In the past three seasons, there have been several occurrences of violence in Canadian long-term care homes.
Our research found that the violence and murders often involve residents with dementia who didn’t even know what they were doing. The prospect of this crisis growing in magnitude is very real, as an increasing number of Canadians are diagnosed with dementia. That number is expected to nearly double to 1.4 million in 2031, according to estimates provided the Alzheimer’s Society of Canada.
The Society set out to find nursing homes with innovative approaches to caring for Canadian living with dementia. It visited six homes across Canada — large and small, private and public, rural and urban — to see “person-centred care” in action in a variety of settings.
Like the Sherbrooke Community Centre in Saskatchewan, profiled here by W5, the selected care homes have moved away from institutional models that merely warehouse the elderly, and have embraced a “culture change” that is putting the “home,” i.e. a familiar and family-like environment, back into nursing homes.
Sherbrooke Community Centre
Sherbrooke is a registered Eden Alternative™ home. The Eden Alternative™ is not a program, but rather a total philosophy that seeks to address what Dr. Bill Thomas calls the Three Plagues of Nursing Homes: loneliness, helplessness and boredom.
Dr. Thomas discovered that medical treatment is necessary but insufficient for quality of life and needs to be the servant and not the master of care.
The Eden Alternative™ was adopted at Sherbrooke after planning for the construction of the Village (where 9 or 10 individuals live together in houses that function like a family home) was complete. It was believed that the environment being constructed would support this philosophy, which above all else demands a change in organizational culture.
The Eden Alternative™ grows easily in an environment like Sherbrooke’s Village. Staff and residents seem to have different expectations of how things can happen, based on the opportunities afforded by the physical environment.
The smaller number of people, who have close and continuous contact, supports the development of intimate relationships, the antidote to loneliness. This is both rewarding and painful. It is more difficult for the staff and residents when there is a death in the house.
Even with this being the case, the staff members find their work so much more meaningful that they report they would never go back to the “old way” of doing things. Residents and families also speak of the increased intimacy and comfort they experience in this environment.
The house environment also supports residents and their families being involved in the day to day chores and activities of life. Residents can assist with any small part of getting a meal on the table, or in the clean up. This is very beneficial to the cognitively impaired who might not make a substantial contribution but who benefit from participation. There is also opportunities to do laundry. The model supports the alleviation of helplessness.
Most of the 11 houses have at least one pet. There are dogs, cats and birds. This helps with the loneliness and in addition creates spontaneity and variety, which addresses the boredom often experienced in these settings. The animals are a drawing card for children, who then wish to visit or volunteer.
The Village Houses promote our philosophy of resident direction. With the small environment and number of residents and staff, decisions can be made quickly with lots of consultation with those affected.
Examples are the residents and families choosing their own china, deciding where pictures should be hung, where the couch works best, what food to serve for supper, whether or not they want a pet, and so on.
The opportunity for decision making at this level increases dramatically when one doesn’t have to worry about other departments and groups of residents. The Daily Living Assistant has the freedom to juggle her work depending on the needs of the resident. There are no “department” routines, barriers or competing agendas.
Suellen Beatty, Sherbrooke’s CEO, and Cheryl George, Sherbrooke’s Education Leader are the Eden Regional Coordinators for Western Canada. For further information, contact Cheryl George at (306) 655-3646 or email.
The results of the Alzheimer’s Society of Canada six-home study are on its website.
In addition to the Sherbrooke Community Centre in Saskatchewan, the Alzheimer’s Society of Canada study includes:
The Delta View Life Enrichment Centres in British Columbia
Fenelon Court by Revera; and Union Villa Long Term Care Home in Ontario
The Donald Berman Maimonides Geriatric Centre in Quebec