Aging in Place may not be what you expected

Homecare is for aging in place when elders wish to continue living in their own homes with support from local resources including family and friends, right? Well, partly.

Research reveals a more involved meaning. The Canadian Association of Home Care describes it thus. ‘Homecare is an array of health and support services for people of all ages, including children with special needs, provided in the homes, retirement communities, group homes, and other community settings to people with acute, chronic, palliative, or rehabilitative health care needs.

It includes assessments, education, therapeutic interventions, curative interventions, personal assistance, end‐of‐life care, and it substitutes for acute hospital care.’

And here’s an extract from the website of the Canadian Bioethics Society………… “As health care continues a shift from hospitals and institutional settings to the home, it’s being provided by an array of caregivers, including health care professionals, family and friends and less skilled low paid care providers. Because health care spending that accompanies this does not fall under the Canada Health Act, there is tremendous variation in the funding and delivery across the country”.

Undoubtedly, there are many examples of successful aging in place with good support from local resources including home care. I wonder though, because of ongoing negative news reports concerning assisted living establishments, could some people simply refuse to move from their homes even if they may not be suited to aging in place? 

Aging in Place and the Eden Alternative

When I heard of the Eden Alternative I realized it could really improve this situation.

It’s the brainchild of an American doctor of gerontology who defined the three plagues of nursing homes as loneliness, helplessness and boredom.

He considered those institutions to be all about the nurses and doctors and not enough about the residents. He recommended bringing plants, birds, pets and children into the settings to give residents’ lives meaning and purpose.

It gave rise to the Green House project in the USA - individual homes in residential neighborhoods with about 10 residents in each home – much more manageable than the number of residents in typical care facilities.

The rooms are situated around a central living space including an open kitchen where the coffee is always on and someone is always cooking. There is no institutional style central nursing station- just visiting RN's as required. Residents' needs are provided by trained support care persons.

Link to how Greenhouses work

I’d heard that Abbeyfield house in High River is a similar model so I went to visit it. With 10 rooms it is nicely situated close to wooded area with pathways and ample parking and it’s within walking distance of the old town centre.

Abbeyfield House

First impression walking in is it truly does smell like home with the faint smell of coffee and cooking. The rooms are a nice size with ensuites and no kitchen or kitchenette - they’re not necessary - coffee’s right there in the kitchen/ lounge area.

Facilities include exercise room, hairdressing room, laundry room, storage space in the basement for each resident and home care services do visit. There’s an administrator, a day kitchen manager and a night manager with her own private room.

Abbeyfield Kitchen

Breakfast is self-serve style toast cereal fruit etc. Lunch and supper is in the common area. Meals are very flexible and the kitchen manager can accommodate requests and suggestions.

It was built through fund raising and is a registered charity and a non-profit. It costs $1750 per month which is considerably less than most for profit elder residences. Residents have ranged in age from 60 to 92.

There is a volunteer operating board from the local community and the president who showed us around explained that the budget per meal is almost three times that of nearby for profit establishments. This struck me as very impressive since good nutrition is so vital for successful aging.

This is what the future of aging in place may look like. Similar homes could be developed by any group based on the Eden Alternative/Greenhouse Project. It can be a charity/fund raising model like Abbeyfield High River, faith based, service club, a cooperative or any group of 10 or so like-minded individuals that want to pool resources and create their own establishment.

It could dovetail well with those who don’t wish to age in place in their own homes, those who have already done so for a spell and anyone who does not wish to go to a more expensive congregative living establishment with higher numbers of residents.