Balancing risky behaviour, independence is goal of innovative seniors care home

Moving your parents into a care home is rarely an easy choice, because it can be hard to come to terms with their inability to live independently. And for them, that loss of independence and suddenly being thrust into communal living can lead to frustration and confusion.

Add dementia, and it can give way to aggressive behaviour and violence.

The Sherbrooke CommunityCentre in Saskatoon is on a very short list of facilities studied and cited by the Alzheimer's Society as having an approach which emphasizes continued independence.

And it delivers on it, even when that independence increases the risk of injury.

"Traditionally, the philosophies that have been used in long-term care have been kind of patriarchal, where we say we know what's best for you," says Suellen Beatty, the long-time CEO of Sherbrooke Community Centre.

"But the bulk of suffering for people who are frail or disabled is really due to a malaise of the spirit, to the loneliness, the helplessness and the boredom."

Sylvia, one of the home's residents, is a good example. Living with an advanced form of dementia, she still has energy and even a desire to dance through the hallways from time to time. But she also has a history of falling.

In some long-term care homes, she'd be confined to her room to reduce the chance of injury. Other homes might sedate her. In short, to prevent her from falling, she'd be discouraged from standing.

Sherbrooke takes the opposite approach.

"Let them lead their life according to how they want to live," says Sylvia's nurse, May Abigania.

That approach extends beyond the locked dementia floors or "neighbourhoods," as Sherbrooke's staff call them. Residents retain considerable control over their own lives: when to wake up, when to have a shower, whether to have a pet (there are many), what activities to participate in, and whether to go outside on their own.

Seniors living in the facility can dine in a large cafeteria, often in small groups. Family-sized kitchens are also arranged throughout the living areas, and staff are given latitude to offer foods preferred by the dozen or so residents living in the rooms around each of them.

"It's all about choices here," says Kari Prodahl, a continuing care aid, as she makes pizza and salad for a small group of residents. "Which makes it easy, because it is a homelike atmosphere."

Sherbrooke is no millionaires club. The publicly supported home to 263 residents receives funding comparable to what many seniors facilities across Canada get. It has no more staff than others like it.

It's also not immune to problems.

Resident-on-resident violence, increasingly common in care homes across Canada among confused and vulnerable seniors, remains a factor at the facility. And the risks that come with greater freedom can lead to serious consequences.

Howard Hrehirchuk's family was dismayed, for example, when he was able to wander outside in severe winter temperatures early one morning last October. They have also complained to the care home and the Saskatchewan Health Authority that the elderly man with dementia has fallen more than 17 times over a six-month period. They insist he should never have been able to leave his locked floor.

Hrehirchuk has a bed alarm, which goes off when an infrared barrier is crossed. His daughter says the care home shuts it off sometimes.

Sherbrooke responded by saying the care home will sometimes do that if the alarm is found not to be the best option for monitoring someone.

Beattysays she knows Sherbrooke isn't a utopia.

"We're living real life here and it's hard,"adding that those who come to Sherbrooke are already at a point where living independently is no longer possible.

And yet, many residents and their families are fans of the approach.

The federal Minister of Seniors, Filomena Tassi, visited Sherbrookein September. It has been celebrated for allowing residents to have greater flexibility over what they do such as when and what they eat and have meaningful things to do in a day.

Some new staff aren't comfortable, and there have been workers who leave. Others have remained for decades, convinced the way the facility operates provides its residents with a good mix of care and independence.

The next phase of Beatty's plan involves desegregation. She'd like to pull away the walls between residents with dementia and those without the condition.

Those who are confused can become even more so when they're surrounded by others with dementia. So integrating the home's population of seniors with and without dementia, Beatty argues, will allow for a more balanced life for everyone.

Resident Alice Cowell may be the pioneer for that new approach. Even though she doesn't suffer from dementia, she chooses to live on a floor with those who do. She sees a purpose to being together helping and being helped.

"I think it's just people being kind to them and treating them like ordinary people you know, like they're good people."

With files fromEmily Pasiuk

Balancing freedom, choice and long-term care | The Fix

6 years ago

Duration 6:47

A long-term care home in Saskatoon offers more freedom and choice to its residents to try and provide them with a better quality of life, even it that can come with more risks.