Non-institutional alternatives to nursing homes already exist

Date added: November 17, 2022
Areas of interest: , ,
Most Canadians who died of Covid-19 lived in nursing homes. Their deaths renewed calls for nursing-home reform. These institutions are the last resort when home care fails to deliver and family caregivers become overwhelmed. Since infections spread quickly in large institutions, why not replace them with non-profit, community-based alternatives? These have a long track record—having been implemented decades ago for people with developmental and other disabilities, as institutions housing them were closed. What are these alternatives? For elders who want to remain in their own homes: robust, flexible home care; family-caregiver payment and respite services; independent living with care-aide funding directly to elders or their families; and microboards or care circles. For elders who don’t want to live alone or with family: small (4-8 residents), staffed group homes; sharing a home and care aide with other elders; and host families. The benefits of these alternatives include health-care providers that elders choose; meeting their social and space needs in homes that include private bedrooms, kitchens, common areas, and gardens; routines that follow residents’ rhythms, not institutions’; reduced depression and ADL decline; supported decision-making for elders about who to live with and who to hire; more frequent interaction with family members, neighbors, and pets. Frail elders and those with dementia deserve the same access to non-institutional alternatives as other people with disabilities. These alternatives are cheaper for governments to fund than nursing homes—particularly profit-making ones. As key stakeholders, gerontology nurses can advocate for non-institutional alternatives to nursing homes.