The Future of Facility Based Care
- abissett22
- Jul 27, 2022
- 3 min read
In my last blog post, I shared my perspective on the human side of long term care, and the meaning and joy that can be found in care facilities. I shared why I choose to work in this area, and briefly described many of the beautiful moments I've experienced. I wanted to focus on the positive in long term care before discussing areas for improvement. In today's post, I'll focus on future directions in long term care, based on a review of recent literature and my own thoughts and experiences.
The COVID-19 pandemic has been devastating in care facilities. News reports have shared high death rates, and intense suffering and distress for residents, families, and staff because of both the virus itself and the measures that have been taken to manage the spread of infection. The pandemic brought many pre-existing challenges to light, and also created new difficulties. Here is the 'silver lining': The first step to improving anything is for people to pay attention. The pandemic has drawn the attention of the general public and government officials, and this attention can lead to opportunities to make improvements for quality of care and quality of life.
Due to the gravity of the pandemic situation in facility based care settings, everything about these facilities is now under examination, including the question of whether they should be abandoned entirely. The resounding conclusion has been that care homes are not only necessary, but can be a beneficial option. There are several reasons that we as a society need care homes, including the fact that not everyone has a home, not every home is safe, and not everyone has a support network in the community (Grabowski, 2021). Established benefits of facility based care include residents and families feeling safe and confident that basic care needs will be met, opportunities for socialization and involvement in activities, relief for informal caregivers, and a collaborative team approach (Armstrong & Armstrong, 2021).
There has been a renewed interest in re-imagining long term care. Recommendations in the literature have included a focus on resident-directed care prioritization of quality of life adequate and sustained funding, well compensated staff, clearly articulated modernized standards of care and accountability, and federal government support for provinces and territories to achieve high standards (Armstrong & Armstrong, 2021, Alkenbrack, 2021; Estabrooks et al., 2020; Grabowski, 2021; Zimmerman et al. 2022).
In Alberta, the provincial government contracted MNP LLP to complete a thorough review of Alberta's continuing care system. Forty-two recommendations were made in this report, under 11 policy directions, including:
Establish quality of life as the top priority.
Enhance quality of care, particularly for residents with dementia.
Improve culturally appropriate services.
Improve care coordination.
Increase staffing hours and consistency.
Enhance working conditions.
Expand choices for clients.
Coordinate monitoring processes.
Optimize use of innovation.
Ensure sustainability and affordability.
Implement learnings from COVID-19. (Government of Alberta, 2021).
This review has informed new legislation that is coming in Alberta to promote person-centered and innovative service delivery, replace multiple existing acts, address gaps in existing legislation, improve transparency and accountability, and align requirements across the continuum of care (The Legislative Assembly of Alberta, 2022).
Although the COVID-19 pandemic has been a very difficult time in care facilities, I am looking forward to being a part of future improvements. I appreciate the emphasis in recent literature on quality of life and quality of care. I hope that we will be able to build on the strengths of facility based care and enhance the services we can offer, to make long term care a better place to live, visit, and work.
References
Alkebrack, K. (2021). Innovative models pave the way for safe, high-quality long-term care
homes. Healthy Debate. https://healthydebate.ca/2021/01/topic/innovative-models-long-term-care/
Armstrong, P., & Armstrong, H. (2021). Is there a future for nursing homes in Canada?
Healthcare Management Forum. https://journals.sagepub.com/doi/10.1177/08404704211037788
Estabrooks, C., Straus, S.E., Flood, C.M., Keefe, J., Armstrong, P., Donner. G.J., Boscart, V.,
Ducharme, F., Silvius, J.L., & Wolfson, M.C. (2020). Restoring trust: COVID-19 and the future of long term care in Canada. Science Applications Forum. https://www.facetsjournal.com/doi/10.1139/facets-2020-0056
Grabowski, D.C. (2021). The future of long-term care requires investment in both facility and
home based services. Nature Aging. 1, 10-11. https://www.nature.com/articles/s43587-020-00018-y
The Legislative Assembly of Alberta (2022). Continuing care act.
Zimmerman, S., Cesari, M., Gaugler, J.E., Sloane, P.D., Stone, R.I., & Werner, R.M. (2022).
The inevitability of re-imagining long term care. Journal of Post-Acute and Long Term Care Medicine. 23(2), 187-189. https://www.jamda.com/article/S1525-8610(21)01106-3/fulltext
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