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DISTINCT

HOUSING NEEDS

SERIES

Supportive Housing for Seniors

CMHC—Home to Canadians

Canada Mortgage and Housing Corporation (CMHC) is Canada’s national housing agency.We contribute toimproving the living conditions and the well-being of Canadians.

Our housing finance activities centre around giving Canadians access to affordable financing solutions. Themain tool to achieve this goal is our mortgage loan insurance program.

We help lower-income households — seniors, people with disabilities,Aboriginals, women and children fleeingfamily violence, youth at risk, and individuals who are homeless or at risk of homelessness — to gain accessto safe, affordable housing.

Through our research, we encourage innovation in housing design and technology, community planning,housing choice and finance.We offer a wide variety of information products to consumers and the housingindustry to help them make informed purchasing and business decisions.

We also work with our government partners and industry to promote Canadian products and expertise inforeign markets, thereby creating jobs for Canadians here at home.

In everything that we do, we are committed to helping Canadians access a wide choice of quality, affordablehomes, and making vibrant and sustainable communities a reality across the country. CMHC is home toCanadians.

Visit us at www.cmhc.ca

You can also reach us by phone at 1 800 668-2642 (outside Canada call 613 748-2003)By fax at 1 800 245-9274 (outside Canada 613 748-2016)

Canada Mortgage and Housing Corporation supports the Government of Canadapolicy on access to information for people with disabilities. If you wish to obtainthis publication in alternative formats, call 1 800 668-2642.

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Supportive Housing

for Seniors

Prepared for Canada Mortgage and Housing Corporation by:Social Data Research Ltd.Ottawa, Ont.

Team members: Christine Davis, Darlene Flett, Laura Johnson, Lorraine Gosselin, Linden Holmes and Erwin Gerrits.Luis Rodriguez of CMHC’s Research Division designed and managed the research project and directed the preparation

of Supportive Housing for Seniors.

CMHC offers a wide range of housing-related information, For details, call 1 800 668-2642 or visit our home page atwww.cmhc-schl.gc.ca


The information contained in this publication represents current research results available to CMHC, and has beenreviewed by a wide spectrum of experts in the housing industry. Readers are advised to evaluate the information, materialsand techniques cautiously for themselves and to consult appropriate professional resources to determine whetherinformation, materials and techniques are suitable in their case. The drawings and texts are intended as general practiceguides only. Project and site-specific factors of climate, cost, aesthetics, and so on must be taken into consideration. Anyphotographs in this book are for illustration purposes only and may not necessarily represent currently acceptedstandards.

Canadian Cataloguing in Publication Data

Main entry under title:


Publ. aussi en français sous le titre: Le logement-services pour les aînés.Includes bibliographical references.ISBN 0-660-18082-0Cat. no. NH15-350/2000E

1. Aged -- Housing — Canada.2. Aged -- Home care — Canada.3. Aged -- Services for — Canada.I. Social Data Research Limited.II. Canada Mortgage and Housing Corporation.

HD7287.92C3S86 2000 363.5'946'0971 C00-980063-8

© 2000 Canada Mortgage and Housing Corporation. All rights reserved. No portion of this book may be reproduced,stored in a retrieval system or transmitted in any form or by any means, mechanical, electronic, photocopying, recordingor otherwise without the prior written permission of Canada Mortgage and Housing Corporation. Without limiting thegenerality of the foregoing no portion of this book may be translated from English into any other language without theprior written permission of Canada Mortgage and Housing Corporation.

Printed in CanadaReprinted, 2005 Produced by CMHC

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Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3How information was obtained . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Part 1: A description of Supportive Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Health trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Social trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Economic trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7The potential for supportive housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9The five key components of supportive housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1: Residential character . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102: Supportive physical environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Providing for safety and security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Providing a safe and accessible environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Providing attractive, safe and accessible common spaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Designing flexible and adaptable environments for changing needs . . . . . . . . . . . . . . . . . . . 15Designing healthy homes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Providing opportunities for active living, socializing and mutual support . . . . . . . . . . . . . . . 16

3: Accessibility to necessary supportive services . . . . . . . . . . . . . . . . . . . . . . . . . . 18Ways in which support services can be provided . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Social and recreational activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Enhancing accessibility to services through community partnerships . . . . . . . . . . . . . . . . . . 21

4: Progressive management philosophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Hire managers who are “people-focussed” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Involve residents in decisions that affect them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Understand and communicate with family members and friends . . . . . . . . . . . . . . . . . . . . . 22Establish realistic expectations about access and costs of support Services . . . . . . . . . . . . . . . 23Have a resident selection process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Support staff in their work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Establish policies on the rights of residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

5: Affordability and choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Types of choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Project size and types of accommodation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Types of sponsorships and forms of tenure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Necessary actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Tabe of contents


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Part 2: Examples of supportive housing in Canada . . . . . . . . . . . . . . . . . . . . . . . 29Example 1: Sydney Senior Care Home Living Ltd. Sydney, Nova Scotia . . . . . . . . . . . . . . . 30Example 2: La Maison des Aînés, Montréal, Quebec . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Example 3: Humbervale Place, Etobicoke, Ontario . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Example 4: ArlingtonHaus, Winnipeg, Manitoba . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Example 5: Villa Royal, Saskatoon, Saskatchewan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35Example 6: Churchview Lodge, Naicam, Saskatchewan . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Example 7: Wedman House, Edmonton, Alberta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Example 8: Laurier House, Edmonton, Alberta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Example 9: Abbeyfield House, Tsawwassen, Brittish Columbia . . . . . . . . . . . . . . . . . . . . . . 42Example 10: The Camelot, Victoria, Brittish Columbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Appendix A: Other examples of supportive housing in Canada . . . . . . . . . . . . . . . . . . . . . . . . 47Appendix B: Definitions of supportive housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Appendix C: Photo credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55End notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

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Advisory Committee for SupportiveHousing for Seniors

Supportive Housing for Seniors would not havebeen possible without the valuable advice andassistance provided by theAdvisory Committee members, special reviewers,and project sponsors and residents of theparticipating case study projects.

Advisory Committee Members

Eileen BadiukProgram Consultant, Community Care BranchSaskatchewan Health

Garry BakerSenior Policy AdviserOntario Ministry of Health

Nick ButManager, Affordable Housing PolicyOntario Ministry of Municipal Affairs and Housing

Veronica Doyle, Manager Housing PolicyB. C. Ministry of Municipal Affairs and Housing

Geri Hinton, DirectorOffice for SeniorsB.C. Ministry of Health and MinistryResponsible for Seniors

Simone PowellDivision of Aging and SeniorsHealth Canada

François RenaudDirection de l’analyse et de la rechercheSociété d’habitation du Québec

Brian RickettsAssisted HousingCanada Mortgage and Housing Corporation

Laurel Russell, Executive Director Policy and Research DivisionNova Scotia Department of Housing andMunicipal Affairs

Kathy Yurkowski, Executive DirectorSeniors DirectorateManitoba Ministry Responsible for Seniors

Special Reviewers

Phil GaudetThe Good Samaritan SocietyEdmonton, Alberta

Colin GrantLutheran Sunset HomesSaskatoon, Saskatchewan

Debbie HumphreysOntario Association of Non-profit Homes andServices for Seniors

David MckelvieNova Scotia Department of Housing andMunicipal Affairs

Didi Radcliffe, Program SupervisorHealth Care Programs DivisionOntario Ministry of Health

Barbara ShropshireDivision of Aging and SeniorsHealth Canada,

John Van DammeOntario Ministry of Municipal Affairs andHousing

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Introduction

Supportive Housing for Seniors describes therange and types of supportive housing forseniors now available—or that could beavailable—in Canada. Supportive Housingfor Seniors is for people who want to find outmore about supportive housing, how itworks, who can benefit from it and how itcan be made available.Part 1 of Supportive Housing for Seniorsintroduces the concept of supportive housingand identifies the essential componentsrequired for a successful project from boththe providers' and the residents' viewpoint.The ideas presented give insight into thecharacteristics and potential benefits ofsupportive housing and the range and typesof supportive housing that can be madeavailable. Part 2 presents 10 Canadianexamples of supportive housing. These reflectmany of the ideas presented in Part 1 andshow the variety of options that are nowavailable.

How information was obtained

The information in Supportive Housing forSeniors draws from several sources. The projectteam reviewed the most recent literature onsupportive housing and then consulted housingexperts and support service providers. Anadvisory committee of representatives fromagencies responsible for housing and healthservices for seniors and a number of specialreviewers helped develop Supportive Housingfor Seniors. The committee members andreviewers are listed at the front of this book.

Canada Mortgage and Housing Corporation(CMHC) staff, members of the advisorycommittee and other experts identified 44examples of supportive housing projectsthat might be included in Supportive Housingfor Seniors. Appendix A lists 34 of theseprojects. Ten of the original 44 were selectedfor Supportive Housing for Seniors. Informationgathered through telephone interviews andcompleted questionnaires provided detailsabout the day-to-day experiences of residents,housing managers and support service providersin these projects. The sponsors and managersof the selected projects provided most of thephotos and illustrations in Supportive Housingfor Seniors.

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Part 1: A Description of Supportive Housing

BackgroundIn his most recent book, Boom, Bust & Echo2000, well-known Canadian demographerDavid K. Foot1 contends that demographicsexplain two-thirds of everything. If this is true,demographics will play a large role in increasingdemand for supportive housing for seniorsover the next several decades. The number ofCanadians over the age of 65 grew by morethan 250 per cent between 1961 and 1996. Ifthat trend continues, by 2031 this populationgroup will have grown and changed in waysthat will have significant implications forCanada. In particular, the number of olderseniors—those older than 75—will escalate tounprecedented levels. It is estimated that bythe year 2031, the number of Canadians in

the 75–plus age group will grow by 277 percent to 4,077,200 from 1,471,100 in 1995and the number in the 85–plus age groupwill more than triple to 1,091,400 from352,000 in 1995.2

The high growth in the number of olderseniors, combined with some importanthealth, social and economic trends affectingCanada, will likely result in heavy demandson public funding unless more efficient waysof meeting the needs for housing and support

services of these seniors are developed widely.Problems are already being experiencedacross the country in meeting the needs ofthe growing number of frail elderly peoplewho may be tenants in private or publichousing or may be living alone with noopportunities to benefit from informalsupport from family and friends.

Trends influencing the need forsupportive housing

Health trends

• Canadians are living longer than ever. In1986, baby boys and girls were expectedto live an average of 72 and 79 yearsrespectively.3 In 1996, these estimatesincreased to 75.7 years for boys and 81.4years for girls.4

2: Total Life Expectancy (years) atSpecified Ages, by Sex—Canada—1996

Âge Total Hommes Femmes

À la naissance 78.6 75.7 81.455 26.5 24.2 28.760 22.3 20.1 24.365 18.4 16.3 20.270 14.8 13.0 16.375 11.6 10.1 12.780 8.8 7.6 9.685 6.6 5.7 7.090 4.9 4.4 5.1

Source: Statistics Canada. Compendium of VitalStatistics 1996. Ottawa: Statistics Canada, 1999(Statistics Canada Cat. No. 84-214-XPE); StatisticsCanada, Health Statistics Division, Special Tabulations.


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• Gains in life expectancy have also addedto the years during which older peopleexperience health problems. Canada,therefore, can expect substantial increasesin the number of older people with activitylimitations. About 46 per cent of Canadiansover 65 have some difficulty in carryingout one or more of the activities of dailyliving such as climbing stairs, taking abath or preparing meals.5 This percentageincreases to 52 per cent for those aged 74-84 and to 74 per cent for those over 85.6

• Canada can also expect significantincreases in the number of older peoplewith chronic disabilities. Disability-freelife expectancy as a proportion of total lifeexpectancy declines with age. For example,in 1991, nine of the 18 years of the averagelife expectancy of people over the age of65 were expected to be free of any disability.Only one of the six years of the averagelife expectancy of people aged 85 or morewas expected to be disability free.7

• Canada will also be challenged to findways of addressing the needs of peoplewho suffer from dementia.8

Social trends

• The majority of women in Canada nowparticipate in the labour force.9 Inaddition, a greater number are takingsenior positions at work which requiremore effort and, therefore, more of theirtime and dedication. Since women havetraditionally been the primary caregivers,it is reasonable to assume that theirincreasing involvement in the labour forcewill affect the level of their volunteercontribution to agencies which providesupport services to seniors as well as theirability to help aging parents.

• The average size of the Canadian familyhas been decreasing since 1961 and it isexpected to further decline, from 2.7people in each family in 1991 to 2.5 bythe year 2016.10 It is also apparent thatgeographic mobility among adult childrenwho seek new or better job opportunitiesis on the rise. These two trends arefurther curtailing the traditional resourcesfor informal support in Canada.

• One of the fastest-growing groups ofCanadians is people who live alone. In1996, nearly 22 per cent of all Canadiansover 55 reported that they were livingalone. This percentage increased to 28 forthose over 65, to just under 39 for thoseover 75, and to 48 for those over 85.11 Ifcurrent trends continue, 35 per cent ofCanadians aged 75 or more, roughly1,700,000 people, will be living alone bythe year 2001.12

• A substantial percentage of olderCanadians who live alone are also limitedat home or in other activities because ofhealth.13 In 1996, close to 17 per cent ofall people over the age of 55 and livingalone were limited at home or in otheractivities. This percentage increased to 20per cent for those over 65, to nearly 25for those over 75, and to just over 35 forthose over 85.14 Many people considerliving alone as the biggest risk factor thatforces a frail or elderly person withdisabilities to move into a long-termhealth care institution.

• It has consistently been shown that olderpeople requiring assistance prefer to livein a residential setting of their own choicerather than move unnecessarily to alongterm health care institution.

• A significant number of older Canadianswho live alone live in single family detachedhouses. In 1996, close to 39 per cent ofall people 55 years old or older who wereliving alone lived in this type of home.This percentage was nearly 40 per centfor those over 65, just under 39 for thoseover 75, and close to 35 for those over 85.15

• Most older people, regardless of theirhealth condition or living arrangementwish to maintain independent lifestylesfor as long as possible, and it is expectedthat more and more will demand thetypes of options that can sustain andenhance their independence.

• Seniors want to engage in a variety ofsocial and recreational activities.According to Statistics Canada, seniorsspend about two hours a day socializing,visiting or talking on the telephone withfriends, going to restaurants, havingpeople over for meals and so on. Theydevote another hour and a half a day to anumber of leisure activities, such assports, hobbies, playing cards and drivingfor pleasure. They also watch televisionevery day for between three and 3 1/2hours. In 1995, close to 50 per cent ofseniors said that they had engagedregularly in physical activities, such aswalking and hiking and exercise or yogaclasses.16 It has been widely recognized inCanada that people who maintain busylifestyles and participate actively in socialand recreational activities are likely tohave healthier, happier and longer lives.

Economic trends

• In general, the living standards ofCanada’s seniors—men and women 65years of age or older—have improved overthe past 20 years. Improvements in thepension system have resulted in steadyincreases in seniors’ average incomes aswell as in decreases in their poverty rate.Between 1981 and 1997 seniors averageincome rose 17 per cent (adjusted forinflation),17 and in 1995, senior’s povertyrate dropped to an all-time low of 16.9

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per cent.18 It is reasonable to assume thattoday’s seniors can better afford housingchoices than seniors could in the past.

• Average incomes in the senior population,however, drop as people grow older. In1996, the average income of people over65 was $40,355. This average decreasedto $36,672 for those over 75, and to$34,676 for those over 85.19

• Seniors living alone have even loweraverage incomes. In 1996, the averageincome of people over 65 living alone was$21,174. This average decreased to$20,438 for those over 75, and to$19,315 for those over 85.20

• The majority of seniors live in dwellingsthat they or a member of their householdown. In 1996, 73 per cent of all people65 years old or more lived in dwellingsthey or a member of their householdowned. This percentage, however,dropped to 67 per cent for those over 75,and to 61 for those over 85.21

• Canada has changed over the past 54years and it will continue to change in thefuture. From 1945 to the early 1970s,Canada was a country with heavygovernment spending on social programs.Starting in the early 70s, and continuinginto 1999, governments became increasinglyconcerned about economic performance,unemployment (particularly among youth),child poverty, homelessness, inflation,deficits and debt, and about their abilityto continue to maintain spending levelson social programs. The new Canada islikely to be characterized by, amongothers, slow but solid economic growth,an aging population and increasedcollaboration between the public, the not-for-profit and the private sectors.

• With the rapid aging of the population,and with the overwhelming desire ofolder people to live independently inresidential environments as long aspossible, it is likely that current trends ofminimizing unnecessary institutional carefor older people and maximizingcommunity based housing solutions forthem will continue


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The potential for supportivehousing

As the 21st century opens, Canadian seniorshave more and more housing choicesavailable. One promising option is supportivehousing. Supportive housing is the type ofhousing that helps people in their daily livingthrough the provision of a physical environmentthat is safe, secure, enabling and homelikeand through the provision of support servicessuch as meals, housekeeping and social andrecreational activities. It is also the type ofhousing that allows people to maximize theirindependence, privacy, decision-making andinvolvement, dignity and choices andpreferences.

There can be various forms of supportivehousing depending on the levels and types ofservices that are provided. The mostserviceenriched forms of supportive housing,such as assistive living22 could be analternative to unnecessarily accommodatingpeople in a nursing home.23

Supportive housing can be most beneficial toseniors over 75 years of age; those who needhelp to carry out activities of daily living;those who are frail or have disabilities andthose who are living alone. It can also benefitseniors who prefer to live with their peers inan environment where they can enjoycompanionship and the freedom to pursuedifferent interests and lifestyles.

Supportive housing can be made available ina variety of building types and sizes. Theserange from small bungalows or cottages, tohomes shared by a group of eight to 10people, to larger buildings containing manydwelling units. The examples shown in Part 2

of Supportive Housing for Seniors give agood idea of the range of choices availabletoday in Canada.

Several types of supportive housing initiativesand programs are offered across Canada.Several provinces have developed their owndefinitions of supportive housing to meetspecific circumstances, requirements and policyobjectives. Some of these are presented inAppendix B. Many of the examples in Part 2have been developed under these programs.

The five key components of supportivehousing

Supportive housing includes the following fivekey components.

1. Residential character2. Supportive physical environment3. Access to necessary support services4. Progressive management philosophy5. Affordability and choice.

Residential characterThe first key component of a supportivehousing project is its residential character.Seniors’ quality of life can be sustained orimproved if they can continue to live infamiliar, welcoming and home-likeenvironments. Supportive housing projectsshould be in good, safe, attractive, residentialneighbourhoods and complement them intheir style and character. Whether in adowntown neighbourhood, suburb or ruralsetting, a good location should always be animportant consideration. Projects should haveeasy, safe and convenient access to community-based services, including public transportation.Ideally, a supportive housing project shouldbe located within a block or two of services

such as a

convenience store, bank, church,pharmacy, medical clinic and hair salon. Ifthis is not possible, good public or privatetransportation, or a combination of the two,can help to bring community services closerto residents. Supportive housing projectsshould be designed to satisfy the needs andpreferences of potential residents, toaccommodate a variety of habits, likes,personalities and to allow individuals to havecontrol over their own private living spaces.Regardless of the size and type of the project,occupants should have their own privatehome—a suite, apartment or other privateliving space—that is self-contained,manageable, safe and secure. Residents’uniqueness can be recognized by allowingthem to furnish and organize their privateliving space the way they want. Projects that


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The residential character can be introduced in all types of housing options

Seniors’ quality of life can be sustained or improved if they can continue to live in familiar, welcomingand home-like environments

offer bed-sitting rooms or studio apartmentsmay include some furniture in the cost ofshelter. However, residents should still be ableto—and encouraged to—bring their ownbelongings, such as artwork, mementoes,family photos and other collectibles, topersonalize their homes. This is importantbecause seniors often move from a largerfamily home where they have enjoyed theirpersonal belongings and family souvenirs formany years. Access to a private outdoor space,such as a balcony or patio, is important.These spaces often serve as added amenitiesfor activities such as gardening or casualfamily dining. They also encourage residentsto enjoy the outdoors. Window boxes orflower beds outside ground floor units or nearentrance doors can enhance the residentialcharacter of a project.

Supportive physical environmentThe second key component of supportivehousing is the physical environment. Goodarchitectural design will produce a safe, secureand enabling physical environment that isaccessible, flexible, adaptable, healthy andencourages socializing and mutual support.

Providing for safety and securityA safe and secure environment is critical insupportive housing. Injuries and crime can beprevented through good architectural andenvironmental design. They can also beprevented through good management practicesand the use of modern technology. Residentsshould be able to feel safe and secureanywhere in the project, and in particular intheir own homes (private dwellings). Theyshould also be able to summon and obtainhelp when needed.

Electronic emergency response services can beuseful to ensure that residents can obtaintimely help. There are a variety of systemsand services available in Canada.24 The mainadvantage of an emergency response service isthat it can be used to call for help themoment it is needed. A small transmitter,

Attractive and functional private outdoor spacesencourage active lifestyles

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Good architectural design will produce a safe, secure and enabling physical environment that is accessible, flexible,adaptable, healthy and encourages socializing and mutual support


12

worn on a neck pendant or wristband, sendsan alarm signal when the user presses thebutton in it. This Volunteer-basedmonitoring services can also help residentsfeel safe and secure. They are usually providedby community-based agencies. When using

these types of services, residents receive adaily phone call from a volunteer. The mainobjective is to find out how the residents aredoing through a friendly contact. The mostimportant thing to do to provide for safetyand security in your project is to be proactiveand implement a well-thought-out safety andsecurity plan for your project. Whenpreparing your plan make sure that youconsul with those concerned with safety andsecurity in your neighbourhood, such as thelocal police and fire departments, hospitaland volunteer groups. Make sure that youidentify all possible safety and security risksthat can exist around the project, includingall seniors’ private dwelling units,25 andimplement the necessary measures toeliminate them.

Providing a safe and accessibleenvironmentAs we grow older, we are more at risk foraccidents and injuries. Most injuries resultfrom falls. Most seniors who are injured arehurt in falls, often around their homes. Onein three seniors who live in their own homehas a fall each year.26 Among people aged 71and over, falls account for 75 per cent of alldeaths and 89 per cent of all hospitalizationsdue to unintentional injury. The majority ofinjuries are preventable if certain measures aretaken. For example, the following designfeatures27 can be implemented to help preventinjuries in the home and to assist residentswith disabilities in their day to day activities.Sponsors of new projects may wish to offerresidents the choice of a walk-in shower stallrather than a bathtub, although in many casesthey may be able to offer them both. Forexample, shower stalls in private suites can becombined with bathtubs in common bathrooms.The shower stalls should be designed toaccommodate a person using a wheelchair.

Basic check list: Designing safe andaccessible bathrooms

• support bars near the tub, toilet and sink• hand-held shower in the tub• non-slip surface in tubs and shower stalls• an outward-opening bathroom door in

case of falls• an entrance door wide enough to

accommodate a walker or wheelchair• single lever faucets with hot and cold

clearly marked• shower seat• heat lamp• portable raised toilet seats to accommodate a

person using a wheelchair or to assist people who may have difficulty getting on and off the toilet

Electronic response systems enable seniors to obtaintimely help when needed

The most important thing to do to provide for safety and security in your project is to be pro-activeand implement a well-thought-out safety and security plan for your project

13


Basic check list: Designing a safe andaccessible kitchen• pantry with pull-out shelves• upper kitchen cupboards low enough for

easy reach• lazy susans in lower corner cupboards• sliding pull-out lower shelves• single lever faucets on the sink• task lighting over sink, stove and work

surfaces• wall oven with side-swing door and clearly

marked on-off switches• open space under kitchen sinks or cook tops

to accommodate a seated person or a personusing a wheelchair

Basic check list: Making sure all rooms aresafe and accessible• non-slip flooring, such as textured tiles, in

entrance foyers, kitchens, and bathrooms• attractive and user-friendly handrails in halls• overhead light fixtures with at least three

light bulbs (if one bulb burns out, the otherswill still be working)

• large windows that bring in lots of light andmaximize the view while sitting

• wide doorways with very low, or no,thresholds to make getting inside or outsidewhile carrying groceries easier

• lever door handles that can be easily turned• electrical outlets, light switches and other

controls that are easy to reach while sitting• water temperature controls to prevent

accidental scalds• good-quality non-glare lighting• closets usable from a seated position

Supportive design features in bathrooms go a long wayin promoting independence and preserving dignity

This seat can allow someone with a back problem to preparemeals comfortably

Pull-out drawers and shelves helpseniors prepare their meals with ease

Basic check list: Designing safe andaccessible indoor common spaces• attractive handrails along corridors (this can

encourage residents to walk along hallwaysin the winter time for exercise)

• fluorescent lighting for increased brightnessin some areas, such as exercise, reading andlaundry rooms

• extra seating areas, for example, alonghallways or places where residents wait forelevators

• dining room furniture which is safeincluding round tables, chairs with arm rests,and chairs with casters on two legs whichallow people to wheel in and out from thetable

• contrasting textures and colours on walls and floors

• safety stripping or other gauge on each stairof a staircase

• wider hallways to accommodate wheel chairsand scooters

• timing mechanisms on elevators set to allowfor "slower" or "delayed" entry and exit

Providing attractive, safe andaccessible common spacesWhen planning the common indoor spaces, itis important to recognize that some residentsuse, or will use, assistive devices, such as walkers,canes and wheelchairs. Good design allowsthe safe use of these devices in areas such asdining rooms, public hallways and elevatorswithout disrupting other residents. It is alsoimportant to keep in mind that residents willneed an appropriate and convenient space to“park” their walkers or set aside their caneswhile sitting or having a meal.

Basic check list: Designing safe andaccessible outdoor common spaces• level entryway into the building • covered entranceway• front door which opens automatically• extra-wide, level walkways around the

building• non-slip finish on walkways and patios• plenty of outdoor lighting• extra seating along the walkways


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Dining chair with casters on front legs can enable frail seniorsto wheel in and out from the table with ease

Light and comfortable furniture give seniors a measureof independence and easy-to-clean furniture is alwaysappealing and welcoming

Designing flexible and adaptableenvironments for changing needsDesigning flexible and adaptable environmentsfor changing needs It is important to thinkabout the changing needs of seniors whendesigning common and private spaces for them.Many seniors who are completely independentwhen they move in may need more assistancein the future. There is an advantage to a flexibleand adaptable design that can be changed overthe years as seniors’ needs change. A flexibleand adaptable design will make it easier andless costly to convert space later. For example,in a multiple storey building storage rooms can

be located in the sameplace on each floor (linedup top to bottom) toaccommodate theinstallation of an elevatorlater on. Otherconversions includerearranging the floor planin a building to create anoffice or converting aprivate unit into acommon dining room ormeeting room.28

Designing healthy homesHousing developments consume energy,materials, water and land, while the environmentaffects our living conditions, social well beingand health. It is possible to balance thesefactors. There are affordable ways to designnew, or retrofit old buildings so thatexisting resources can be used more efficientlyand our homes can be healthier. This approachto housing design can benefit residents as wellas the natural environment.

Basic checklist: Producing HealthyHousing®29

• low-odour, non-toxic materials• toilets and faucets that can be set at low-

volumes• energy efficient appliances• energy efficient windows that provide

optimum lighting• smart use of solar energy• high levels of insulation• rain water cisterns for domestic water and

garden use

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It is important to think about the changing needs of seniors when designing common and privatespaces for them

Safe, accessible andattractive outdoor spacespromote well-being

An accessible bathtub withwatertight gate.

Adjustable kitchen cupboards and counters permitchange without major renovation. This is anadaptable kitchen with standard features andcabinetry.

Providing opportunities for activeliving, socializing and mutualsupportSupportive housing can encourage activeliving, social interaction and mutual supportby offering attractive common areas, bothindoors and outdoors, where residents cangather for meals, recreation, or conversation.Common indoor amenities can include adining room and kitchen, a laundry room, alibrary or reading room, a computer room, alounge for special gatherings and a games orexercise room. In multistorey buildings, theideal is both a laundry room and alounge or meeting room on each floor.It is very important to have washroomsnear the lounge or dining areas. Other indooramenities include a hairsalon, a small convenience shop and an

office for visiting health professionals. Ifresidents are able to walk or take publictransit to nearby amenities and services,it may not be necessary to offer some ofthese services in the building. Offering guestsuites for out-of-town family members orfriends who wish to visit is a good idea.Seniors also appreciate extra space that allowsfamilies or friends to eat a meal together orshare discussions, particularly if their privatedwellings are small. Other indoor amenitiesthat encourage visitors include a hospitalitylounge where refreshments are available, witha nice view of the landscape and comfortablefurniture.


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The same kitchen after removal of lower cupboardsto enable users to work from a sitting position.

An adaptable wheel-in shower can be convertedto accommodate a bathtub and vice versa

Outdoor spaces are as important as indoorspaces in supportive housing. Studies showthat activities such as gardening and walkingare enjoyable and therapeutic for people of allages and cultures. Providers of supportivehousing should pay a great deal of attention tooutdoor amenities that promote opportunitiesfor seniors to remain active. The kinds ofoutdoor features they enjoy include:

• landscaped gardens or courtyards withraised flower beds so that seniors can worktogether in the garden from a sittingposition (raised beds can also be designedso that they are accessible for people usingwheelchairs)

• colourful flowers throughout the gardenarea which seniors can enjoy while strollingoutdoors

• comfortable, conveniently-placed benchesin shaded areas for seniors to sit, rest,chat,and watch nearby activities

• extra wide, level walking paths—thesepaths should be kept clear of snow in thewinter so seniors can have access tooutdoor space all year

• gazebos, arbours, bird baths or otherinteresting focal points which seniors canenjoy together

• covered patios or porches outside thecommunal lounge or dining room whereseniors can gather as a group to socialize innice weather

• vegetable gardens, particularly in ruralprojects which seniors can tend together

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Physical activities and socialization promote activeliving and can delay the onset of disabilities

You are never too old—a 93 year-old man enjoysthe treadmill


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Although many seniors in supportivehousing— particularly those in urban areas—may no longer drive, some still do. Most haverelatives and friends who visit them frequently.It is important to find out how many parkingspaces, and what type of parking, you need tomeet the residents’ needs. You will also needto know how much parking you will need foryour staff and visiting support workers.

Accessibility to necessary supportiveservicesThe third key component of supportivehousing is access to the types of supportservices that will enhance the safety,independence and well being of residents.These30 include:• meals• housekeeping• laundry• transportation• access to recreational, and social activities• information and referral as well as

individual or group counselling on issuesthat affect older people

• assistance with medication• help with dressing and bathing• wellness clinics where checks on weight,

blood pressure, and so on, can be done.

Supportive services can be provided in manyways. The examples in Part 2 and the followinginformation show the many different, possibleways. Regardless of the approach taken, however,the following general principles apply:

Well-designed outdoor spaces arerevitalizing and provide the opportunityto socialize as well as commune with nature.

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• it is important to understand the needs forservices of the target market, both currentand into the future, as well as theirpreferences. It is also important to find outhow much seniors can afford to pay for theservices they need. This information is keyto implementing a successful strategic plan.

• residents should have choice both in themenu of services available to them, as wellas in the way services are delivered—“onesize fits all” is not the way to organizesupport services; service packages andarrangements should be flexible and beable to accommodate the various andchanging needs of the target market. Aflexible plan should be designed which isappropriate for residents as they get olderor their circumstances change.

• it is important to recognize that residentsmay choose to make their own arrangementsfor help regardless of what managementoffers in the way of services.

Ways in which support services can be provided1. Services can be offered as part of the

resident’s monthly accommodation fee.Services offered in this way typically caninclude one or more meals a day,housekeeping, laundry, assistance withpersonal care and professional healthservices. This may be the best approach ifmost of the residents in the buildingrequire daily assistance. The shelter andservice package can still be tailored to theresident’s individual need and should bereviewed by staff from time to time. Toensure overall economic feasibility, it is agood idea to establish a minimum set ofservices that will meet the needs of allresidents. Additional services can be offeredon an individual basis depending on theresident’s needs and preferences.

Intergenerational visiting

Transportation

Meals on Wheels

Social visits and support

Foot care

On-site hair care

Help with dailyactivities

Access to necessary support services can enhance the safety, independence and well being of seniors


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2. Residents can receive services directlyfrom community agencies such as HomeCare or Meals on Wheels. In some casesthese services can be paid for by agovernment program or health plan. Inother cases residents may pay user fees.Supportive housing providers should beprepared to offer assistance in arrangingthese services when needed. Seniors oftenare not aware of what services areavailable in the community or how toaccess the services. It is a good idea tohave an on-site service coordinator—either full-time or part-time—available tohelp residents access services when theyneed them.

3. Residents can use services on a pay-asyou-go basis, at a monthly or yearly fee.Under this arrangement, residents do nothave to pay for services they do not wantor need. Services can be delivered eitherby on-site staff or contracted out to localagencies.

It is also possible to use a combination of theabove approaches to ensure access to services.

Social and recreational activitiesIt is important to support residents’ in theirinterests and hobbies. While social andrecreational activities are important to manyseniors, not everyone may want to be a“joiner.” It is just as important for supportivehousing providers to respect a resident’s rightto privacy as it is to offer activities to thoseresidents who wish to participate.One way in which housing providers canpromote active living and encourage socialand recreational activities is by offeringattractive indoor and outdoor commonspaces. (See Providing opportunities for activeliving, socializing and mutual support, page 12)

Another way is to support volunteers in theirefforts to organize activities. This can bedone by offering in kind assistance such asthe printing of flyers and posters or byproviding space for a meeting. If the projecthas a residents’ association, management andthe association can share the responsibility oforganizing the social and recreational eventsin the project.

Recreational activities encourage socialinteraction and broaden horizons

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Enhancing accessibility to servicesthrough community partnershipsProject sponsors can enhance accessibility tosupport services for their residents by workingtogether with local organizations that serveseniors. This approach can encourage residentsto socialize with other people who livein the surrounding community. Partnershipscan also make on-site services financiallyfeasible and more cost-effective. These are thekinds of things a sponsor can do:

• provide a complimentary membership ina neighbouring seniors’ activity orrecreation centre to all new residentswhen they move in

• offer a membership on a monthly basis toseniors living outside the project to givethem access to services in the building.The residents’ association could beresponsible for administering themembership drive

• form an association with a local homesupport agency which offers day programsfor seniors—if enough residents attend theday program, the agency may assist withtransportation

• consider leasing out space on the groundfloor to an agency which providesprograms for seniors; seniors in theneighbourhood as well as residents couldparticipate in the programs; residents couldalso volunteer in the programs

• encourage “intergenerational activities” byworking with local schools to arrange visitsfrom school children

• work with local “mother and baby”programs to arrange visits by young singleparents (residents can act as surrogategrandparents)

• offer the use of the central kitchen to otheragencies—for example, a Meals on Wheelsor Wheels to Meals program could operatefrom the central kitchen; the meals couldbe served to residents as well as seniorsliving in the surrounding area

• form a partnership with a local shoppingmall or grocery store—retail stores will oftenoffer free transportation and discounts ifenough seniors come to shop in their store

• connect with a gerontology program in alocal university or college—educationalinstitutions are always looking forplacements for their students

• form a partnership with an organizationthat provides training, education orsupport to staff such as a local college orhome support association

• make a communal meal program availableto people living in the neighbourhood aswell as residents to increase its economicviability—work with local churches andcommunity centres to make people awareof the program

• encourage private entrepreneurs such as atravel agents, restaurateurs or retailersspecializing in seniors to set up shop in thebuilding

Progressive management philosophyThe fourth key component of supportivehousing is good management.31 A questionthat managers and other staff of supportivehousing for seniors should ask themselvesis…“What would I like to have if I were tolive here when I’m 80 years old?”

Hire managers who are “peoplefocused”The key attribute of a manager of supportivehousing is a genuine love of people. The tosocialize with other people who live primary

The key attribute of a manager of supportive housing is a genuine love of people


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role of the manager is to know theresidents and their needs and preferences.The manager fulfils almost a “concierge”function. Experience has shown that by“getting to know each other” residents (andtheir families) are very comfortableapproaching the manager on a wide range ofissues. Having good listening skills is a bigpart of the job. It is also important to knowwhen to help and when not to help.

Involve residents in decisions thataffect themProgressive managers involve residents indecisions that affect them. This can be donein a number of ways including:• upporting resident associations or

working committees• having an “open-door” policy for

residents and making residents feel thatthey can always come and see themanager if they have any concerns

• communicating personally and throughnewsletters or regular staff/residentforums

• conducting annual satisfaction surveysand acting on the results

• inviting residents to sit on managementboards

• inviting residents to choose decorativefeatures such as art work and colourschemes, in common areas

• seeking input from residents about theirpriorities for discretionary expenditureson things such as artwork and otherdecorative items in common areas

• having a suggestion box to obtainongoing feedback from residents

Understand and communicate withfamily members and friendsFor most residents in supportive housing,family and friends are important sources ofsupport. If the resident agrees, it is a goodidea for managers to meet regularly withfamily members or friends. There may betimes when family involvement is vital. Forexample, if a resident becomes unable to copeand becomes a risk to himself or herself andothers in the building, discussions with familyare essential. A co-operative effort by theresident, family, health care providers andmanagement will ensure that the next stepsare in the resident's best interests.

Establish realistic expectations aboutaccess and costs of support services In trying to serve the needs of residents anattempt should be made to balance theexpectations of residents and what they canafford to pay with the resources available todeliver the services. Here are some ways inwhich this can be achieved:• use a “Negotiated Service Agreement”32

process where the resident andmanagement formally agree to share theresponsibility for supportive services. Inthis process, residents are encouraged tobe as independent as they are able to be.Family and friends are encouraged tocontinue their supportive relationships,and management takes responsibility forthe provision of certain support services.

People-focused managers are important in supporttive housing

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• for non-profit organizations, it is a goodidea to involve personnel with a history ofworking in the “for-profit” sector on themanagement team

• management teams should include staffwith experience in housing as well assupport service provision. This balancesthe team and helps ensure that bothhousing and support services aresustainable over the long term.

Have a resident selection process Supportive housing may not be suitable foreveryone. It is important to recognize thisand have a selection process in place to helpdecide who should live in the building. Someprojects use a fairly formal process that involvesan independent written assessment of theresident’s needs and preferences. The contentof the assessment may be dictated by provincialguidelines for seniors housing and services. Insmaller group living arrangements, a moreinformal interview approach by managementwith prospective residents may be all that isnecessary. In either case, the assessment shouldconsider a resident’s income and health,including cognitive ability and level ofindependence, as well as the availability ofsupport from family or friends.

In smaller projects, the resident’s personalitycan be an additional or more importantfactor to consider. In these projects, it isextremely important that residents becompatible with each other. Whilepersonalities do not always mix, experiencehas shown that mixing age groups or genderin a small group setting is not necessarily aproblem.

Support staff in their workSupportive housing projects need full-time orpart-time staff to help with administration,service provision, and building maintenance.Staff should be sensitive to residents’ needs.But remember also that it is just as importantfor management to support front-line staff intheir work as it is for staff to supportresidents. There is a positive relationshipbetween employee satisfaction and quality jobperformance. Here are the kinds of thingsthat sponsors and managers can do to supporttheir employees in their work.• offer employee assistance programs that

provide access to confidential counsellingand referrals for work related, personal,financial, legal or other issues

• offer general ongoing trainingopportunities and provide training onspecific topics such as burnout, dealingwith grief, dealing with conflict, andproblem solving

• provide professional training such as CPRand quality customer service

• provide financial assistance andopportunities for educational upgrading

• conduct regular employee satisfactionsurveys and act on the results

• use rotating staff schedules and duties toavoid burnout

• offer mentoring to match experiencedstaff with new employees

• conduct regular meetings with staff andhave an “open door” policy betweenmeetings

• use a teamwork approach rather than ahierarchical structure

• provide good quality equipment andmaintain a safe work place

Ensuring that the rights and interests of residents are protected is very important in supportive housing


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• provide up-to-date information on newproducts and resources that can helpemployees do a better job

• establish a regular employee recognitionprogram and maintain a good workingenvironment

Establish policies on the rights ofresidentsEnsuring that the rights and interests ofresidents are protected is very important insupportive housing. For example, under whatcircumstances can management legally ask aresident to move out? More and more provincesare adding protection for residents living incare homes to their residential tenancy acts toensure that the rights and interests of peopleliving in seniors housing are protected. This isparticularly important in projects offering newtypes of tenure, such as leaseholds, life leases,life tenancies and shared equities.33 It isimportant to become aware of currentgovernment legislation, or guidelines, designedto protect the rights and interests of residents.

Supportive housing providers should establishand implement clear written policies34 dealingwith the rights and interests of residents intheir projects. For example, one of the policiescould set out the reasons a resident may beasked to move out as well as the actions thatmanagement and residents should take undersuch circumstances. It is very important tohave a written agreement, signed by the resident,a family member, and the project manager,before the resident moves into the building.

Affordability and choiceThe fifth key component of supportivehousing is affordability and choice. Seniorshave many different backgrounds andinterests and various levels of health, fitness,

incomes and assets. Needs, circumstances andpreferences also change as people grow older.These differences combined with the expectedhigh growth in the number of older seniorswill most likely result in an increasing demandfor a variety of supportive housing choices.

In particular, seniors will likely be seekingoptions that will enable them to sustain orenhance their independence, options that cansupport the lifestyle of their choice, andoptions that they can afford. There are manyopportunities to respond to these demands ifgovernments and the housing and supportservice industries are well informed andprepared to take the necessary action.

Types of choicesSupportive housing can be developed inmany forms depending on the types and levelof services to be provided, the project sizedesired, the types of accommodation preferred,the types of tenure wanted and the types ofsponsorship available.

Project size and types ofaccommodationA supportive housing project can be small,such as a large house accommodating eightto 12 people. It can be a medium project, for30 to 50 people or it can be a large projectfor 100 or more.

Market surveys have found that seniors whoare looking for new housing prefer mediumrather than large projects. The trend now is tobuild projects that accommodate between 30and 50 people. If you want to offer a supportservice package, at least 30 dwelling unitsmight be needed for economic feasibility.However, economy-of-scale principle maymake it best in the end to increase the

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number of units from 33 to 46. Once a roofand a mechanical system are in place, it maynot cost that much more to add a smallnumber of units to the project. All styles ofhousing are possible. Supportive housing canbe created in large single detached houses,multi-storey apartment buildings, singlestorey side by side motel-style units orattached bungalows. Supportive housingprojects can offer a single type ofaccommodation, such as self-containedapartments with a full bath and kitchen; or acombination of accommodation types, suchas mingle suites, studio or bed-sitting roomswith a private bathroom and self-containedapartments with a full bath and kitchen. Inmany cases, it may be necessary to offerseveral two-bedroom units in a project. Thistype of accommodation is becomingincreasingly important to meet marketdemands.

In small projects, residents often have theirown studio or bed-sitting room and share acommon living room, kitchen and diningroom. They can prepare breakfast and snacksin their rooms or in the common kitchen. Anon-site housekeeper prepares the two mainmeals of the day.

Types of sponsorships and forms oftenureSupportive housing projects can be sponsoredor developed individually by the private,notfor- profit or the public sector, or bypartnerships between them. Different types oftenure can be offered in supportive housingprojects, including rental, condominiums,and life leases. It is also possible to have morethan one form of tenure option in a givenhousing development.35

Supportive housing can come in all shapes and sizes

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Necessary ActionsThe following actions are necessary to make awide range of supportive housing typesavailable for seniors.

1. Municipalities should introduceinnovative changes in planning, zoningand building regulations in order toimprove housing affordability and increasethe range of supportive housing optionsfor seniors in their jurisdictions.36

2. There should be on going mechanisms inlocal communities to promote andfacilitate information exchange andconsultation on seniors’ needs andpreferences for housing and supportservices between seniors, the public, andthe housing, health and support serviceindustries in the public, not-for-profitand private sectors.

Examples of types of accommodation

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3. There should be ongoing co-operation,co-ordination and partnerships betweenthe housing, health and social servicesectors to provide seniors with a choice ofthe most cost-effective combinations ofaccommodation and support services.This is particularly important for thoseseniors who are particularly vulnerable tohaving to move unnecessarily into longterm care institutions, such a nursing home.

4. Seniors should have access to housing andfinancial options that can enable them touse their own resources, including theirequity in their homes, most effectively.


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5. The housing and support serviceindustries should be encouraged toproduce more affordable supportivehousing options for seniors.

6. The housing industry should beencouraged to incorporate the keyfeatures of FlexHousing®—accessibility,adaptability and affordability—in all newtypes of housing they develop so that itcan meet the varied and changing needsof the growing number of seniors whowish to age in a place.

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Part 2: Examples of Supportive Housing in Canada

Part 2 describes the findings of the 10 casestudies. It summarizes the tips from sponsorsand managers, describes the generalcharacteristics of the residents in theparticipating projects and shows how the 10providers included the five key componentsof supportive housing in their projects.

Success tips from supportivehousing sponsors and managers

Here is some advice from supportive housingproviders to those planning new projects37 orwishing to improve existing seniors’ housing.

• conduct a community needs assessmentsurvey38 before you start—this gives yougood information to share with variousparties as you develop your project andmay help to reduce any opposition

• involve potential residents in the planningstages to help avoid design mistakes

• inform neighbours early about yourproject and invite them to participate inthe planning stages—this can avoidneighbourhood opposition later on; invitethe community to your opening

• make sure the local health agencies,including doctors in the community,know about your project—this willincrease referrals

• dwelling units without full kitchens andprivate balconies won’t sell—even if theyare not used much by residents, they arepsychologically important (from a privatecondominium development)

• never underestimate the power ofcontinuous marketing to keep yourproject fully occupied—don’t stop untilyou go out of business; also, don’t beafraid to advertise (from a not-for-profiturban project)

Characteristics of the residentsThe following is a summary of thecharacteristics of the residents living in the 10projects studied.

• the average age of residents in the tenprojects is between 76 and 85, althoughsome residents are over 100 years old.

• most residents are women who livealone—this is not surprising consideringthat 70 per cent of seniors in Canadaaged 85 years or older are women.

• residents come from all income groups—in some projects the majority of residentslive on basic government pensions;however, in other projects many havemiddle or higher incomes and havepreviously owned their own homes.

• supportive housing addresses a range ofhealth-related needs—in about half of theparticipating projects, the majority ofresidents needed help with activities ofdaily living such as shopping, cooking,laundry, housekeeping, and banking.

Map of Canada showinglocation of examples

Montréal


30

1

• most residents in the 10 projects aremobile, however, many use an assistivedevice, such as a cane or walker, forincreased mobility; in most projects,fewer than five per cent of residents usemotorized scooters or wheel chairs.

• few residents in supportive housing havecognitive impairments or dementia.39

Embracing the five key componentsof supportive housing.The map of Canada shows the location of the10 examples of supportive housing projectdescribed in the following pages.40

Sydney Senior Care Home Living Ltd.New Dawn Enterprise Sydney, N.S.

A grassroots organization transforms a formerradar base into a supportive community

“It's like home, I have my own bedroom andfurniture. My family doesn't have to worry.”—a resident of Sydney Senior Care HomeLiving Ltd. (Home Living) Managed by NewDawn Enterprises Limited, this uniqueresidential option for seniors offers residents ahome environment and family atmospherewith a measure of independence and freedomat an affordable cost. Home Living, at aformer radar base, is on the outskirts ofSydney and about 15 minutes walk fromdowntown. New Dawn refurbished 12attached bungalow units, eachaccommodating three seniors on one side anda caregiver and family on the other. Theseniors have their own bedrooms which theycan furnish themselves or have Home Livingfurnish. The caregiver has both interior andexterior access to the seniors' unit and is ableto keep constant contact through a monitor.New Dawn Enterprises Limited is a

community development corporation withthe goal of establishing and operating locallybased ventures that contribute to the creationof a selfsupporting community. In 1991, afteridentifying a need for supportive housing,New Dawn established Sydney Senior CareHome Living Limited. Through Home Living,seniors have the security of 24-hour care,

including meal preparation and housekeeping,as well as attention to health and personalneeds from a caregiver trained in first aid andCPR, fire and safety, medication and crisisintervention. Home Living is a not-for-profitsupportive housing project. The cost forresidents is about $1,500 a month, whichincluded food and shelter, laundry, cleaningand transportation to appointments once amonth by the caregiver. Services available toresidents at a small additional cost includefoot care and hair care.

Two of the attached bungalows

The living-dining room of one of the bungalows

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When asked what she liked best about HomeLiving, one resident said the “home-likeatmosphere.” She said she would not changea thing. Another resident moved to HomeLiving from a nursing home after her doctorhad diagnosed her as depressed. (“My son soldeverything and placed me in a home.”) Sincemoving to Home Living, she reports that shehas stopped smoking, her blood pressure isnormal, she has lost weight and she doesn'thave any stress. “I love it. I like the caregiver,and I’m not lonesome. I do my own laundry.”When asked how she liked her unit, she said:“It's wonderful. There's one special chair forme.”

More and more, Home Living is attractingyounger people who have psychiatric disordersand are in need of supportive housing.Consequently, in some of the homes, olderand younger residents live together. This hasworked well, according to the management,and is mutually supportive for residents.Younger residents learn from the wisdom oftheir older neighbours and are often motivatedby the active lifestyle of their older neighbours.

La Maison des Aînés, Montréal(Québec)Habitations Les deux volets Inc.

Bringing new life to an urban neighbourhoodthrough many community exchanges

“I like everything from A to Z.”—a residentat La Maison des Aînés

La Maison des Aînés is not just a housingcomplex. It's a community center open toparishioners and organizations in the area.Residents and staff at La Maison extend awarm, friendly welcome to family membersand people in the community. The communityis invited to activities such as birthday parties,bingo, casino, holidays celebrations (souper“cabane à sucre”, le brunch de Pâques, la St-Jean- Baptiste), and garage sales. At no charge,La Maison offers a common room to communityagencies for meetings, celebrations and groupactivities. The cafeteria is open to those whowant to eat a nutritious hot meal andsocialize. One resident said, “the meals aredelicious.” There's a charge of $4 for a meal.La Maison des Aînés is a non-profit,charitable supportive housing project. Built in1990, it is in the La Petite Patrie de Montréalresidential area. The building wasintentionally designed to be compatible withother homes on the street. It is not too large,with 29 bachelor suites and 16 one-bedroomsuites. Each suite has a private balcony. Oneresident said: “I decorate my balcony with alittle flower garden in the summer...it'sbeautiful.” Located only minutes fromshopping conveniences (grocery stores,pharmacy, bank, beauty salon, bus terminaland a medical clinic) residents are encouragedto maintain an independent lifestyle.

Two of the residents in the living room of their home

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The common dining room is brightlydecorated with plenty of space toaccommodate 64 people comfortably. Thecommon living room is furnished with chairs,a sofa and a table, and seats 30 people. Thereis also a library for residents.

Residents’ private suites have a fully equippedkitchen, dining/living room, bathroom and aprivate balcony. The suites are all adaptablefor people who use wheelchairs. Designfeatures include adjustable height cupboards,accessible private balconies, common outdoorareas, higher electrical outlets located highenough so that seniors don’t have to bend andgrab bars in bathrooms. The outdoors arewell landscaped, with flowerbeds, gardens andshrubs, a patio and lawn swings. There is amulti-purpose room for residents who wantto participate in a variety of games. Inaddition to rent, residents pay $145 a month

for a service package. The package includestransportation services for residents who arereferred by the Centre local de servicescommunautaires (CLSC), 24 hour, on-callmaintenance, housekeeping (once a week)and one prepared meal served every day inthe common dining room. Residents, thekitchen staff and volunteers create the menu,prepare and serve each meal together. Thecommon kitchen is also available to residentsto prepare meals for their social gatherings.

Working with tenant committees andvolunteers, the recreational coordinator plansactivities for residents. As part of their monthlyfee, residents can participate in physicalexercises and relaxation, coffee breaks,monthly field trips, bazaars, craft classes,bingo, casino, horse races, card gametournaments, monthly parties, holidaycelebrations and more. One resident said:“we're always busy doing something, it's a lotof fun.” Also included in the monthly fee is a24-hour security service, which gives residentsa peace of mind. An attendant is available 24hours, 7 days per week. One resident said:“it’s a good feeling knowing that someone isalways available if you need help.”

View of La Maison des Aînés

La Joie de Vivre

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When asked what she liked best about livingat La Maison des Aînés, one residen said: “Ilike everything...everything about myapartment,” and that she has everything sheneeds. Another resident stated that: “it’s like abig family living here,” and that staff membersare warm and sensitive to residents' needs.“Everyone helps each other even if it meansgoing to the corner store to buy a loaf ofbread for someone.” As one resident proudlystated: “I love this complex.”

Humbervale Place,Etobicoke, OntHumbervale Christian OutreachFoundation Inc.

An on-site agency also serves seniors in thesurrounding community

“Meal time is my favourite. I enjoy socializingwith my friends. I don't have to eat alone.”—a resident at Humbervale Place

One of the best things about Humbervaleplace, according to residents, is the mealprogram. Residents make their own breakfastand lunch, but dinner is provided in thedining room for $6 a meal. Meals are madeon-site by staff in a fully equipped commercialkitchen. On occasion, special dinners are alsoserved in the dining room.

In addition to having access to a meal service,seniors who live in Humbervale Place cantake advantage of other on-site services andprograms such as help with personal care andactivities of daily living and emergency response.These services are provided through a specialpartnership between Humbervale Place andan on-site service provider—DCVS Services

for Seniors. DCVS is anon-profit agency thatdelivers care and supportservices to seniors inHumbervale Place and thesurrounding community.Other activities thatDCVS provides at no orminimal cost are fun and

fitness classes, a hearing clinic, an arthritisclinic, educational seminars, social craftgroups and a volunteer transportation service.These programs are possible because thedevelopers built as much common space asthey could afford, knowing that someday itwould be required.

Humbervale Place was built on churchownedland and provides 108 independent, affordableapartments for seniors in a fourstorey apartmentbuilding equipped with elevators. Opened in1995, the building has six bachelor, 89 one-bedroom and 13 two-bedroom suites. Sixsuites are wheel-chair accessible. All suiteshave supportive design features, includinggrab bars in the bathroom. Rent for aboutonethird of the suites is market based; rentfor the others is geared-toincome. When she

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Front view of Humbervale Place

Social activities and mealsmake the difference atHumbervale


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was asked what she liked best about herapartment at Humbervale Place, one residentsaid: “the brightness, windows, air conditioning,independence (support bars are great) and it'scomfortable.”

ArlingtonHaus, Winnipeg, ManitobaManitoba Housing and BethaniaMennonite Personal Care Home

A unique partnership makes supportivehousing possible for seniors with differentneeds

“I like everything about the services..the mealservice is there when I want it.”—a residentat ArlingtonHaus

Some residents have lived in ArlingtonHausfor more than 20 years. They do not want tomove. As one resident put it: “I loved everyone of those years.” As a result of apartnership between Manitoba Housing andBethania Mennonite Personal Care Home,residents who live in ArlingtonHaus nowhave the choice of an array of support servicesto help them stay in their apartments as longa they wish.

ArlingtonHaus is a renovated, 11 storeyapartment building with 96 studio suites and20 one-bedroom apartments. The interiorcommon spaces have been modified forwheelchair access. Individual apartments have

been adaptedwith designfeatures suchas grab barsin thebathrooms.Some unitshave beenmodified to

allow the use of wheelchairs. This is done onan “as needs” basis. The second floor has ninestudio and two one bedroom suites of assistedliving for tenants who can and want to liveindependently, but who no longer wish to beconcerned about the routines of dailyhousehold maintenance or meal preparation.In addition to rent, assisted living tenants pay$550 a month for a service package. Thepackage includes housekeeping and laundryservices and three meals a day, seven days aweek in the main floorcongregate dining room.At no extra charge,tenants can also takeadvantage of therecreational opportunitiesin the building such asthe spa tub room,movie nights andexercise classes. There isalso counsellingavailable for tenants andtheir families on issuesrelated to aging.

A view of ArlingtonHaus from the street

The main lobby and lounge

A typical kitchen insuites with minifridge and microwaveshelf located highenough so that peopledo not have to bend

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The third and fourth floors of ArlingtonHausare reserved for people with early to middlestages of dementia. On these floors, staff ison duty 24 hours a day, and they work toencourage and support daily livingactivities. Special design consideration has beengiven to the layout of these floors.41

All other tenants live on the upper floors atArlingtonHaus. They can access the assistedliving services on a pay-for-use basis orpurchase the full package on a monthly basis.At ArlingtonHaus, staff is available in thebuilding 24 hours a day to provide peace ofmind. A tenant resource coordinator offersadditional recreational programs and servicessuch as reading assistance, flu clinics, friendlyvisitors, escorts and shopping.

One of the features most appreciated byresidents interviewed at ArlingtonHaus is theextra attention being paid to safety and security.A resident on each floor acts as a monitor. “Wehave to put a ticket that says Good Morning onthe door each night. If it's still there in themorning when she comes, she picks up theticket and checks to make sure I'm OK.”

Villa Royal, Saskatoon, SaskatchewanProject owners, N.C.O. HoldingsService Providers, Lutheran SunsetHomes of Saskatoon

A public-private partnership in a life leasedevelopment results in a supportive settingand brings new life to a familiar neighbourhood

Location is a key factor in the success of VillaRoyal. Many of its residents chose Villa Royalbecause they had lived in the neighbourhoodfor a long time. Villa Royal offered them anopportunity to remain in a familiar environmentin a supportive setting. According to residents,Villa Royal also has “wonderful access to agrocery store, pharmacy, beauty shop, travelagency, bakery, car wash, mini mall, book store,cafe and service station. It's not even a blockaway.”

Villa Royal offers 48 affordable life lease,oneand two-bedroom apartments in the$47,900 to $69,900 price range. The price isconsiderably below that of another life leaseproject in Saskatoon. According to the owner,

the lower price was possible because thecompany has owned the building for morethan 25 years. The owners converted thebuilding from a market rental building at acost of about $1 million. One of the bestloved features of Villa Royal, according toits residents, are the balconies.

“Going out for fresh air means a lot tome.” Residents also appreciate thesmall, fully equipped kitchen, whichhas lots of cupboards; and the living-dining room that is spacious enough forfamily to visit. The brightness of theapartment appeals to residents, particularlythose living on the upper stories.

Bathroom doors swing out for safety and are wideenough for people who use wheelchairs or otherassistive devices

Common bathing room with assist tub, sink and toilet

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The third level of the building has a commondining room for residents to gather for socialoccasions, have a meal together or play cards.A part-time resident service coordinator (“sheis a very caring young woman”) helpsresidents gain access to services not providedelsewhere in the community.

A major attraction of Villa Royal for residentsis the availability of support services. Theowner has contracted Lutheran Sunset Homesof Saskatoon, a recognized non-profit careprovider, to manage and deliver services. Oneof the most popular is the evening mealservice for all residents on Mondays,Wednesdays and Fridays in the third floordining room. Other services include a weeklywellness clinic staffed by a nurse and a weeklyworship service. Residents are charged amonthly fee of $140 to pay for the services ofSunset Lutheran Home. The dinner service isoptional at $97 a month or $6.25 a meal.Based on the size of their apartment, residentsalso pay a monthly fee to cover taxes,maintenance and the upkeep of commonareas.

The support services are housed in a newbuilding that connects the formerly separatehalves of Villa Royal. In addition to a kitchen,dining room and space for support services,the link building contains the elevators.

Churchview Lodge, Naicam,Saskatchewan Saskatchewan Housing Authority,Saskatchewan Assisted Living Services

Supportive housing in a rural communitybenefits all seniors

“It's the best place in Naicam”—a resident atChurchview Lodge

Churchview Lodge is a 29-unit SocialHousing project managed by the NaicamHousing Authority and funded by the federal,provincial and municipal governments. It islocated in the residential section of the Townof Naicam, a small, rural community with apopulation of about 800 people. Naicam is50 km from the nearest centre providinghealth services. Each of the 29 apartments isself contained, with a private bathroom,living room, kitchen, and bedroom. Eachapartment also has two doors—one to theoutside, which gives residents a sense ofprivacy, and one that opens to the hallwayleading to the common areas. Access to thebuilding is through a security-controlled maindoor. Tenants pay 25 per cent of their incomefor rent, which includes heat, water and

View of the front of Villa Royal

A typical two bedroom apartment

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maintenance. Tenants pay extra for any otherservices. Acceptance is based on need, withpriority given to individuals with low incomes.Health and social needs are also considered.

The project, built in 1980, began with veryfew services as the tenants were younger andmore active. Gradually services have beenintroduced, and adaptations made to individualsuites as the tenants aged-in-place.Churchview Lodge is close to the town'sservices and a senior's activity centre. Manyof the tenants find it difficult to get out dueto mobility problems. With the average age ofthe tenants being 84 years, the communityhas taken the initiative to bring a number ofvolunteer services into the lodge. As in manysmall rural towns in Canada, governmentagencies, local groups and individuals cometogether and co-ordinate their strengths toprovide support. In return, the communitybenefits from the many outreach servicesmade possible because of these partnerships.Churchview Lodge has a number of well-usedamenities. They include a multi-purposelounge for dining, birthday celebrations,meetings, exercise programs, crafts and familygatherings. The room contains a treadmilland an exercise bike designed for seniors,small library area, television- VCR, andpiano. Most were donated by communitygroups or purchased through the fund-raisingby the Churchview Lodge Tenant Association.

Other indoor amenity spaces include a laundryroom, wheelchair-accessible public washroomsand hair salon. Churchview Lodge will soonrenovate an area for a tub room providingtenants with the opportunity to enjoy ahydrotherapy bath with the convenience of awalk-in, sitdown tub. Kitchen facilitiesinclude a fully equipped area for the tenantsalong one wall of the main lounge, and acommunity kitchen where meals are preparedfor the tenants and the Meals-On-Wheelsprogram for individuals living in the community.The community kitchen is the result of a needidentified by the community, the space beingprovided by the Naicam Housing Authorityby converting a one-bedroom suite, thehealth district approving the plans and thecommunity providing the funds. There is avery positive working relationship betweenthe health and housing systems. Home careservices are provided on an assessed-needbasis, as they would be for any other individualliving in the community. The Guardian AngelProgram started as a health pilot particularlytargeted to rural communities such as Naicamwhere additional home-based services wereneeded.

Young people from the schools are linkedwith seniors to assist with odd jobs, visits orto entertain. There is a volunteer co-ordinatoron-site who has developed a number of

Meals on Wheels

View of Churchview Lodge


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programs which help people in ChurchviewLodge as well as the community with suchthings as transportation, housekeeping, yardcare, recreation activities, banking and shopping.The co-ordinator matches those who need theservice with people in the community whocan provide the service. There may be a smallfee depending on the type of service.

When the coordinatorarranges for educationalevents and speakers, suchas safety and securityworkshops by the localRCMP, seniors in thecommunity are invitedto attend with theChurchview tenants.Additional services suchas help with

housekeeping, laundry, and assisting with theirtenant association activities are beingconsidered through the Saskatchewan AssistedLiving Services (SALS), a program recentlyintroduced by the provincial government.

Tenants mentioned how much theyappreciated the modifications made to eachapartment to make it easier—things like “lotsof well-placed plug-ins,” safety grab bars inthe tub and toilet area, lazy susans in thelower corner cupboards of the kitchen andimproved lighting in the eating area. Someapartments have been modified to accommodatethe needs of seniors using a wheelchair, andto include sliding shelves and drawers in thekitchen and a modified sit down shower unit.

The residents at Churchview Lodge love thefact that they can go from their own apartmentsto the open green space. There are benches forresting around the development. Residentshave their own space to plant and care for agarden or flowers and they are close enoughto downtown to walk. Another well-appreciatedservice, according to the residents, is thepersonal alert phone system. The HousingAuthority provides the equipment, and thetenants are responsible for arranging theprimary response contacts. There is a $10-a-month fee for the 24-hour answering service.Living close to others offers security and

Seniors in their home

Living-dining area in one of the apartments

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opportunities for socialization, yet individualsuites allow for independence and privacy. Allsupport services in Churchview Lodgepromote an independent environment byencouraging tenants to continue to performtheir daily tasks to the best of their ability.Tenants have the option of choosing thesupport services they want and pay only forthe services they choose. The community ofNaicam is taking a particular interest inpromoting the physical, mental and emotionalwell-being of its seniors by improving theirquality of life with supportive services.

Wedman House, Edmonton, AlbertaThe Good Samaritan Society

Using the assisted living model to provide acaring and supportive environment and offera residential setting in a caring environment

“I don't think I could have done better. Thepeople are very nice.”—a resident at WedmanHouse

One of the Wedman House residentsinterviewed was 92 years old when she movedto her new apartment at Wedman House. Shehas been living there for two years and feelslucky to have found Wedman House. Whenher doctor advised her to move for health

reasons (she had broken her vertebrae, hadknee problems, was legally blind and livingalone) she thought a room in a nursing homewould be her only choice. Instead, she has abright studio apartment with a fully equippedkitchenette and her own furniture. To makelife easier, she has chosen the optional mealplan. “There are three wonderful cooks. Theirmeals are just delicious. I put on about 15pounds—and I don't like it.”

Wedman House is in a beautiful residentialneighbourhood, according to residents, and iswithin walking distance to a conveniencestore, restaurant, bank, hair salon, dry cleaner,fast food restaurant and coffee shop. It is asingle storey development with 30 studioapartments. The apartments and commonareas are designed for people who usewheelchairs. The building’s access to anenclosed courtyard permits and encourages

View of the dining room

View of interior courtyard

A typical residential suite

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residents to freely and privately enjoy theoutdoors. Residents appreciate the many treesand flowers in the garden area. “We like towatch the birds.”

By following the Oregon Model of AssistedLiving,43 Wedman House is able to offer aresidential option for seniors who may need24 hour care. Wedman House has acomplement of multi-skilled staff on-site,including specially trained assisted livingworkers who help residents with personalcare, laundry, housekeeping, meals and areresponsible for cleaning the common areas. Ahalf-time registered nurse is responsible formonitoring and assessing health and for liaisingwith family doctors. A therapy aide trainsvolunteers and co-ordinates recreation activities.The cook prepares and designs menus accordingto the preferences of the tenants. In additionto her clerical duties, a receptionist helps servebreakfast and assists tenants as necessary.Residents have a choice of services. They orderonly what they need. The basic accommodationfee includes the evening meal, housekeeping,basic laundry and personal response system.For an additional $30 a month, a tenant canorder breakfast and lunch. A full laundryservice is another $30 a month.

Tenant fees cover about one-third of the costfor services. The Regional Health Authoritypays the remaining two-thirds. To live atWedman House, residents must qualify fornursing home care in Alberta.

Laurier House, Edmonton, AlbertaThe Capital Care Group

A new concept combining health and personalcare services with life lease ownership in aunique continuing care residential setting

One couple, both in their late 60s, choseLaurier House because the husband had aprogressive disease and could no longer carefor himself. His wife has very bad arthritisand is unable to help. Laurier House enablesthem to continue to live together, and each isnow able to enjoy their favourite activities.They take advantage of the full-meal servicein the common dining room and have dailyassistance in their apartment withhousekeeping and personal care. They payabout $1,500 a month for support servicesand their share of operating costs, includinglong-term maintenance.

Laurier House is a new life lease project. Itcombines health and personal care with

The site plan for Wedman House

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The main dining room

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housing designed for people who enjoy theirindependence but who can no longer meet allof their own needs and qualify for nursinghome care in Alberta. It is a 78-suite project,built in two phases, with 10 studio, 41 onebedroom and 27 two bedroom units. LaurierHouse combines the best features of acomfortable classically styled new homewith the peace of mind that comes withknowing assistance is there when you need it.The cost of the lease for the suites rangesfrom $90,000 to $136,000 depending on sizeand location in the complex. At the beginningof the lease, residents make a capital paymentbased on the size of their suite. This amountis returned (less any money owing and withoutinterest according to the terms of the life leaseagreement) when the suite is vacated. Inaddition, residents arrange a monthly paymentto cover operating costs and the domestic andfood services they select. This monthly feecan be renegotiated if needs change. AlbertaHealth funds the health services residentsrequire. All of the suites, both ground andupper level, are wheelchair accessible andhave a state of the art staff call system. Eachsuite has a kitchenette with under-counter

fridge, countertopstove andmicrowave toprepare lightmeals and snacks,and a modernwheelchair-accessiblebathroom.

Laurier House has a team ofcaregivers,professionalnurses andrehabilitation staff

who work with residents and their families tocreate a service plan that meets the individualneeds of residents and maintain theirindependence. Residents can continue to seetheir own doctor or specialist or choose adoctor on call at Laurier House. Staff isavailable 24 hours a day to provide assistancewith personal care services, such as bathing,toileting, dressing, nail and foot care,continence management, assistance withfeeding and nutrition and medicationadministration.

View of Laurier House

Appartement type d'une chambre

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Abbeyfield House, Tsawwassen, B.C.Abbeyfield House, St. David’s

A family atmosphere where live-in helpmakes the difference: a residential settingwith shared support

“When the time comes, that's the place I wantto be”—comment from a resident when shefirst saw Tsawwassen House before she movedin.

What appeals to residents about thissupportive housing project is the familyatmosphere. “I didn't want to live with myson and be a burden. Here I feel like I have afamily and still live at home.”

This comment is typical of the way mostresidents in Tsawwassen House feel. Eighteenresidents and three service co-ordinators livein two, detached side-by-side, nine-bedroomtwo-story homes. There is a guest room onthe second floor of one home for overnightvisitors.

The homes are surrounded by a lush garden.“When I look out my window, and when thesun is out, it's beautiful” one resident saysabout the garden area. There are outside patioareas with umbrella tables and chairs. Twice amonth, residents from both homes enjoygetting together in the patio areas for “happyhour.”

The kitchen

The dining room

The exterior of St. David’s Abbeyfield House

The living room

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Residents have their own private bed sittingroom on the main floor of each home. Eachbedroom has an attached bathroom with atoilet and sink. In one of the two houses,residents have a full bathroom with a showerattached to their bed-sitting room. In theother home, residents share a large showerand bathroom. There is a large comfortablecommon dining area and living room in eachhouse. One of the most loved features of thehome, according to the residents is “having adoor from your room to the hall (which leadsto the dining/living room), as well as a doorto the outside garden area.”

Both homes have design features to helpresidents with their day-to-day activities. For instance, all door handles and taps are“easy grip” design. There are support barsbeside the toilet and in the bath and showers.If a resident wants emergency help, there isan alarm buzzer in each private suite whichalerts the house service co-ordinator. Quite afew of the residents use walkers and appreciatethe larger rooms, wide hallways and pavedwalking paths in the garden area and frontentrance.

The house service co-ordinator lives on thesecond floor of one home. She, (there areactually three coordinators who work inshifts), is responsible for the preparation of

lunch and dinner, (residents make their ownbreakfast in the kitchen at any time they want)keeping the common areas tidy and groceryshopping. The co-ordinator also helps residentsarrange outings and social activities whenresidents request the help. Residents often gettogether for recreation including ferry trips toVancouver Island, picnics and field trips.

Residents pay about $1,300 a month to liveat Tsawwassen House. The monthly fee includesthe services provided by the coordinator. Someresidents also have a homemaker who helpswith housekeeping and personal care. Theypay for this separately.

The Camelot, Care-a-Minium,Victoria, B.C.Birch Projects Ltd.

A comdominium developer shows howsupportive housing can be created by theprivate sector

“This is the life—I never thought I could liveso well.”

When asked what she liked best about livingat The Camelot, one resident said: “I likemingling with other people at dinner. WhereI was living before, I was isolated. I like to

View of The Camelot

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socialize.” Another resident said he “liked thecompanionship with other residents” whenthey go to the dining room for their eveningmeal. Residents also mentioned the brightnessof the suites and how much they liked thelarge windows and open plan concept of thekitchen, dining and living room areas.Located in James Bay, The Camelot gives itsresidents the benefit of living in a warm,supportive community in a home they own,designed with their comfort and needs inmind. Just one year old, The Camelot has 34condominium units—15 two bedroom, nineone bedroom, six one bedroom and a den,and four penthouses—larger suites with a fewextra amenities.

There is also a guest suite in the building, acommercial kitchen, communal dining room,a library and an office. The units range inprice from $129,900 to $179,900 dependingon size and location in the building. Thepenthouses range from $209,900 to

$229,900. Residents also pay monthly strata(condominium) fees, ranging from $62.83 to$136.13 for property management, buildingmaintenance and related services.

When asked why they chose The Camelot,residents said they were attracted by thefamiliar location—within walking distance ofshops and the harbour, the meals andhousekeeping services and the security ofliving in a safe building.

For a monthly fee of $830 for one person,and $410 for each additional person,residents get 24-hour security (using a lifelinepersonal response system), referral andsupport services, a daily dinner served in thedining room, weekly housekeeping in theirsuites, weekly linen and towel service, laundryand social programming. If residents needadditional services, they are available on a feebasis. These services include personal care,repairperson services, shopping assistance,transportation, additional meals, and parking.There are many thoughtful design features inthe private suites and common areas.Residents appreciate the extra-wide hallwayswhich easily accommodate walkers andscooters, the automatic opening front doorand the motion sensitive elevator door withchimes. In the private suites there are wide-angle peep holes in the entrance doors, leverhandles, easy-to-reach cabinets in the kitchen,raised electrical outlets to reduce stoopingand a sitdown shower. Residents with ahearing impairment can have a strobe-lightalarm installed in their suite.

The Library with fire place

A sitting area

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One resident commented he felt extra safebecause the building was “earthquake proof.”This is a concern for people living on the WestCoast. Heavy steel rods were embedded in thefoundation of the building and then broughtup through the walls and to the top of the roofto make the building earthquake resistant.

A typical two bedroom suite

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Atlantic region

Northwood Centre Inc.Halifax, N. S.Telephone: (902) 454-8311

Cranbury CourtDartmouth, N. S.Telephone: (902) 434-6953

Québec

Résidence du Phare Inc.Gaspé, Que.Telephone: (418) 892-5261

Habitation Communitaire GrandeMaison BeaulacBeaulac, Que.Telephone: (819) 879-5783

Foster Care in Public HousingOffice municipal d'habitationMont-Saint-Hilaire, Que.Telephone: (450) 464-3696

Hébergement Nouveau HorizonsMagdalen Islands, Que.Telephone: (418) 969-2955

A large, multi-level care development.Tenants include persons with dementia.

Apartment townhouses for persons of all ageson low income

Small project for nine seniors, with eight self-contained single suites and one double.

Small project, with 10 self-contained, onebedroom apartments.

Seniors in 143 units in a larger complex arepart of the foster family program. Each fosterfamily is comprised of one couple providingservices to nine residents.

Twenty rooms in a hotel for seniors. Includesservices.

APPENDIX AOther examples of supportive housing in Canada

Ontario

MomijiToronto, Ont.Telephone: (416) 261-6683

Storefront Humber IncToronto, Ont.Telephone: (416) 259-4207

OWN (Older Women's NetworkCooperative)Toronto, Ont.Telephone: (416) 533-9586

Jean Dudly HouseToronto, Ont.Telephone: (416) 691-7407

Elmridge Group Living ResidenceToronto, Ont.Telephone: (416) 785-2500

Preston School ApartmentsCambridge, Ont.Telephone: (519) 653-5719

Fenelon Falls Independent Living CentreFenelon Falls, Ont.Telephone: (705) 887-1122

Sterling PlaceOttawa, Ont.Telephone: (613) 829-6572

Independent apartments with services forJapanese community seniors.

Two hundred apartments for seniors andpersons with disabilities on low income.

A nine-story, 142-unit cooperative for womenof all ages.

Seniors Link, a private, non-profit agency, hasconverted two townhouses into supportivehousing for 10 seniors.

Group home for 14 Jewish seniors, developedby Baycrest Centre for Geriatric Care.

A retrofit, operated by Fairview MennoniteHome Inc. Has 49 self-contained apartmentsfor seniors.

A rural housing project for seniors, where themanager facilitates residents’ access to requiredcommunity services.

Privately-operated, modern seniors residence,a retrofit of a former motel including theincorporation of a historical family home forcommunal spaces, such as dining andrecreational activities.


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Supportive Care ApartmentsDeep River, Ont.Telephone: (613) 584-1900

Manitoba

Rimmer House (The Lions Club ofWinnipeg Housing Centres)Winnipeg, Man.Telephone: (204) 784-1255

Heritage House(aménagé par Fred Douglas Society)Winnipeg, Man.Telephone: (204) 947-3044 (Winnipeg YMCA)

Ross HouseSelkirk, Man.Telephone: (204) 482-7268

The Stoney Plains TerraceBeausejour, Man.Telephone: (204) 268-1029

Saskatchewan

Luther HeightsSaskatoon (Saskatchewan)Telephone: (306) 664-0374

Bethany ManorSaskatoon (Saskatchewan)Telephone: (306) 242-9019

A rural project with 10 self-containedapartments (mainly one-bedroom) as part ofa non-profit development that also includes21 long-term care suites.

Adaptive re-use of one floor in an establishedseniors apartments building for seniors withearly to middle stage Alzheimer Disease andother memory disorders.

Located on the top floors of the historic YM-YWCA building downtown Winnipeg.(Under construction in late 1999.)

Small, for-profit, shared living project forseniors in rural community.

Small, multi-level, continuing carecommunity in rural community.

Large, 120 life lease apartments style condounits with an adult day care centre attached.

Larger development combining subsidizedindependent living units, life-lease apartmentsand assisted living suites—includes townhousesand apartments.

Ilarion ResidenceSaskatoon, Sask.Telephone: (306) 373-7011

Regina VillageRegina, Sask.Telephone: (306) 757-5646

Alberta

Southside ManorEdmonton, Alta.Telephone: (403) 447-3840

McQueen LodgeEdmonton, Alta.Telephone: (403) 447-9201

Wentworth ManorCalgary, Alta.Telephone: (403) 242-5503

British Colombia

Dania SocietyBurnaby, B.C.Telephone: (604) 299-2414

New VistaVancouver, B.C.Telephone: (604) 525-3288

Kincourt NorthTsawwassen, B.C.Telephone: (604) 943-0737

Larger development for seniors and personswith disabilities on low income.

Two blocks of subsidized apartments, one andtwo bedroom, totaling 65 units, with life-leaseunits on the same property.

Includes 85 apartments—74 rental and theremaining life-lease.

Sponsored by a partnership involving all threelevels of government, a large, new modernbuilding offering 120 single and doubleoccupancy rooms replaced three, 35-year oldsenior citizen lodges.

Larger project for seniors using the assistedliving model.

Larger project with a tenure and income mix.

Large, multi-level care building with twohighrise and three lowrise apartment unitsserving an intergenerational and multi-culturalcommunity of residents.

Large—216 subsidized apartment units adjacentto care facility and recreation centre. Sponsoredby the Kinsmen Retirement Association.


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Seton Villa Burnaby, B.C. Telephone: (604) 291-0607

Hollyburn HouseWest Vancouver, B.C.Telephone: (604) 922-7616

Lakeshore PlaceKelowna, B.C.Telephone: (250) 860-3223

Wishs Co-opVancouver, B.C.Telephone: (604) 732-6296

Cedar Hill CourtSaanich, B.C.Telephone: (250) 477-1167

Combination of different types of units includingself-contained bachelorsand one bedroom suitesas well as single and double bachelor suites forseniors who wish to have all meals in dining roomor require assistance with personal care andhousekeeping.

Private development with one and two bedroomunits offering diferenttypes of accommodation,including congregate living and long-term care.

Private, for-profit residential development with75, one and two bedroom suites. Long term careto be offered in next phase.

Co-operative for younger and older women builtas an infill on leased land.

A 42-unit seniors life-lease project sponsored bythe Luther Court Society.

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CanadaAlbertaAlberta Health and Wellness recently commissioned a long term review to look into the types ofpolicies and strategies that could enable the health care system to respond to the implications of theaging of the population. A report on this initiative was expected in November, 1999. It was toinclude a definition of supportive housing for seniors,

British ColumbiaSupportive housing in British Columbia combines building features and personal services to enablepeople to remain living in the community as long as they are able and choose to do so. It is housingwith a combination of support services, including, at a minimum:• a private space with a lockable door• a safe and barrier-free environment• monitoring and emergency response• at least one meal a day available• housekeeping, laundry and recreational opportunities available.Nursing and other health-related services are delivered by the local health authority by specialarrangement or as they would be to any other individuals living independently in the community.

ManitobaSupportive housing in Manitoba provides personal support services and essential homemaking inpermanent, grouped, community residential settings, for frail and/or cognitively impaired elderlypersons; persons with physical disabilities or other chronic conditions requiring extensive long termcare, when their service requirements justify the need for the availability of 24 hour on site assistance.

Nova ScotiaIn Nova Scotia, enriched housing is one example of supportive housing for seniors. It combinesindependent, rent-gearedto income apartments with professionally delivered on-site support services(such as meals, housekeeping, laundry, nursing, personal care and medication). The goal is toprevent unnecessary institutionalization and keep seniors independent for as long as possible.

Ontario Supportive housing in Ontario is social housing where the housing provider either directly deliversessential support services to tenants with special needs or has an agreement with a support servicedelivery agency to allow the provision of essential support services to special needs tenants withintheir project. Essential support services are provincially or municipally funded services that a personmust have to remain independent in the community.

Quebec Supportive housing for seniors is collective housing which combines one or more types of dwellingunits, such as self-contained apartments, bed sitting rooms or bedrooms and a range of supportservices designed to maintain seniors' autonomy such as meals, security, and recreational and socialservices. The dwelling units are the homes of the seniors who occupy them.

APPENDIX BDefinitions of supportive housing


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SaskatchewanA residential option for older persons who do not need the services of a health care facility, yet needsome assistance to remain independent. The residential option may be referred to as “assistedliving” or “retirement living” projects. Accommodation is usually independent suites which may ormay not have full kitchens, and a range of motel-type services —such as housekeeping, laundry,meals, a personal response system, and the co-ordination of scheduled needs e.g. transportation,medical appointments, social and recreational activities. The range and payment of services varies.Health services are accessible on an assessed need basis through the health system. Assisted livingprojects in Saskatchewan do not offer 24-hour supervision or personal care.

United States

Assisted Living Facilities Association of America Assisted living is a special combination of housing, supportive services, personalized assistance andhealth care designed to respond to the individual needs of those who need help with activities ofdaily living and instrumental activities of daily living. Supportive services are available 24 hours aday, to meet scheduled and unscheduled needs, in a way that promotes maximum dignity andindependence for each resident and involves the resident's family, neighbours and friends.44

États-Unis

Assisted Living Facilities Association of AmericaLe logement avec assistance aux États-Unis est une combinaison d’hébergement, de services d’aidegénéraux, de services d’aide personnalisés et de soins de santé conçus pour venir en aide auxpersonnes qui ont besoin d’assistance dans les activités de la vie quotidienne. Les services d’aidesont offerts jour et nuit, de manière à répondre aux besoins habituels et occasionnels des résidantset à préserver le plus possible leur dignité et leur indépendance, avec l’aide des familles, desvoisins et des amis des intéressés.44

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Canada Mortgage and Housing Corporation thanks the following individuals, organizations andproject sponsors for the use of their photographs and floor plans in this publication.

Abbeyfield House, St. David's Society, Tsawwassen, B.C., 7, 13, 14, 28, 40, 41, 59, 61, 98, 99, 100, 101

Architect Edward de Grey, Vancouver, 31, 32, 33

ArlingtonHaus, Winnipeg, and architect Rudy P. Friesen, Friesen Tokar Architects, Winnipeg, 10, 63, 80, 81, 82, 83, 84

Bath Ease Inc., U.S.A., 30

Canada Mortgage and Housing Corporation, 3, 24, 25, 26

Churchview Lodge, Naicam, Sask., 6, 9, 11, 18, 19, 22, 23, 29, 34, 42, 49, 53, 87, 88, 89, 90

Harmer House, Ottawa, 38

Humbervale Place, Etobicoke, Ontario, 36, 43, 44, 45, 46, 47, 58, 77, 78, 79

La Maison des Aînés, Montréal, 5, 12, 20, 35, 37, 39, 48, 50, 51, 52, 73, 74, 75, 76

Laurier House, Edmonton, 8, 62, 67, 95, 96, 97

Life line, Mississauga, Ont., 17

Ms. Anna Kistruck, Disabled Living Foundation, London, England, 21

Northminster Court, Peterborough, Ont., 15

Riverwind Towers, Edmonton, 69

Salford Retirement Village, Adelaide, Australia, 16

Sterling Place, Ottawa, 4

Sydney Senior Care Home Living Ltd. and New Dawn Enterprises; and Cyril LeBlanc, regional director, Ministry of

Housing and Municipal Affairs, Sydney, N.S., 54, 70, 71, 72

The Camelot, Care-a-Minium, Victoria, 55, 64, 66, 68, 102, 103, 104, 105

Villa Royal, Saskatoon, 57, 65, 85, 86

Wedman House, Edmonton, 27, 56, 60, 91, 92, 93, 94

APPENDIX CPhoto credits

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End Notes

1. According to David K. Foot in Boom, Bust & Echo 2000: Profiting From The DemographicShift In The New Millennium. Toronto: Macfarlane Walter & Ross, 1998.

2.. According to Population Projections for Canada, Provinces and Territories, 1993-2016.Catalogue 91-520 Occasional. Population Projection Section, Demography Division,Statistics Canada, 1994. Projection No.2, pages 158 and 191.

3. According to the Demography Division of Statistics Canada, July 14, 1997.

4. According to the Statistical Report on the Health of Canadians, 1999. Part B, Health Status,Total Life Expectancy, page 323. By Health Canada, Statistics Canada and the CanadianInstitute for Health Information under the auspices of the Federal, Provincial and TerritorialAdvisory Committee on Population Health (ACPH), Cat no. H39-467/1999E.

5. According to Statistics Canada's 1986-1987 and 1991-1992 Health and Activity LimitationSurveys.

6. Statistics Canada. Profile of Canada's Seniors. Catalogue No. 96-312E, Tables 8.2 and 8.3. p. 62, and Table A3.1, p. 87.

7. A Portrait of Seniors in Canada, second edition, by Statistics Canada. Catalogue no. 89-519-XPE.

8. According to the 1991 Canadian Study of Health and Aging, nearly 253,000 Canadians sufferfrom dementia, and current projections estimate that this number will triple by the year 2031.

9. According to the 1996 Census by Statistics Canada, 58.6 per cent of all women - those 15years of age or older - participate in the labour force. This percentage increases to 80 for those45-49.

10. Canada's Population: Charting into the 21st Century. By Tina Chui, in Canadian SocialTrends, Autumn 1996. Statistics Canada. Catalogue no. 11-08-XPE.

11. Custom tables obtained from Statistics Canada's 1996 Census by the Market Analysis Centreat Canada Mortgage and Housing Corporation.

12. Living Arrangements of Canada's Older Elderly Population. Canadian Social Trends byStatistics Canada, Autumn 1988.

13. According to Statistics Canada, this means that they have any type of long-term physical ormental condition, health problem, disability or handicap which has lasted, or is expected tolast, for six months or more.


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16. According to Seniors: A diverse group aging well, an article by Colin Lindsay in CanadianSocial Trends, Spring 1999, by Statistics Canada. Catalogue no. 11-088.

17. According to Seniors: A diverse group aging well, an article by Colin Lindsay in CanadianSocial Trends, Spring 1999, page 25. Statistics Canada -Catalogue No.11008.

18. Poverty Profile 1995. A report by the National Council of Welfare. Spring 1997. Minister ofSupply and Services Canada.




22. The concept of assisted living originated in the United States. Although many states,insurance companies and associations have developed their own definitions of assisted living,there is no standard definition that could be used nationally in the United States. However,the definition adopted by the Assistive Living Facilities Association of America is presented inAppendix B. This definition presents an approach which encompasses most of the primarycomponents of assisted living. Source: the 1995 Guide to Assistive Living and State Policy,prepared by Robert L. Mollica, Keren Brown Wilson, Barbara S. Ryther and Heather JohnsonLamarche, and published by the National LTC Resource Center at the University ofMinnesota and the National Academy for Health Policy.

In Canada, assistive living is considered to be one step above most other forms of supportivehousing and one step below a nursing home. It is the type of option that allows people to agein place with little or no worry. An important aspect that distinguishes assisted living fromother forms of supportive housing is that in assisted living the housing providers are also thecare providers and as such they assume the risks and responsibilities associated with their role.In most other forms of supportive housing, the residents are responsible for their own risks.

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23. Data from the United States suggests that as many as 25 to 30 per cent of nursing homeresidents have few daily living impairments and could be cared for in a residential setting.Source: page 46, 1995 Guide to Assistive Living and State Policy, prepared by Robert L.Mollica, Karen Brown Wilson, Barbara S. Ryther and Heather Johnson Lamarche, andpublished by the National LTC Resource Centre at the University of Minnesota and theNational Academy for Health Policy.

24. Detailed information on personal response services can be found in Safe at Home: A Guideto Personal Response Services. Canada Mortgage and Housing Corporation, Cat. No. NH15-106/1995E, NHA 6837.

25. To find out how seniors themselves can protect their homes against burglary you may want toconsult the publication How to Lock out Crime: Protecting Your Home Against Burglary,NHA 6923, 1996, developed jointly by Canada Mortgage and Housing Corporation and theRoyal Canadian Mounted Police.

26. The Economic Burden of Unintentional Injury in Canada, by D. E. Angus etal.,SMARTRISK, 1998.

27. Additional information about ways of increasing safety in seniors’ homes is in Bruno andAlice: A Love Story in Twelve Parts about seniors and safety, by Health Canada, Minister ofPublic Works and Government Services Canada, 1999, Catalogue H88-25-1999E; and in anumber of publications by Canada Mortgage and Housing Corporation, includingMaintaining Seniors’ Independence: A Guide to Home Adaptations, NHA 6165, 1989, andMaintaining Seniors’ Independence through Home Adaptations, A Self-Assessment Guide,NHA 6732, 1989.

28. More ideas on flexible and adaptable designs can be found in FlexHousing: Homes thatAdapt to Life's Changes by Canada Mortgage and Housing Corporation, Cat. No. NH15-202/1999E, 1999.

29. Additional information about how to design healthy homes can be found in HealthyHousing: A Guide to a Sustainable Future, 1993, NHA 6725; Healthy Housing: PracticalTips, 1997, NHA 6736; and Healthy Housing Renovation Planner, Cat. No. NH15-271/1998E, NHA 2172, all by Canada Mortgage and Housing Corporation.

30. More information about support services can be found in Housing for Older Canadians,Chapter 7: Services and Amenities by Canada Mortgage and Housing Corporation, Cat.No.NH15-295/1999E, NHA 2184.

31. For additional information on this topic, see Chapter 10, Management- in Housing for OlderCanadians, a publication by Canada Mortgage and Housing Corporation, Cat. No. NH15-295/1999E, NHA 2184.


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32. As an example, Washington state provides a negotiated risk agreement in assisted livingprojects that is developed as a joint effort between the resident, family members (whenappropriate), the case manager and project staff. The document specifies that the agreement’spurpose is to “define the services that will be provided to the resident with consideration forpreferences of the resident as to how services are to be delivered.” The agreement lists needsand preferences for a range of services and specific areas of activity under each service. Aseparate form is provided to document amendments to the original agreement. Signaturespace is provided for the resident, family member, project staff and case manager. If assistancewith bathing is needed, for example, the process allows the resident to determine and choosehow often, what assistance will be provided and when it will be provided. It allows residentsto preserve traditional patterns for eating and preparing meals and engaging in socialactivities. The negotiated service agreement operationalizes a philosophy that stressesconsumer choice, autonomy and independence over a project's determined regimen thatincludes fixed schedules of activities and tasks that might be more convenient for staff andmanagement of an efficient “project.” It places residents ahead of the staff and administratorsand helps turn a “project” into a home. The process allows the participants to identify a needand determine with what task the residents themselves wish to receive help. For example, ifresidents have difficulty bathing, they may prefer to undress and get into the tub and bathethemselves even though the staff member and perhaps family members feel the residents mayplace themselves at risk of falling. The risk is expressed but the final decision to bathe restswith the resident. Source: page 60 of the 1995 Guide to Assistive Living and State Policy,prepared by Robert L. Mollica, Keren Brown Wilson, Barbara S. Ryther and Heather JohnsonLamarche, and published by the National Long Term Care Resource Center at the Universityof Minnesota and the National Academy for Health Policy.

33. Descriptions of these and other new types of tenure can be found in Chapter Eight ofHousing for Older Canadians by Canada Mortgage and Housing Corporation, Cat. No.NH15-295/1999, NHA 2184. Canada Mortgage and Housing Corporation is currentlycarrying out a study of housing projects which have implemented a number of the new typesof tenure that are emerging in Canada, such as life leases, shared equity ownership, leaseholds,equity co-ops and cohousing. A report of this study is expected to be published in the thirdquarter of 2000.

34. In developing your project's policies and guidelines, make sure that they comply with existingpolicies and legislation of your province or territory. You may also want to review relevantliterature, such as Principles of the National Framework on Aging: A Policy Guide, developedby the Division of Aging and Seniors at Health Canada, Cat. No. H88-3/21-1998E

35. For complete information about building the ideal team for your project, the numerous andinnovative financing options available to housing developers, the full range of types of tenurethat can be made available, and much more, consult Housing for Older Canadians: byCanada Mortgage and Housing Corporation, Catalogue No. NH15-295/1999E, 1999.

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36. There has been recognition on the part of the housing sector professionals and regulatoryofficials that the regulatory environment at the local level can discourage and impedeinnovation, add significantly to the cost of housing development, particularly for atypicalprojects, and limit the range of housing choices for low and modest income households andpeople with special needs such as seniors and persons with disabilities. The ACT(Affordability and Choice Today) Program funded by Canada Mortgage and HousingCorporation is designed to encourage changes to planning and building regulations andresidential approval procedures in order to improve housing Affordability, choice and quality.Through the ACT program, grants are awarded to municipalities, private and not-for-profitbuilders, and developers planners and architects to help them undertake innovative regulatoryreform initiatives in municipalities across Canada. A number of projects are selected througha competitive process, by a national committee of housing experts each year (1990-2002).The program falls into five main categories: streamlining the approval process and raisingawareness of housing issues; facilitating new forms of housing; identifying new approaches toinfill, intensification and conversion; examining alternative land and site developmentstandards; and developing cost effective renovation standards.

37. Detailed information about how to plan new housing for seniors can be found in Housingfor Older Canadians by Canada Mortgage and Housing Corporation, Catalogue No. NH15-295/1999E, 1999.

38. To find out how you can conduct a needs assessment survey in your community, consultPlanning Housing and Support Services for Seniors by Canada Mortgage and HousingCorporation, NHA 2014, Cat. No NH15-57/1998E, and its companion computer program,SENIORS, NE6843, also by Canada Mortgage and Housing Corporation.

39. Detailed information on the range of housing options that can be developed to meet theneeds of people suffering from dementia can be found in Housing Options for People withDementia by Canada Mortgage and Housing Corporation, Cat. No. NH15-302/1999E,1999.

40. All costs, fees, etc. are based on 1999 rates.

41. To find out more about these two floors, see Housing Options for People with Dementia byCanada Mortgage and Housing Corporation, Cat. No. NH15-302/1999E, 1999.


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42. Life leases are a relatively new approach to housing for seniors. A purchaser acquires a legalinterest in a housing unit and may occupy it for life by making a lump-sum advance payment(entry fee) and paying monthly fees. The entry fee is usually the current market value of theunit, although it could be less, particularly when partnerships are involved. The monthly feescover maintenance, operation and management costs of the housing development. Bypurchasing a life lease, residents are essentially giving the sponsor of a housing project aninterest-free loan before construction starts. The size of the loan is established by the sponsorand is usually equal to part of the market value of the purchaser's unit. This interest-freefinancing, combined with zero profit for the sponsor, usually results in 10- to 25- per-centsaving for the occupants. For example, instead of paying a full market price of $100,000 for acondominium dwelling unit, people could move into a similar unit in a life-lease project bylending as little as $75,000 to the sponsor. Additional information on life leases can be foundin the following publications: Source Book on Life Leases: Findings of a Survey of ProjectSponsors, Canada Mortgage and Housing Corporation, Ottawa, 1993; Elfield TenureApproaches for Seniors' Retirement Housing Projects, Canada Mortgage and HousingCorporation, Ottawa, 1991. Innovation in Housing for Seniors. Canada Mortgage andHousing Corporation's Housing Awards, 1988.

43. Oregon defines its model as follows: “assisted living means a program approach, within aphysical structure, which provides or coordinates a range of services, available on a 24 hourbasis, for support of resident independence in a residential setting. Assistive living promotesresident self-direction and participation in decisions that emphasize choice, dignity, privacy,individuality, independence and home-like surroundings.” The state of Oregon has adoptedassisted living regulations and policies which encourage the use of the arrangement tosubstitute for nursing homes and to offer homelike environments which enhance dignity,independence, individuality, privacy, choice and decision making. Facilities are required tohave written policies and procedures which describe how they will operationalize theseprinciples. Source: Guide to Assisted Living and State Policy, May 1995, Appendix, page 56,prepared by Robert L.Mollica, Keren Brown Wilson, Barbara S. Ryther and Heather JohnsonLamarche, and published by the National LTC Resource Center at the University ofMinnesota, and the National Academy for State Health policy.

44. Guide to Assisted Living and State Policy, May 1995, Appendix, Definitions, page 1,prepared by Robert L.Mollica, Keren Brown Wilson, Barbara S. Ryther and Heather JohnsonLamarche, and published by the National LTC Resource Center at the University ofMinnesota, and the National Academy for State Health policy.

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