A seniors-care revolution
City facilities for people with dementia are making a remarkable transformation
Grief, loss — that’s what I read in 99-year-old Mary Palmer’s eyes as she sat quietly on a couch in Canterbury Court, staring across the atrium at the front door she’s not allowed to walk through.
“I do lots of crying. I doesn’t do any good but I can’t help it,” she says softly, mourning a loss of freedom, her cats, the birds, garden and old farmhouse where she lived until two years ago when a fractured pelvis landed her in the hospital.
Palmer has dementia. She gets confused when too little blood flows to her brain. But her spirit longs for the open air, the wind and freedom.
Canterbury Court, a non-profit seniors’ care facility run by the Canterbury Foundation in Laurier Heights, celebrated the sod-turning for its new $31.5-million expansion and improved dementia-care facility last week. When I look in Palmer’s eyes, I see why it matters.
The existing Canterbury Court is a good facility. But it recognizes the old model of caring for seniors is lacking.
Traditional centres feel like a hospital or apartment building, where residents are patients with charts that focus on medical stats and behavioural challenges, not who they really are. It makes people passive and isolated, focused on what they’ve lost.
The new expansion will help Canterbury change.
Edmonton is several years into a badly-needed revolution in seniors care.
It started about five to seven years ago when several local leaders toured dementia-care facilities in The Netherlands and brought expert Dr. David Sheard here to speak. Sheard argues the wandering, hitting and biting many dementia patients do is not something to be treated with anti-psychotics but a sign they’re frustrated, searching for something they can’t find.
Twenty years ago, he pioneered a new way: creating family-sized cottages instead of large wards, and taking time to find out what each resident needs. They might not recognize loved ones, speak or think clearly, but smells, sounds, bright colours and tactile material like cloth, wood and shavings help residents settle and reconnect with their past.
The key is to bring back independent decision making, said Lara Pinchbeck, a designer and human ecologist who worked on the Canterbury redesign.
Rather than one big atrium and dining room, the new ward will have many smaller spaces, all different, so residents can seek for themselves the busy coffee shop or the quiet art gallery.
It will have a secure outdoor courtyard, where people who used to find strength from their garden can still putter about.
Three mini kitchens will bring the smell of dinner cooking right to the residents. It can also get them involved, helping to set the table, cook and serve, or iron for an afternoon, or hang their laundry, any ritual activity the mind clings to that brings purpose and meaning.
Pinchbeck’s role for the next three years is to help staff understand the possibilities, then study how the lessons learned in dementia care can help the whole population in the facility. She’s expecting a $150,000 federal grant over three years to study, then share those lessons.
Other facilities in Edmonton are in different stages of this transformation.
Renate Sainsbury of Lifestyle Options Retirement Communities said before their transformation, four out of five residents could be on anti-psychotics. That all but disappeared. Those
medications are now reserved for patients with an actual mental health diagnosis as care was reformed site by site.
Four out of their five facilities have already been renovated and staff retrained in the new approach. Staff no longer wear uniforms. They eat meals with the residents in small cottage groups, and spend time talking or just holding a resident’s hand, she said. With the same number of staff, the work still gets done and it has improved morale. They reduced sick time among employees by 90 per cent.
Others, including the large public provider CapitalCare, are also pushing in this direction. CapitalCare added kitchens to each floor in several older facilities, paid for through private fundraising. They added a research team and are trying to shift the staff culture.
Back at Canterbury Court, Janet Palmer explained how she chose this facility for her mom. They were looking for a countrystyle decor and a window that looks into a quiet outdoor courtyard. That’s Mary Palmer’s favourite place, and the staff-run activities can distract her from her loss. She won $27 the other day racing rubber ducks in the fountain.
It’s hard to choose a home for a parent, especially when they need it but don’t want it. This revolution can’t come soon enough.