This housing experiment could help Ontario save millions of dollar
Anxiety crept into Donna Meloney’s thoughts.
Sometimes, it ate into her sleep when Meloney, then in her mid-60s, lay awake at night, worrying about a future alone. More often, it arrived in the morning when the day ahead looked like an empty horizon.
With no one to rely on, Meloney, a retired retail manager living in a Burlington apartment, grew fixated on isolation and decline, determined to avoid a nursing home. It scared her.
A few blocks north, in the concrete and glass building that is Burlington City Hall, an accountant-turned-councillor named Paul Sharman was consumed with an idea that mirrored Meloney’s fear: older adults need a better way to live.
The same age, but from different social circles, their goals would intersect in a promising new experiment, improving life for dozens.
Now, Sharman’s plan to improve the lives of people over 65 is seen as a solution to the universal anxiety of Canadians who worry they will grow frail, with a lonely ending in a hospital or long-term-care home.
Since opening in 2019, the Community Wellness Hub has helped older adults in a Burlington community housing apartment building remain independent, in their own homes, by surrounding them with health care and social supports.
Housing program seen as missing piece for isolated seniors
The Halton Community Housing program has an on-site leader called a “community connector” to help residents find their way through Ontario’s complex health-care system; organize social events; visit apartments to ensure there is food in the fridge; talk about medication and, organize the services of more than a dozen different agencies providing home care in the building. It is supported by the Burlington Ontario Health Team.
Meloney moved into the building as the Hub pilot began. To her, this new program was the missing piece and the nightly grip of anxiety lessened.
“Any time you had any problems, you could go to them,” she said. “The door was never closed.”
It is easy for Meloney to drop by the office and chat with staff about an issue she can’t quite solve. She leaves feeling calm. Weekly coffee conversations, about anything really, make her feel part of a community. And, on a winter morning or stifling summer day, there is no excuse not to make exercise class when it’s held inside the building.
Like exercise, proactive health care is part of the mix. Every week, Steve the paramedic sets up the private medical room to do blood pressure checks, peer into ears to check on hearing, or track weight gain. He once confirmed a resident was veering into heart attack territory, a potentially life-saving diagnosis.
Program has improved residents’ health outcomes
Health data shows that Sharman’s idea is changing lives.
Compared to a similar population, the data from 410 John St. shows that Community Wellness Hub members have 14 per cent fewer non-urgent emergency department visits.
Hospitalizations related to chronic conditions such as asthma, diabetes, chronic obstructive pulmonary disease, heart failure, hypertension and epilepsy are fewer and shorter in duration, according to the analysis from Dr. Reham Abdelhalim, manager of population health and evaluation at the Burlington Ontario Health Team.
Extrapolated to reflect the wider population, the overall savings are significant, Abdelhalim said. Her analysis is based on 100,000 people, in the same age range, with similar health conditions as those living at 410 John St., using 2022/23 calculations for hospitalization costs.
If the program spreads, reaching 100,000 older adults, it would save the health-care system nearly $90 million a year.
Housing idea inspired by mother’s final years
Sharman’s interest in a better life for older adults began in 2012, after watching his mother struggle in what he considered a less-than-compassionate retirement and nursing home system. She died in 2015, her final years marred by the rigidity of rules that, he said, did not consider individuals, their needs and fears.
For Sharman, it was illuminating. Before his election as a councillor in 2010, he spent his career working with numbers. A career accountant who dug into the internal operations of companies, Sharman saw the needs of an aging population as a new challenge for his skills.
He was named one of the “Top 100 Most Influential People” in the U.S. accounting world in 2005, 2006 and 2007 by “Accounting Today” and worked as a consultant, specializing in the deconstruction and reconfiguration of struggling companies.
Sharman arrived at Burlington City Hall with the swagger of a finance guy ready for a new challenge.
It wasn’t long before he decided to change the operational approach to aging.
In Canada, survey after survey shows older adults want to stay independent, to remain at home, in a house, apartment or condo, until the end.
The question is, how?
Similar housing models have blossomed in other jurisdictions
The goal of living and dying at home, surrounded by emotional, social and medical support, is a normal part of aging in other jurisdictions.
Sharman was inspired by a U.S. program called PACE, which surrounds older adults with the professional help needed to stay at home.
In some ways, the idea behind PACE is similar to the philosophy found in New York City NORCs-with-supports, apartments that are home to a lot of residents who have aged in place, hence the name Naturally Occurring Retirement Communities.
What began in the 1960s with neighbours-checking-on-neighbours, now has state legislation and annual government funding for staff who help residents navigate the health care system, organize classes focused on dementia care or diabetes, help with the communal meals, social activities or fitness classes.
Interest in NORCs-with-supports is growing in Canada, dramatically, according to the NORC Innovation Centre at University Health Network. And for years now, Queen’s University has partnered with Oasis Senior Supportive Living to add NORC supports to buildings in Kingston, Vancouver and elsewhere.
Meloney’s building is not ‘naturally occurring.’ A block east of Burlington City Hall, Wellington Terrace, otherwise known as 410 John St., is a Halton Community Housing Corporation apartment, supported by the Burlington Ontario Health Team, specifically for residents over the age of 65.
The nine-story brick building overlooks a downtown parking lot used by patrons of Burlington’s nearby ‘Village Square,’ a Tudor-inspired car-free zone of restaurants, spas and chocolatiers.
Inside the glass doors, is the office of Jennifer Johnstone, the “community connector” and unofficial den mother to more than 100 residents who signed up for the program. To Meloney, her presence is reassuring.
At the opposite end of the hall is the community room, with table and chairs for card games or talks from the local pharmacist on good sleep and the avoidance of Lyme disease from Ontario’s growing population of ticks.
Johnstone follows the near universal philosophy of NORC or PACE programs: Help people feel important. Be a good listener. Build trust.
She also organizes the health and social services work of more than a dozen community agencies that have been providing care in the building for years. Much of this work is done through the Burlington Ontario Health Team, one of the provincial government’s not-for-profit organizations that “promotes the health and well-being of the general public.”
‘I would be in dire straits’
In 2022, Meloney fell and fractured her hip, an injury that, among many older adults, can lead to a spiral of decline.
She spent several weeks in hospital, returned to 410 John St. and in time, started exercising, perhaps too enthusiastically, pulling a leg muscle, an intense, painful injury. The in-house physiotherapist at 410 John St. got to work and helped her recover.
If she was still living alone, Meloney, now 74, believes she’d be overwhelmed.
“I would be in dire straits.”
Sharman, who just turned 73, sees fear among the older adults who come out for his talks on the program. It is expanding into two other Halton community housing buildings this year but the demand, he said, is now coming from a wealthier cohort.
“I presented to a meeting three weeks ago in a (local) art gallery to 150 attendees,” he said.
“They were older, older adults. Many of them frail.
“These are people who had money and they’re with their notebooks, writing, and saying, ‘Where can we go?’ Tell us where to go.”
This article was first reported by The Star
