Ottawa expands project to make long-term care centres feel more like home
The City of Ottawa is expanding a program that staff say provides residents of its long-term care homes with more autonomy and a better overall quality of life.
The "person-centred care" model has already been rolled out in parts of the Garry J. Armstrong and Peter D. Clark homes, allowing residents to make a series of small but profound decisions such as choosing when to wake up or have a snack.
"Look at all the choices you get to make in a day, and then imagine if you didn't make most of them," said Sheila Bauer, who oversees the program. "It's a very disempowering kind of feeling."
The result is not just an environment where people feel listened to and understood, but also a place with fewer falls, reduced reliance on medication and improved nutrition.
An outside review by researchers at the University of Ottawa provided the evidence to support an expansion to all areas of the city's four long-term homes by the end of 2026.
A feeling of helplessness
Over the past three years, the city has filled close to 150 front-line nursing positions, explained Dean Lett, Ottawa's director of long-term care services.
The added staff has allowed it to increase the amount of direct care per resident from 2.75 hours to four hours daily.
Coun. Theresa Kavanagh was among those who pushed for the model after hearing from residents whose family members were feeling isolated within the homes.
"They felt very helpless at the time, and that was what motivated us," said Kavanagh, who also serves as council's co-liaison for older adults.
"The root of this transformation is organizing care according to residents' needs rather than staff schedules."
Theresa Kavanagh is the city councillor for Bay ward and the council co-liaison for older adults. (Francis Ferland/CBC)
Anna Lyall has been involved in long-term care for 24 years, first as a caregiver for her father and later as a volunteer.
She used her opportunity to speak to the community services committee on Tuesday to share the thoughts of residents who have experienced the change first hand and noting the importance of creating new spaces for socializing.
"In other words," she said, "the kinds of space similar to any one of our own homes."
More complex needs
Right now, the waitlist to enter a city-run home is 3,000 deep.
Lett notes people can be on lists for multiple facilities simultaneously, with individuals remaining on them for anywhere from 117 to 600 days.
"That is concerning," said Kavanagh, noting that demographic changes suggest demand "is going to grow."
Of the 717 residents at the four city-owned homes, 70 per cent have dementia.
Linda Garcia, a professor emeritus at the University of Ottawa who has researched how different environments affect the quality of life of individuals with neurological disorders, praised the person-centred model to the committee.
Linda Garcia, professor emeritus at the University of Ottawa, has researched how different environments affect the quality of life of individuals with neurological disorders. (Francis Ferland/CBC)
"If I end up having multiple strokes and developing dementia, I don't just want competent care — I want someone who understands me," she said. "Someone who remembers I like funky glasses, I love to dance, and I also need downtime."
Garcia told CBC the centres used to be smaller and feel more like home, but as the population ages and health problems become more complex, they started feeling more "institutionalized."
That's starting to change back, Garcia said.
"We're starting to give much more importance now to things like loneliness and human connection," she said. "We're starting to put those things back in and making them look like homes again."
No additional funding needed
The city increased funding for the program by $500,000 in the last budget, said Lett. That will continue through the expansion process, ensuring that no additional funding is needed.
"We're not greedy about money," said Lyall, also a member of the program's steering committee. "We may need more as we go along, but with the inroads that have started, I can only see us going forward."
Anna Lyall represents the Champlain Region Family Council Network on the City of Ottawa's person-centred care steering committee. (Francis Ferland/CBC)
That could depend on the provincial government, which made this shift possible when it increased funding. Lett said there's committed support for at least the next two years to support the expansion.
Bauer is already thinking beyond that.
"I don't think the general public, the residents, family, staff will allow this type of care not to continue," she said.
"When people experience joy, it's just wonderful. So, I think it will thrive. The government, I think, will respond positively to that."