Univ. Of Fla. Researcher: Canada Can Learn From U.S. Elder Care Model

February 16, 2001

GAINESVILLE, Fla. — Despite fears that the United States is unprepared to care for its rapidly growing elderly population, the system of assisted-living facilities actually place it on firm ground, especially when compared with its Canadian neighbors, a University of Florida researcher has found.

That may be an important consideration for millions of baby boomers in both countries who will begin turning 65 during the next decade and may eventually need such care, said Stephen Golant, a UF gerontologist specializing in housing and long-term care issues.

“The Canadian system is a perfect example of the government taking responsibility and reaping negative rewards,” said Golant, a U.S.-Canada Fulbright Scholar and a core faculty member of UF’s Institute on Aging. “The nursing home model in Canada is clearly not working well. I think Canada could benefit greatly from the U.S. [assisted-living facility] model.”

Current U.S. Census projections show the 65-and-over population will grow from its current 34.8 million to 53.7 million by 2020, an increase of 54 percent. In Canada, that group is expected to grow even more during that time — nearly 85 percent.

While the vast majority of older people live out their lives independently in their own homes, many become mentally or physically unable. Depending on their degree of frailty, they may move in with other family members, or they may require the kind of full-time attention offered in a nursing home.

But what about the millions who fall between those extremes? That’s who Golant wanted to find out about.

Golant did his study in conjunction with the Gerontology Research Centre at Simon Fraser University in Burnaby, British Columbia, during a five-month period. In addition to reviewing past studies of shelter and care alternatives in Canada and the United States, Golant also visited nursing homes and assisted-living facilities, interviewed administrators at those places and polled industry experts.

Canada relies most heavily on two areas for elder care: in-home care by family and/or friends, and publicly subsidized nursing homes. In the United States, by contrast, assisted-living facilities, or ALFs as they commonly are known, gained popularity in the 1990s.

ALFs fill the gap between in-home care and nursing homes. They offer residents care and support for mental or physical frailties, but residents still enjoy considerable independence, dignity and privacy, because ALFs operate much like inns or hotels, Golant said.

Since Canada already has a nursing home shortage that can only be expected to worsen as the elder population grows, he said, will the ALF option work for Canadians?

“Yes, it is highly likely that provinces will realize lower long-term care costs and more Canadians will not have to experience the indignity of nursing home life,” he said.

Unfortunately, ALFs are uncommon in Canada, Golant said, and many of the existing facilities are poorly regulated and don’t accommodate seniors as frail as in the United States. “Sadly, many provincial leaders and senior consumers are unaware of the benefits of the ALF and view it as just another type of nursing home,” he said.

Golant admits that ALFs in the United States have some down sides, but by and large it’s a system worth borrowing from.

“It is not a perfect alternative,” he said, “but overall Canada can learn much from our success with this option. Canadian seniors will be the big losers if ALF development is not promoted.”