The Alberta government recently launched an ambitious capital grant program in 2023 to develop small, stand-alone care homes across the province. This initiative, running from April to November 2023, garnered significant attention, receiving 74 applications from 33 different applicants. The program aims to create 1,600 small care home spaces by 2030, aligning with recommendations from a 2021 report on facility-based continuing care in Alberta.
The shift towards small care homes represents a significant departure from the traditional large, hospital-like institutions. These homes, housing between four and 14 residents, promise a more personalized interaction between residents and staff. Dawn Harsch, founder and president of Exquisicare Senior Living, has long advocated for this model. She applied for grants to construct eight publicly funded small care homes in rural areas of central and northern Alberta.
"You become a friend with the [licensed practical nurse], for instance, that looks after you. There's so much more personable interaction than there is if they're in a publicly funded residence with maybe 400 residents." – Dawn Harsch
This model not only fosters better relationships but also boasts lower staff turnover rates compared to larger facilities. A recent report from the National Institute on Ageing emphasized the urgent need for provinces to prioritize small care homes, highlighting their benefits such as improved care and enhanced personal interaction.
"What we're really calling for is governments like Alberta — that have actually taken an interest in small care homes — to actually get on with it," – Dr. Samir Sinha
The Alberta government is currently reviewing the grant program following the transition of continuing care responsibilities to a new ministry. The ministry has allocated $654 million over three years to its overarching continuing care capital program to develop new spaces or modernize existing homes.
Harsch believes that swift action on these grants could significantly address the demand for senior care within a short timeframe.
"I think if the government of Alberta would announce those capital grants and let us start building these small homes, we could help address the need within about 18 months." – Dawn Harsch
"Once we are notified that we can start building and getting our permits, it's really about a 12-month build for small homes. And we can build them all concurrently. So we can start to make a difference very, very quickly." – Dawn Harsch
Dr. Samir Sinha, a prominent advocate for small care homes, stresses the importance of making this model accessible through the public system, not just private facilities.
"Move this forward so that it's not just an option available for people who can pay in private facilities. But that this is something that the public system can offer." – Dr. Samir Sinha
The advantages of small care homes extend beyond personal interactions. They have been associated with better clinical outcomes, including fewer falls, improved nutrition, and reduced emergency department visits, ultimately saving costs for the healthcare system.
"Because we get better clinical outcomes — such as fewer falls, better nutrition, fewer trips to the emergency department — we are saving the system money on a whole, not to mention just better quality of life for seniors who deserve it." – Dr. Samir Sinha
Davida Thompson-Upton’s experience with her 92-year-old mother, who moved into a private small care home in Edmonton in April 2024, illustrates the model's appeal.
"It's like living in your own home," – Davida Thompson–Upton
Dr. Sinha points out that smaller staff teams in these homes can take on varied roles, leading to more meaningful face time with residents.
"With a smaller number of staff taking on a larger variety of roles, they can actually spend more face time with the residents, they can build stronger relationships," – Dr. Samir Sinha
