Is the Era of Institutionalized Care Really Over?

Long Term Care (LTC). Institutionalized systems as we have known them, don’t appear to be changing their models that quickly, yet perhaps it is fair to say – there is a timely need to evolve our vision of how we build facilities and deliver services for difficult conditions of health in various stages or levels of elder care. However, this is not a sudden awareness.

Conversations between caregivers – families and neighbours – on one level have been continuous for years, as shared stories about our direct experience with LTC evoke anxious emotions that often lead to questioning – how can we do this in a better way? At the same time, in meetings with elder care specialists and at conferences I’ve attended, there is a rolling dialogue about innovation and presentations of new ideas in development around the world.

What smudges the dialogue on the road to innovation is the language and labels we use. As a carryover from the 1950’s, there are still some people who call any institutional care facility for frail elderly people an “old-folks home”; and of course in many countries, the distinguishing polite term “long term care facility” is frequently termed a “nursing home”. Not to mention that descriptions on the continuum of care in later life move from retirement homes with limited care, to homes with elevated levels of advanced care… and so on.

While we untangle ourselves from terminology and hangover memories (like when we said in the 1960’s, my aunt lived in a chronic care hospital); there are several bright voices who bring a higher level of dialogue to provoke us into thinking differently, to be more demanding of innovative change. Some of these voices come from organizations in the care home industry, and one that I’ve been following for a while is UK based Evermore Wellbeing – part of Evermore Global, an international aging and healthcare consulting firm.

A recent Evermore blog article – The end of nursing homes and what will replace them – includes a short video featuring Dr. Bill Thomas, their Global Chair (also Founder of Changing Aging.org) and Sara McKee, Founder of Evermore. A geriatrician, Thomas calls himself a “nursing home abolitionist’ and provides a strong opening to the narrative here. In the video, McKee extends this with her UK outlook, a variation on other commentary I’ve heard from many others here in Canada, the US and elsewhere.

This video and written blog transcript is worth sharing, at least to stimulate responses to – is the era of institutionalized care really over? Let aspirational ideas and options continue to follow for all generations to help build new models. We all need to keep pushing the envelope, as long as we will find ourselves giving and receiving the appropriate level of care in a place that makes us feel more at home, connects us more to a broader community and is less like living in an isolated fortress.

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