Three years ago, Judi Wild and her husband Lorne were struggling as he began to experience more advanced symptoms of dementia.
That changed when he moved into a Vancouver Island facility at the forefront of what’s envisioned as the future of dementia care in the province.
“The difference is night and day. (At home) he was kind of in chaos, and his mind wasn’t working right, and agitated, and of course that reflected on me as well,” she said. “Now he’s just so relaxed. Smiling, happy, joking around. Just the way he used to be.”
Lorne lives at The Views in Comox, one of two publicly-funded homes operated by Providence Living that are conducting pilot versions of the B.C.-born “Home for Us” model.
The concept draws heavily on the European “dementia village” model, and the province hopes to eventually see it spread out to publicly-funded care homes across the province.
The model is being piloted at the Youville Residence in Vancouver and The Views in Comox, a converted hospital that will move in July to a new, custom-built dementia village of 13 households of up to 12 residents in private suites.
“Home for Us essentially transforms an institutional medical model of care which is focused on staff and the needs of staff and the needs of the institution itself,” said Providence Living CEO Mark Blandford. “It converts the rhythm of the day to the resident needs and the resident goals.”
The concept has been at work in the private sector for years but is now making the jump to public care homes.
The key to the model is the creation of “households” of about a dozen residents, with person- and family-centred approach built on individual independence and social connection.
Instead of institutionalized daily routines such as breakfast daily at 9 a.m. and laundry pickups and drop-offs that are determined by the facility’s needs, the homes take a more flexible approach driven by the residents.
Patients have free access to kitchens and laundry facilities in their own households and decide if they want to sleep in or stay up late watching a movie, when they want to eat, or if they want to partake in chores.
Meals are cooked in the household, residents can help prepare them, and dining is conducted in a more family-like format.
“The real outcome is that people with dementia don’t need to be medicated as much, they don’t need to be controlled as much, they have freer access,” he said. “We’re using for instance, trackable technologies to allow people to move freely around not just their immediate environment, but the bigger environment, the outdoor environment, so that we can see where they are, we can keep them safe, but we can give them that freedom to move.”
The homes will also use tunable lighting to help manage people prone to nighttime wandering and reduce the use of sleep medication.
While medical staff like nurses will still be a key component, they will make scheduled stops to visit residents in their homes, rather than residents feeling like they live in someone’s workplace.
The homes also include a new type of multi-service worker assigned to a household to help with food service and housekeeping and who will get to know the residents and their preferences personally.
For Wild, whose husband began exhibiting symptoms 17 years ago, and who was formally diagnosed six years ago, the support has been life-changing. She said she reached out for help when Lorne’s condition deteriorated to the point she could no longer support him at home.
“One day I knew I couldn’t do it any more,” she said.
Lorne entered an adult day program for six months before moving in full time two years ago.
Now, Wild says she visits daily and shares lunch with her husband. The staff on site know her by name and treat her like family, she said.
“Everything just fell into place,” she said. “The staff are just amazing. Honest to god they are like angels on Earth. Just so intuitive. I just can’t say enough good things about them.”
The Youville pilot in Vancouver is already underway.
Providence Living says it will incorporate what it learns from those experiences into a new long-term care village planned for Prince George and a new St. Vincent’s Heather long-term care village coming to Vancouver.
Eventually, it wants to roll the model out to most of its long-term care homes throughout B.C.