Inspired by The Hogeweyk or Dementia Village in the Netherlands, Providence Living, with a series of government funding and philanthropic donations, launched The Views, a social-relational long-term care model project in 2024.
The project’s evaluation team is being led by Advancing Health’s Associate Director, Dr. Amy Salmon, and members of the Advancing Health Seniors Care research group. This includes Muyi Iyamu, Adam Easterbrook, Wei Zhang, Habib Chaudhury, Farinaz Havaei, Rick Sawatzky, Joseph Puyat, Jenyo Banjo, Rochelle Gamage, Saranee Fernando, and Daphne Guh, who are evaluating the project from its founding stage by embedding themselves in this innovative care model for older adults.
Tasked with bringing together people from across the province to focus on transforming health care for seniors in BC, Dr. Salmon’s work is supported through the inaugural Conconi Family Foundation Distinguished Scholar in Seniors Care.
In this Q&A, Dr. Salmon discusses what it means to work on this project and how it could be the key to redefining the health care system’s approach to long-term care.
What drove you to take on the evaluation of Providence Living at The Views?
I do a lot of work in developmental evaluation, which is an approach where an evaluator or evaluation team is embedded into a project at a very early stage. I started working with the Seniors Care team at Providence in late 2017, at which point, Providence Health Care and Providence Living were embarking on some transformative work around their model of care to move away from strict institutional practices in long-term care homes while retaining the highest standards for quality clinical care. Our team was thrilled to be able to continue this partnership, while working on transforming the care model with a new built environment.
Could you highlight a few high-level successes from the past year?
The Views draws on the Dementia Village concept from the Netherlands and is the first demonstration in Canada of the approach within a publicly-funded health system. For all parties involved, a key aspect of this project has been reimagining the question, “How do we transform long-term care?”
The research and evaluation team’s role is ensuring that this project is guided by strong evidence that supports decision-making, alongside strong values about what we hope to see for older adults.
The biggest success so far is that on July 8th, 2024, 156 residents and staff moved into the new building, which was a huge undertaking after the COVID-19 pandemic. Our evaluation so far shows that implementing this social-relational model of care is possible within the public health care system.
The project is also quite collaborative, with input from scientists at four different universities, and our Advancing Health team informing our research and evaluation processes.
What are some key challenges and learnings from the first year?
Although the “dementia village” care model has been implemented several times across the world, ours is the first comprehensive, independent evaluation of this model in Canada. One of our biggest challenges as an evaluation team has been thinking about how we build and adapt a protocol for evaluating something like this in as close to real time as possible without sacrificing methodological rigour.
Another challenge is that with a new concept, everyone involved is making decisions about how to implement this model of care for the first time. We’ve had to think very creatively about the challenges that are cropping up — like the fact that the typical training provided to the staff for nurses, care aids, recreation staff, janitorial and food services staff is rooted in institutional ways. Now, Providence Living has a team in place designated a team to help them move from task-oriented to social-relational approaches.
In terms of what the general public should know about this project; we are taking exciting measures within the province to redefine acceptable care models, specifically in light of the COVID-19 pandemic and the realization that our long-term care system has been sorely neglected over many decades.
What are some goals your team hopes to achieve in the next 3 years?
The next three years are going to tell us what’s working or what’s not working when it comes to this model, such as whether quality of life is improving for people who live at The Views.
Given that Providence Living is committed to growing this model of care across the province, one of our long-term goals is to figure out how this model of care can be replicable in other contexts. We’re also hoping to answer some big picture questions — like whether we’re improving the outcomes and experiences for residents and staff, especially related to staff burnout (which has come to the forefront since the pandemic).
Lastly, and most importantly, is this intervention sustainable within our system and is this investment money well spent from a provincial funding context?
What would you say is the most rewarding aspect of this project?
On a personal level, I would say it’s the opportunity to support meaningful change in an area of our health system that is deserving of care and attention but hasn’t necessarily garnered the care and attention that it should have. It’s also rewarding to be able to do this work within a partnership, where our team can use the skills that we have to support these important change initiatives as they develop.
As we look to the future, Dr. Salmon’s team is committed to working with the team at Providence Living to adapt and develop strategies that will foster better quality of life outcomes for Canadians in long-term care. For more information about The Views, check out the website here.
