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.
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 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