Personal care homes not the only answer to seniors boom: Manitoba study

A "middle option" for seniors could alleviate some of the demand for personal care home beds as the population rapidly ages, a new study from the University of Manitoba suggests.

Right now 25 per cent of Manitobans aged 85 and older live in personal care homes, and the report says the need for beds is slated to spike 50 per cent in the next 15 years.

The study examined supportive housing as an alternative to creating more personal care beds.

Supportive housing provides a place for people who are no longer able to live independently, even with home care, but do not need the round-the-clock services of a personal care home. Residents live in a private apartment, but typically get help with meals, laundry, housekeeping and personal care such as bathing and dressing.

Unlike assisted living, the province subsidizes a portion of the costs and determines who is eligible to live in supportive housing.

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The province has started to offer this "middle option" with more than 500 units in Winnipeg and Manitoba. Researchers found it is offsetting the need for personal care beds.

The study compared people who moved into supportive housing to those who moved into a personal care home between 2006 and 2011. Scientists tracked their health, the fees they paid and the challenges family caregivers experienced for an additional year. 

10% stayed out of care home

The study found 10 per cent of supportive housing tenants never had to use a personal care home. Those who did had a much shorter stay, helping to reserve care home beds for people who need them the most, the report states. 

The study also found 10 per cent of newly admitted personal care home residents were clinically similar to most supportive housing tenants. For example, both groups needed minimal help to complete tasks such as getting dressed or feeding themselves.

"Based on these and other results, the report shows that decision-makers have the option of expanding supportive housing substantially as opposed to only building more PCH beds," said Malcolm Doupe, study author and associate professor in the Rady Faculty of Health Sciences.

The report also points to a need to reform supportive housing to make it more accessible. User fees are higher for supportive housing residents, at $19,500 per year compared to $15,444 annually for personal care homes, the report says. The option also relies heavily on informal caregivers, such as family and friends, the report says. 

Doupe added that government money for operating supportive housing ($14,400 per unit annually) is a lot lower than than for of care homes ($45,000 per unit annually), so reform is needed for supportive housing to reach its full potential. 

"Manitoba has the second highest supply of personal care home beds per 85-plus-year-olds in Canada," said Doupe. "This is a strong signal that building more PCH beds is not the only option. Supportive housing works and has great potential as an alternative to PCH care for some people in Winnipeg."

By the end of the six-year study, one-third of the people were still living in supportive housing, Fourteen per cent of the residents had died, and just over half had moved to a personal care home.