Residents Viviane Robinson and Judy Allen at Garry J. Armstrong Long-term Care. [Courtesy of Bintu Kallon]
Long-term care homes (LTC) throughout the city of Ottawa are striving to transform their design and infrastructure plans to improve situational awareness with an emphasis on residential needs through person-centred care (PPC). At Garry J. Armstrong long-term care home, Viviane Robinson and Judy Allen are two residents who have felt the positive impacts of this new person-centred care program.
“I found that it was more hospital-like than residential when I got here, it was a bit difficult for me to accept the rules and regulations compared to the other place – but now it’s really much better, “describes Allen. Transitioning to Garry J. Armstrong after living in a private long-term residence had its challenges, she adds.
The person-care program was introduced in August of 2023 as part of the City’s quality improvement plan, which Allen claims kick-started a less-structured living environment for her and her neighbours, allowing for slower-paced mornings, with less scheduled times and more freedom to partake in individual activities such as games, puzzles and increased outdoor access. According to Robinson, who has been living at Garry J. Armstrong for five years, the access to individual activities and projects has been a positive change in her day-to-day routine, living in a wheelchair has made her increasingly dependent on staff to bring her around, and having her own time alone is her favourite part of the day.
Person-centred care (PPC) is an integrated health services approach that relies on a variety of factors to strengthen resident comfort and safety, by providing an understanding of the unique range of capabilities and limitations specific to different residents. PPC relies on three major components in delivering a quality living environment: improving functional ability, intrinsic capacity and focus on environment. As seen in this WHO report, describing this foundational health improvement strategy.
https://www.who.int/publications/i/item/9789240017900
The implementation of person-centred care in LTC relies on enhanced staff training and knowledge. At Garry J. Armstrong, staff members Bintu Kallon and Mercy Amos-Alphaeus are ambassadors of PPC, recognizing that residents on each floor have specialized needs and cognitive abilities. Their positions aids in decision-making and helping residents have an input into activities tied to the residential program, such as hosting special dinners and community events.
“They did a wonderful job; they hosted a dinner for 25 of us down in the atrium. It was just gorgeous. It was a five-star meal,” says resident Allen.
On Level Seven (otherwise known as neighbourhood Seven) at Garry J. Armstrong, where Allen and Robinson live, residents can partake in surveys and discussions that allow for customized change to their living environment.
“The patient population of seven, they are very cognitive, and you can have a dialogue with them, and they can tell you how they want things done. “
LTC models rely on various infrastructure practices to provide a PPC approach, enhancing quality-of-life for residents. The most prominent infrastructure model in architectural, PPC design is the need for human factors, which prioritizes the application of both physiological, psychological needs, to a variety of designing systems and processes. In 2015 Ontario introduced a long-term care design manual containing the design standards and practices that every home needs to follow to properly facilitate interdisciplinary care for residents dealing with a wide range of needs and disabilities.
Through these resources, service providers are expected to provide a comfortable and enjoyable living experience including co-design and family engagement that ensures that those closest to residents can aid in shaping the place that their family members will call home.
According to Chantal Trudel, Associate Professor in Industrial Design at Carleton University, the push for safer, more viable independent living for residents relies on complex methodologies including workplace, assistive technologies (dementia care monitoring), activity services, scheduled recreational therapy and outdoor access…etc. which aids in strengthening patient protection. “It’s not a clinical environment. Residents who live in long term care, this is their home. The clinical aspects of infection management role are crucial while balancing a very person-centered environment,” Trudel explains.
The City of Ottawa is planning on fully implementing this new PPC structural model in 2026 with an emphasis on educational growth and improvement. This push for cultural change is allowing residents to live with potential “risks” that come from independent living and acknowledging that residents lead full lives prior to their transitions to long-term care. According to Linda Garcia, Professor in the Interdisciplinary School of Health Sciences, and Director of LIFE Research Institute at the University of Ottawa, the most defining characteristic when transferring an individual into LTC from acute care is to facilitate connection. Physical space is meant to accelerate social connection opportunities for residents, improving their mental health and allowing for the growth of physical, mental, and spiritual relationships.
Garcia also specializes in the social and physical environment that impact individuals with neurological disorders such as dementia. She emphasizes the importance for stimulating environments and well-trained staff members that recognize resident capabilities as well as their functional limitations. Garcia states that among these requirements is the demand for three fundamental factors that ensure a healthy quality of life: “If I’m 85 years old and have dementia, and you’re wanting to design a new coffee shop for me, you need to understand that I’m going to need to see some contrast. You want to maximize my eyes and my ears because my brain is starting to have issues with cognition. I always come back to three things: Do you have a safe place to live? Do you have something meaningful to do? And do you have someone to love?”
The future of long-term care relies heavily on the growth of PCC. After the city of Ottawa increased funding by $500,000 towards the PCC program, the push for LTC expansion is growing steadily.
