June 9, 2020

Older-adult care: What needs to change — and what doesn’t

Faculty of Nursing’s Gwen McGhan reflects on the need for a systemic global conversation about senior care

As the COVID-19 pandemic has escalated, long-term care facilities — home to a population that has, of course, been devastatingly affected by the virus — have consistently made headlines here in Calgary and around the world. Questions, worries and widespread scrutiny of such settings is an expected and necessary upshot of an extremely difficult time; it’s also proof that perceptions, approaches, and strategies around how we care for an aging population demand an elevated place in the public conversation on an ongoing basis, rather than only when something goes wrong. 

For Dr. Gwen McGhan, PhD, assistant professor in the Faculty of Nursing at the University of Calgary, understanding and improving quality of life for older adults and those who care for them, has been the focus of her work long before the pandemic. While COVID-19 has introduced an unprecedented and traumatic set of challenges, it has also put into stark relief what has long been working, and what has not.

A webinar featured this week on UCalgary’s COVID Community Support page, featuring Dr. McGhan’s colleague nursing professor Dr. Lorraine Venturato, explores why the senior-care sector has been hit so hard by the pandemic, and considers the future of long-term care post-COVID-19. She’ll discuss how, while advances in medical research mean that more people may be able to “age in place” with some support, there will certainly always be some need for communal palliative and long-term care facilities. The biggest challenge, she says, is “the mixed models of care here in Alberta — many great things are happening in long-term care, but that variety means that there is excellence, there are also times when things can fall over.”

Meanwhile, Dr. McGhan shares her thoughts and research on where we’re at and where we’re going even as rapidly changing policies, staffing shortages, resident and family concerns, media requests and significant budget implications weigh heavily on residents, staff and families alike.

People helping people

“I think what is working in long-term care are the people behind it. There are so many people who want to provide care to older adults. That’s where they choose to be and they are doing their absolute best to care for people. People who work with older adults are generally very committed to that work — they want to engage with older adults to improve their quality of life and to customize their care to make things meaningful for them.”

Creativity is key

“There’s been some really creative work recently around how to further refine customized care for older adults in long-term care settings. We want to understand ways to engage residents in unique ways that are meaningful to them and address their preferences."

There’s a push for staff to engage families more and more in terms of learning as much as we can about an individual and what they might respond to.

“An example I saw recently was for a resident with dementia who had previously worked as an architect; the staff set up a desk for him to work at, which really engages him.”     

Designed to thrive

“There’s ongoing research being done around how we can better design facilities to be not only safer in terms of being able to isolate people from potential infection, but in general to make these settings more like a home environment than an institution. They’re taking the old ways of having long hallways with rooms for up to four people in them, and changing the design to create a more central hub along with an increased number of private and semi-private rooms. There’s also a push for more outdoor space space for residents to enjoy.”

Amplify the conversation

“What is most needed is a systemic global conversation about the future of care for older adults. And have to talk about it from different perspectives. We need to bring people from different background together: nurses, physicians, social workers, architects, even geographers to map areas where older adults live.” 

We need that wide lens in order to create care facilities and neighbourhoods that are, for instance, dementia friendly.

“We need more resources to help keep people healthy and comfortable. And we need to support family caregivers in their role of looking after an older adult who can then stay in their community longer. There are a lot of people doing great work and we need to support them by amplifying the conversation and getting the right resources in place as we move forward.”