This presentation will provide an overview of the approaches, methods, and emerging findings from an interdisciplinary evaluation of a new long-term care home (Providence Living at The Views, herein “The Views”), which stands as the first publicly funded adaptation of a “dementia village” concept to be implemented in Canada. Located in the province of British Columbia, and inspired by the Dutch Hogeweyk care concept, this long-term care home welcomes older adults with and without dementia, as well as younger adults with disabilities who are in need of long-term care. Home to 156 residents, the goal of care at The Views is to ensure that residents thrive through maintaining independence, social connections, and engaging in meaningful activities. By shifting away from institutional practices and towards a social-relational and resident/family-centred model of care, The Views aims to support residents in living their best lives within an environment that feels like home, fostering autonomy, dignity, and community. A critical aspect to this model of care is the focus on resident’s needs for freedom of movement across indoor, outdoor, and community spaces. This is supported by prepared environments that enable residents to safely maximize opportunities to enjoy the qualities of nature that are inherent in this small coastal community and are central to the experience of healthy aging for many.

 

Our five-year evaluation of The Views incorporates developmental, formative, and summative dimensions, assessing both the implementation of a social-relational model of care (known as Home for Us) and the creation of a new built environment. In addition, it will highlight some of the pragmatic adaptations to the Hogeweyk care concept that were made to reflect the realities (including financial and operational constraints) of British Columbia’s system requirements for long term care homes. The presentation will focus on our team’s methodological approach, as well as emerging findings from the first year in the new care home, incorporating four years of qualitative and quantitative data. In so doing, the presentation underscores the importance of interdisciplinary collaboration when developing a learning health system, and in assessing quality of life and well-being, in long-term care. This includes the importance of selecting person-centred measurement tools for quantitatively assessing self-reported quality of life that are meaningful and appropriate for older adults living with dementia in long term care, and will share findings from ten cycles of data collection using these tools. Our approach to environmental assessment is also committed to person-centred perspectives, using structured assessments and ethnographic observations to understand how built environments impact quality of life in long term care settings. The presentation will also include a reflection on the imperative to include contributions of qualitative data to understanding quality of life for those who live, work, and visit in long term care, and for understanding how these everyday lived experiences provide much needed insights into the challenges of equity- and justice-oriented efforts to transform long term care in directions that safeguard the rights, dignity, and autonomy of older adults and persons with disabilities.