'Nursing Home Without Walls' will offer care for the elderly in their communities

“There are huge gaps in support for older adults in Ontario and across Canada,” said Levin, who lobbied for the program in Ontario.

“A lot of the supports that are available are for people when they become really, really sick so they go to the hospital … and end up in long-term care — but there is a lot less support that is free or low cost that helps people stay at home longer and that is where people want to be.”

Originating in New Brunswick, the two-year project is rolling out at Algoma Manor in northeastern Ontario, Fairview Mennonite Home in Cambridge and Perley Health in Ottawa. It was launched last month with $420,000 from the Waltons Trust and Healthcare Excellence Canada, both of which have a focus on older adults. 

The provincial government is not involved in Nursing Home Without Walls although Levin said she hopes it will get onside after the pilot project — and its funding — ends in 2028. 

Last year, Ontario’s Ministry of Long-Term Care started a $15-million, two-year pilot project offering some nursing home support to individuals who are on or eligible for years-long wait-lists, a designation defined as requiring support that cannot be offered in the community. The program provides access to some services in nursing homes, including wound care, podiatry, pharmacy, personal hygiene and social programs. 

A spokesperson for Long-Term Care Minister Natalia Kusendova-Bashta said Nursing Home Without Walls was one of the programs studied for its nursing home wait-list pilot project. 

Unlike the government’s program, Nursing Home Without Walls is aimed at older adults who may never need long-term care — especially if they are provided assistance to live independently.

It was created in 2019 by Suzanne Dupuis-Blanchard, a registered nurse and professor at the Université de Moncton’s school of nursing, and quickly spread across New Brunswick.

Dupuis-Blanchard said she realized a new approach was needed while researching the concept of “aging in place.” Older adults repeatedly spoke about the challenges of remaining at home, not from a medical perspective but rather the need for healthier meals, help with chores or transportation to social events. Some used transportation services for medical appointments but not for equally important social events. 

Over time, the decision to retreat from outside connections lessens independence, Dupuis-Blanchard said.

“All those little things added up, and at one point people just decided, ‘That’s it, I can no longer stay at home,’” she said.

The first to embrace the idea were the nursing home operators, she said. The program became an instant hit and the province soon got onside with funding.

Nursing Home Without Walls is now offered in 36 of the New Brunswick’s 70 long-term care homes, although all can apply for funding that, Dupuis-Blanchard said, ranges from roughly $200,000 to $250,000, mostly for extra staff.

She also heard from families who described parents as suddenly excited to get out of bed and go to events at the local nursing home, saying “I’m going to the spa,” in reference to the bathing rooms and the offer of pedicures, which the system calls “footcare.” 

While independent evaluations are ongoing, Dupuis-Blanchard said data from 2023-24 found a 6.6 per cent reduction in primary care costs, although the government spent three per cent more on social supports. As well, she noted, 89 per cent of the participants said they can now remain at home. 

Ontario is the first province to be approved for the pilot project, part of a national rollout by Healthcare Excellence, Dupuis-Blanchard said. 

Levin, who spent the last few years lobbying for the program, said she expects Ontario’s pilot project will show that deteriorating health and hospitalization can be prevented. For now, the three homes chosen to participate are identifying people in their communities who need help. After that, a “navigator” makes the connection to discuss needs.

Some might want a fitness class. Or caregivers struggling to bathe a spouse might benefit from the nursing home’s spa room with staff to help.

Not all communities need the program but for those that do, Levin expects the evaluation to prove it helps older people remain healthy, independent and away from expensive beds in hospitals or nursing homes. 

“The intention,” she said, “is to make this sustainable and get government funding over the long term.”