There is no one size fits all solution for continuing care

Grace Snider Open letter to Health Minister Mike Nixon: Continuing care is a new topic of conversation at our dinner table as we have recently begun to investigate future care options for a loved one. It all feels a bit overwhelming. What are the long-te

COMMENTARY

by Grace Snider

Open letter to Health Minister Mike Nixon:

Continuing care is a new topic of conversation at our dinner table as we have recently begun to investigate future care options for a loved one. It all feels a bit overwhelming. What are the long-term care options in our community?

To get answers to our questions, some family members and I recently attended a free videoconference on long-term care. I walked in the door feeling hopeful and optimistic. The videoconference was called Reimagining Long-Term Residential Care: An International Study of Promising Practices.

Perfect. This is exactly what we needed. What are the “promising practices” for long-term care? What is working for the care of the most vulnerable people in our society? And where is this offered in our community?

I learned about a recent research project that was conducted by a group of 25 international, interdisciplinary researchers who spent seven years visiting long-term care residences in six countries. Here are some of their findings for “What Matters?” in long-term care:

First: location matters. A facility should be near a hospital, public transit and shopping centres. It should be integrated with other services, residences and generations.

Second: size matters. Larger facilities should be broken into smaller units, with easy connections among units, sight lines for staff, and way-finding for residents. Avoid long hallways. Allow wandering. Provide space for hairdressing and doctor visits. Include combined living/eating areas, fitness rooms, therapy pools and gardens.

Third: staff matter. They should be involved with the facility design. Staff should be given adequate space to get away, do their charts, change and meet. And the facility should be appropriately staffed to provide a continuity of care to residents.

Aside from location, size, and staff, the “matters” go on to other important details such as clothes/laundry, food/dining, cleaning, dying and debates. The researchers reiterated several times that they did not find a “one-size-fits-all” long-term care residence.

After the presentation there was a Q & A session, and that’s when I began to feel confused. There appears to be a serious disconnect between the findings of this current research and what is happening here in Whitehorse.

I raised the point that if location matters the most, why is there a plan to build a long-term care facility in Whistle Bend, a location which does not appear to meet most of the criteria for “location matters”? My loved one and many friends and family who would visit on a regular basis don’t drive or feel comfortable traveling independently on public transit, so visitor access would be limited, especially in winter. Our loved one would be unable to access services such as the bank, doctor’s office, pharmacy, stores, church, coffee shops, etc. It is also a long way from the hospital. “Isolated” is the word that comes to mind.

If size is another important criterion, I wonder why this facility will house 150 residents, with the possibility of adding 150 more, for a total of 300 residents under one roof? From my perspective this seems to be placing a large group of vulnerable people with a large group of staff.

Will our loved one be able to form meaningful relationships within this large group of people? The research project describes the ideal size of a home having about 100 residents divided into smaller units. I don’t see this.

My family did an online “fly through” of the Whistle Bend continuing care facility. It appears to be a very beautiful and impressive structure and it is very large. One person’s observation was, “It looks like a mall!” I thought it seemed very institutional. Maybe it was designed as a university campus dormitory? I cannot imagine my loved one feeling comfortable living in this space.

Have staff been consulted throughout the planning of and programming for this new facility?

A few years ago an elderly friend’s family began researching housing options for her and they were told, “Your mother will be dead before she gets into seniors’ housing in Whitehorse.” A year later she had a stroke. After the stroke she was no longer able to live independently in her apartment and was “living” in the Whitehorse General Hospital, which demonstrates the urgent need for various levels of long term care in our community. How unfortunate that her story isn’t that uncommon.

I think we all agree that there is a desperate need for more options for continuing care, and that there is no “one-size-fits-all” solution. I remain hopeful that you will take the time to consider and to put into place the “promising practices” from the current research (some of which I have outlined above) before proceeding further with the construction of a long-term care facility that does not appear to be able to meet the needs of some of our most vulnerable Yukoners.

Grace Snider lives in Whitehorse.

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