By Jena Lynde-Smith
Canada’s long-term care system faces a growing crisis, with the senior population expected to surpass 11 million by 2043, far outstripping the number of care beds available – which sat at under 200,000 in 2021.
Burdened by outdated infrastructure, underfunding, and staffing shortages, Susan Braedley, a researcher in Carleton University’s School of Social Work, is committed to improving Canada’s long-term care system from the inside out. Collaborating with international research teams and Carleton colleagues, she studies care homes worldwide to identify practices that could enhance infrastructure, care quality and working conditions in Canada.
“My objective is to translate research into practical solutions,” she explains. “As long as we continue to undervalue care, we undermine the dignity of both those who provide it and those who rely on it.”
Susan Braedley at a long term care home in Australia with an older adult
Building Community-Focused Care Homes
One of the key solutions Braedley’s team advocates for is redesigning long-term care homes to be more integrated into their communities. Through her extensive research — having visited over 200 long-term care facilities across Canada, Australia, the U.S., U.K., Norway, Sweden, Denmark, and Taiwan — they have identified models that foster a sense of connection between care homes and the larger community.
In Norway, for example, some long-term care facilities are co-located with shopping malls and community centers. This innovative design allows residents to feel more connected to everyday life, rather than isolated in remote, institutional environments.
“There, you can visit grandma while doing errands and even take her out for coffee in the mall,” Braedley says. “People aren’t afraid of nursing homes because they’re familiar with them.”
Braedley members of the international team and collaborators in New Zealand
Braedley believes Canada can adopt a similar approach by integrating long-term care facilities into community hubs, creating spaces that are more inviting, accessible, and familiar to residents and their families.
“By redesigning care homes to be more community-focused, we can create environments that are both functional and welcoming,” Braedley explains.
This shift, she believes, can help reduce the social isolation of seniors while also making care facilities more appealing and accessible to families.
Designing Inclusive Long-Term Care
Another key finding in Braedley’s research is the importance of inclusive care, which could help ease the long-term care crisis by addressing the diverse needs of residents and staff.
Her team has found that many Canadian care homes predominantly serve a “mainstream” population, neglecting the needs of, for example, immigrant and 2SLGBTQ+ communities.
Some facilities have addressed this challenge by dedicating specific areas or floors to different cultural groups. For example, a home may create spaces designed to reflect the cultural practices, languages, and foods of specific communities. Braedley advocates for bringing this model to more Canadian care homes.
Mon Sheong Long Term Care centre in Scarborough, Ontario, Canada, a long-term care cultural specific home for aged (iStock)
“Culturally specific care is essential for meeting the unique needs of diverse populations, yet providing it universally remains a challenge,” she says.
This extends not only to the residents but also to the staff. Immigrant workers make up a significant portion of the workforce in long-term care homes, yet their cultural needs are often overlooked.
“We need to reassess everything from food to holidays to ensure that care homes are welcoming environments for everyone,” she says. “That means recognizing and supporting the diverse needs of both residents and staff.”
Attracting and Retaining Talent
To further address the long-term care crisis, proactive measures are needed to enhance the recruitment and retention of skilled care workers. Canada is currently experiencing a staffing shortage for long-term care facilities. In Ontario, long-term care homes still have high vacancy rates for nurses and personal support workers (PSWs) — about 8,000 open positions in 2022/23.
By prioritizing improvements in working conditions, the sector can attract and empower professionals to thrive in their roles, ensuring a high standard of care and room for more residents.
“These are incredibly difficult jobs,” she says. “We need to figure out how to make these positions safer, more attractive, and retain talent.”
Braedley testing long-term care equipment in Taiwan
In comparing working conditions in Canada’s care homes to those in other countries, Braedley has identified practical solutions to make care work more appealing. This includes advocating for better wages and job security, improved safety standards and more support for workers’ mental and physical health.
“A stable, supported workforce is key to quality care, but staffing and training must improve to meet growing resident needs,” says Braedley.
“By reducing workloads, enhancing safety, and creating better working conditions, we can attract and retain the caregivers essential for delivering compassionate, high-quality care.”
Recognizing the urgency of these issues, Braedley is dedicated to using her research to institute meaningful change by engaging with policymakers and industry leaders to drive improvements across the long-term care sector.
“I want to ensure that care is not only recognized but truly integrated into the fabric of our society. This work is a step in that direction.”
Tuesday, October 1, 2024 in Faculty of Public and Global Affairs, Research, Social Work
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