New design uplifts personal care homes

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This article was published 26/12/2014 (1517 days ago), so information in it may no longer be current.

FISHER BRANCH — We're all going there eventually, either to stay or visit. So we might as well make them as much like home as possible.

That's the thinking behind the Chez Nous ("our house" in French) concept employed at the Fisher Branch Personal Care Home.

In 1999, the Interlake community contracted Friesen Tokar Architects to design a unique Chez Nous-style personal care home. One of the aims was to eliminate the long, narrow hallways that have suites running off them, typical in PCHs.

Eliminating halls is huge. People with dementia — on average of 80 per cent of PCH residents have some form of it — tend to roam. When they get to the end of a hall, many become flustered. Some turn around, but others stand there, getting agitated, and don't know what to do.

So the architects designed a building with three circular pods — think of giant light-bulb shapes — with 10 suites in each, to replace halls. No more dead ends. Each pod connects to a spacious central hub that people can roam, like a walking track.

The pods also create a more intimate atmosphere. There are 10 residences to a pod. The 10 residents share a kitchen, dining area, living room, and outdoor patio.

That's a big change from the large dining rooms at most PCHs that can be noisy, and where "some people don't eat in an attractive way," said Tara-Lee Procter, PCH regional director for Interlake Eastern Regional Health Authority. "Many seniors have been living alone for a period of time, and suddenly they're having breakfast with 50 people."

The Chez Nous concept was started at the PCH in Notre Dame de Lourdes in 1988 by Jacqueline Theroux, its director of nursing back then. Theroux observed how her father-in-law, who had dementia, responded to stimulus. "Whenever the environment changed, such as more people around, or more noise, he was different," she recalled.

"The way these facilities were being built, everything was enormous, long hallways, 40 people in the dining room, and dementia patients didn't cope well with that," Theroux said. "There was too much motion and noise. Dementia patients were perpetually lost. Even trying to find their own room was impossible."

So Theroux and the provincial government embarked on an experiment to build a more home-like setting, with better control of stimulus, in a 12-resident wing of the 60-resident PCH.

Staff treat it like a home, so they also bake and clean, often with help from residents. "Residents will help washing tables. They may wash the same table 20 times, but it doesn't matter," said Theroux.

Within just six months, medication for the residents in that wing fell dramatically, said Theroux. Today, the Chez Nous model has spread into Saskatchewan and Alberta more than Manitoba, although some features have been adopted by PCHs here. A Chez Nous-style PCH is in the planning stages for Peguis First Nation.

The only other one in Manitoba is in Fisher Branch. In the late 1990s, Donna Lindal was on a committee to find a PCH model for that town. Lindal is a firm believer in relying on your gut, and her instinct told her to adopt the Chez Nous model as soon as she visited the Notre Dame PCH. "It was pleasant, inviting, warm, all those things," she said.

If you've visited a loved one in different PCHs, you'll know the ones with a good reputation can still feel emotionally sterile, like hospitals, and those with bad reputations seem almost like cinder-block prisons with very elderly inmates.

The atmosphere in Fisher Branch PCH is surprisingly positive. You don't have that feeling like you can't wait to leave. It helped that students from Fisher Branch Collegiate were on hand that day baking cookies and giving manicures. The students visit at least once a month, including grade- school kids who practise their oral reading skills on the residents. Monica Sigurdson, 97, has been at the Fisher Branch PCH for more than a year. It's not the Hilton, allowed Sigurdson, who has not lost her cognitive ability. But she agreed with her daughter, Monica Johnson, that it's more like a home. She was panelled here because the facility at Arborg, where she is from, had a waiting list. When a bed finally came open at Arborg, she toured the facility but decided she preferred Fisher Branch.

Before coming to Fisher Branch, she was frequently prescribed antibiotics for a urinary bladder infection. She hasn't required any since arriving here because she eats better, said Johnson.

Sigurdson is able to decide things like when she gets up, and when she has breakfast. "It's so much better having meals in the smaller pods," added her daughter. The PCH plans to expand the range of choices, Lindal said.

bill.redekop@freepress.mb.ca