At 83, Joan Phillips’ body is frail, but her mind is sharp.
Physically, there is little she can do for herself. She needs help to get out of bed, help to go to the bathroom, help to bathe, help to dress and help to cut her food.
"I’m healthy, actually. I just can’t get around," Phillips says as she sits in an easy chair in her comfy room at Thorvaldson Care Center, a residential care home for seniors.
If the centre — a fixture on Stradbrook Avenue in the Osborne Village area since the 1970s — didn’t exist, Phillips would likely be in a personal care home — or nursing home, as they used to be more commonly called.
Thorvaldson Care Center has more the feel of a large home — or a hotel — than an institution. For those clients who can get around, there are several communal areas in which to gather. Sofas are stationed at the ends of bright, sunlit halls.
Meals are prepared on the premises and served in dining rooms located on both the main and second levels. There is a host of activities, including daily exercises, games, crafts and sing-alongs, for those who wish to participate in them.
Housekeeping is provided, beds are made, health-care aides are on hand around the clock and a registered nurse is on duty Monday through Friday during business hours. Staff administer medications, inhalers and eye drops and treat simple wounds.
In the ever-broadening spectrum of living choices for seniors, the privately owned Thorvaldson Care Center is unique in Winnipeg. It bills itself as an intermediate care facility — or "personal care home light," as administrator Jocelyn Thorvaldson calls it.
Thorvaldson and her sister, Karen Thorvaldson Banfield, the centre’s marketing director, have been pressing health authorities for funding so they can build a second facility. Government now pays $42.35 per client per day to cover staffing costs at supportive-housing facilities, which care for seniors with cognitive issues. These clients are generally mobile and do not suffer serious health problems, but need reminders on when to take medications. Meals and other services are provided and the facilities are secured to ensure clients don’t wander off.
The women who own and operate the centre say their 35-person staff does all that and more and should get similar government support, which they would plow into providing much-needed new facilities to fill an ever-growing need.
"If we had funding, absolutely we would open other facilities," Jocelyn said, while giving the Free Press a tour of the centre last fall.
Officials with the Winnipeg Regional Health Authority have been in discussions, on and off, with the centre for some time but have made no commitments.
Réal Cloutier, the WRHA’s point man on long-term care, contends that many of the tenants at Thorvaldson are similar to those in assisted-living facilities, where seniors are supplied with meals and light housekeeping services but are otherwise fairly independent. The province supplies home-care services to these residences, just as it would to someone in their home.
Yet, Cloutier knows there is a great grey tide of folks in Manitoba who are heading into old age in the next two decades, and he doesn’t rule out some arrangement being worked out with the centre in the future.
"My guess is we’re going to need a multitude of models to deal with an aging population," he said.
The province, along with the WRHA, is in the midst of creating a new planning document that will guide long-term care policies into the future. Officials are examining future personal care home needs and exploring new care models.
Last year, the WRHA unveiled a new hospital home team service for chronically ill patients. The teams are staffed by doctors, nurses and home care staff who co-ordinate care for patients in their own homes. The service is available in River East and St. James and is expected to be expanded to other parts of the city.
The baby boom generation will start hitting age 75 in 2021. That’s when the demand for all kinds of housing and care options for seniors is expected to start rising dramatically. By 2036, according to a recent study by the Manitoba Centre for Health Policy, the province is expected to need anywhere from 5,100 to 6,300 more personal care home or supportive-housing beds than it has now.
Personal care homes accept residents who need the greatest care, and they’re the most expensive to build and maintain. The WRHA estimates the cost of building a nursing home these days at about $275,000 per bed. Government spends about $120 per client per day to operate such facilities. The cost to residents is based on income and ranges from $32.50 to $76 per day.
Many seniors with less serious cognitive and physical problems, who might have wound up in a personal care home a decade or two ago, now reside in assisted-living or supportive-housing facilities (see box for definitions). These places, especially the former, feel more like a home and less like an institution.
Personal care homes are now catering increasingly to those with the most serious mobility, cognitive and general health problems. It wasn’t always that way. Back in the 1970s, a big issue at some nursing homes was a lack of resident parking. It’s not a concern anymore.
Since 2006, the province has instituted an "aging in place" policy that emphasizes keeping seniors in their homes or communities as long as possible. The government has encouraged alternatives to personal care home placement by paying for staff costs at supportive-housing units and encouraging the construction of assisted-living facilities. There are now 50 of these facilities in Winnipeg alone, many of which have been constructed in the last half-dozen years.
But despite all this activity, there are substantial waits at all care facilities. Even with boomers years away from knocking at their doors, demand is huge.
For instance, at the Riverside Lions five-storey seniors complex on Worthington Avenue, there’s a two-year wait to get into the one-bedroom assisted-living units and a six-month to two-year-wait for the more closely supervised supportive-housing bachelor suites on the top two floors, said executive director Laura Devlin.
Thorvaldson Care Center, a three-generation family-owned business, doesn’t readily fit into any category of care created by government bureaucrats.
Its 70 residents include people such as Geoffrey Anthony, 85, a former anesthetist, who had difficulties coping on his own after suffering a heart attack a couple of years ago. "I was living on my own and I was not doing very well for a whole lot of reasons. I really had to be rescued. I was totally isolated," he said.
Anthony is now thriving at Thorvaldson, where his meals are provided and he can socialize as much or as little as he pleases. He often leaves the building and goes for walks. He would fit in fine at many of the city’s assisted-living facilities.
But unlike assisted-living or supportive-housing units, Thorvaldson has a nurse on duty to manage medications, take someone’s blood pressure and often solve a problem or provide reassurance that prevents an ambulance from being called.
It will also take palliative care patients — at least up until the last two weeks of their life — and other clients with heavy care needs.
Even though it is privately operated and receives no direct government subsidies, admissions to Thorvaldson must still be approved by the WRHA. Clients pay $2,050 per month, which covers rent, meals, housekeeping, laundry and other services.
Thorvaldson client Joan Phillips (who is now recovering in hospital from a broken wrist suffered in a recent fall) got emotional last fall as a Free Press reporter and photographer were leaving her room during a tour.
"I love it here," she said.
"Ah, sweetheart," co-owner Jocelyn Thorvaldson responded, giving her a hug. "You’ll make everybody cry."