Too far, too big, too dangerous — families pitch alternative to large care homes ahead of budget

The long-term care home is so small, it could be mistaken for a large suburban house.

Ten beds, a kitchen and a shared living room — this is emerging as one key option for reforming Alberta's pandemic-battered elder-care system.

Many families of dementia patients are now behind the concept, and the government's own expert panel last May recommended 10 per cent of any new builds use this tiny concept. That would be a projected 1,600 new beds in small-scale facilities by 2030.

They're hoping for a sign these beds are coming in the provincial budget Thursday. 

Lisa Poole has an image in her mind of one moment that captures exactly why these small homes are needed.

Her father, John Poole, was diagnosed with dementia in his early 70s, a decade before he died. Lisa walked into his long-term care room once to find him naked, cowering in the corner of the shower. Three unfamiliar care staff were trying to rush him through his morning routine. His face was just fear and confusion.

"How would any of us feel if someone was trying to take off our clothes and we didn't understand why?" she said.

"The different faces all the time. When you're in the big facilities, I think they call them rotating staff assignments. Everyone is just set up for failure."

John was in several different care homes before he died, including one tiny, experimental one that had just three clients and round-the-clock care staff. By coincidence, it was just down the street from their family home. He and his wife would take walks together, stopping to chat with former neighbours. Stress levels in the whole family dropped.

But it was not sustainable; it closed 10 months after he moved in, said Lisa.

"We had a glimpse of when it can work well. It was amazing."

Advocates say care homes with roughly a dozen clients have become popular in various jurisdictions, including Saskatchewan, the United Kingdom and Australia. They feel more like a home, which is better for dementia patients. The model also makes it easier to create secure, accessible outdoor spaces and let clients participate in normal household routines, such as baking or cooking dinner.

Fewer staff take on a variety of tasks, so the same person might do some of the cooking, light housekeeping and social activities.

Kim Brundrit, who is leading the lobby effort with Dementia Network Calgary, says a home like this would also make the transition easier when it's no longer safe to care for someone in their own home.