative care approaches provide good principles to guide how we should create new long-term care homes and update existing ones.

Certainly the Langley dementia village – a privately funded facility that operates on nearly a one-to-one staff-resident ratio – is unlikely to be replicated on a large scale across Canada. But we can and should think about how to bring its core principles – a life with some purpose, individualized care and more choice – into our long-term care industry writ large.

Right now, too many homes follow regimented routines that force people out of bed at an early hour and rush them to breakfast. Then they are left alone for long stretches while workers race through the day, trying to keep up with wet briefs, call bells and government-mandated documentation. We know that life in these institutional settings makes people bored, frustrated and, in some cases, angry.

Long-term care homes operate in a provincial system that focuses them on tasks and regulatory compliance rather than the broader health and happiness of residents.

But expectations of care are moving beyond simply achieving a passing grade from Ontario’s inspection system for keeping people clean, fed and safe.

Even practised on a smaller scale than the village, there are benefits to both residents and staff of more individualized models of care. When the Butterfly program, which works to connect residents suffering from dementia to their past lives and interests, was first introduced in Peel Region homes, staff sick days declined, as did resident falls, antipsychotic drug use and depression.

Those all result in cost savings, not to mention happier lives. It also fits into Canada’s first-ever national strategy on dementia, which seeks to prevent dementia, identify treatments and a cure – and improve the quality of life for people with dementia and their caregivers.

Long-term care homes shouldn’t be sterile spaces that just warehouse people. They should be comforting homes with proper programming and staff levels that allow people to actually live out their final days.

An editorial from the Toronto Star

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One Response to “The future of dementia care”

  1. Southern Albertan says:

    This appears to be wonderful, for those with dementia who are still mobile. And, in Alberta, it remains, with expected cutbacks to social services, as to whether public money would be dedicated to instigating these types of facilities, or, whether private operators are expected to do this, let alone funding highway expansions, bridge fixes, funding wholistic approaches to what surrounds the opiate crisis…. Trouble is, some folks cannot afford the cost of some private supportive care facilities already. This follows, in many instances, that ‘private’ is often, more expensive…which is fine if one ‘has money.’
    Then, there are the folks with dementia who require total care, i.e.assistance with everything, including hoyer sling mechanical lifts for transferring in and out of bed and wheelchairs or broda chairs, while still being fearful, hallucinating, etc. along with, still, the physical and verbal aggression and in a short-staffing scenario. The short-staffing, in itself, is heartbreaking for these fully dependent folks who many times do not get the full care they deserve or even get it in a timely manner….and it’s not the fault of the frontline staff who often bear the brunt of voiced frustration which can be abusive.
    This is why some of these folks, if they could ‘see’ themselves now in their ‘past life’ eyes, would be horrified. Some folks, in my experience in long term care, and according to their family members, would have chosen ‘assisted death’ and arranged for it when they still had capacity. Unfortunately, our laws still do not allow for this, i.e. to make arrangements ahead of time stating when whatever might happen physcially and mentally, actually happens.
    Maybe in light of what all of this costs, the AB UCP should cancel the 8% corporate tax rate for the wealthy, cancel the $20 million ‘war room,’ do more fair taxation, stop subsidizing big business, amend taxation to fix tax loopholes……and the same applies, in the big picture, to the federal Conservatives and Liberals who, all, have not dealt with our increasing gap between the rich and the poor and kept those in the top 1% wealthy and are not trickling the wealth down as is/was meant to do.
    It should not be forgotten, that what happens with social services such as health care and education, and that what is expected once one/we enter into these services, is intertwined with the politics for which gets the votes. As one of our local doctors said during the Klein health care cutbacks, “folks need to decide what they want.” It is a revealing thing when we or our loved ones suddenly enter the ‘system’ and expectations are not met.