We know that COVID-19 outbreaks are occurring disproportionality in long-term care and seniors’ homes. Our Prime Minister says the outbreaks in these facilities are “unacceptable,” and that we must ask “tough questions” about how this situation came about. I am calling for transformational change in how we care for our community’s greatest treasures – our seniors.

There is no need to ask the “tough questions.” The answer is staring us all in the face, and it has been for years. The current funded model for institutionalized senior care doesn’t work. When we warehouse our seniors in wards it is impossible to contain the spread of colds and influenza – let alone a pandemic.

Two things need to change in order to transform senior care:

  1. We need to move towards residential models of care
  2. The funding needs to follow the resident

Why do we have this funded institutionalized model of care?

During World War II, many of Canada’s children and young adults were either sent away for safety’s sake or pressed into service. For the first time, there was a huge generational gap in the ability and resources for families to care for their elders. The response was to put the seniors into ward-style care where the focus was on maximizing the facility’s square footage and making things as efficient as possible for the medical staff. The institutional model of long-term care that we see in North America was instituted to be cost effective, by having limited staff to care for multiple people. These facilities were designed with the work of the staff in mind; designed to make workflow processes better for staff. That is why you see shared rooms and long institutional hallways.

And consider this – we used to house and care for disabled adults in the same institutional  fashion. Why is it that our Alberta government figured out that we shouldn’t be institutionalizing our disabled adult population and closed down those institutions, but it’s still ok to institutionalize our elderly?

Times have changed, but the model for seniors has not. This has had deadly consequences.

Clearly things need to change, but how?

The situation will not be fixed by suggestions to do away with for-profit care homes. In fact, removing private care from the equation exasperates the problem (personalized attention, higher staffing levels, and increased social distancing are more achievable in most private care homes). Nor is the solution to throw more money at existing care facilities, which has been our governments’ response so far in this pandemic.

There is a straightforward solution: give seniors the ability to choose their living and care solution.

If we do this, we will naturally see a transition to residential models of care. The ‘consumers,’ the seniors themselves, will clearly tell us that what matters to them is continuing to live out their lives in a true home (their home…wherever they chose that to be), surrounded by the professional care they need. We (caregivers) should be fitting into their lives, they shouldn’t be forced to fit into our workplaces.

Funded seniors vs funded facilities

Government funding and income subsidies should follow the senior not the facility. With funding that is not tied to a particular long-term care facility, the senior can choose what type of care they wish to have and where they would like to reside. Some seniors may choose the open ward concept of institutionalized homes, while others will thrive in residential care. Some prefer to stay in homes operated by certain religious or lifestyle organizations, while others have the ability (with the right support) to age in place at home.

At ExquisiCare, I am dedicated to proving that a residential model of care is both achievable and results in better outcomes. I am proud to acknowledge that in ExquisiCare homes, where seniors reside in residential communities with their own bathroom and bedroom, and with an exceptional level of individualized care, we have not experienced any COVID-19 related illnesses and typically also avoid the seasonal flu and other transmittable outbreaks.

I say this not to pat myself and the ExquisiCare team on the back. We are not smug about this. We push forward the results of this model to prove that with some changes to the system, seniors can have much better outcomes in their final years, receiving the care they need and the respect and dignity they deserve.

Senior, not facility, funding is something we have advocated for (and we will continue to do so). We want the government to recognize this and fund seniors, not facilities, so more of our most vulnerable can make their own and personal choice. Who are we to take that choice away from them just because they are elderly?

The “tough question” has a simple answer: fund the senior, not the facility. Do this and you will see a remarkable turnaround in mental and physical senior wellness, an eased burden on the long-term care system, more robust and personalized support, and decreased seasonal/pandemic outbreaks in long-term care homes.

It’s a bold statement, but it really is that simple – and bold statements are needed right now because our seniors are dying unnecessarily. So, I’ll say it again: rather than being forced by economic constraints into a facility that may not meet their needs, seniors, not facilities, should be funded so seniors can make the choice that is in their best interest.

The current situation is unacceptable. The answer is not public versus private. It’s about the seniors and the care they receive. Change the funding model. Make organizations more accountable to the seniors they serve, and we will see a natural progression to safer, better quality, residential models of care.


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