Supportive Living Models For Younger Adults With Physical

106 Pages·2012·2.02 MB·English

by  Ava Czymoch

2012
Supportive Living Models for Younger Adults with Physical Disabilities:
A Review and Proposed Best Practice Models
Table of Contents
Acknowledgements ......................................................................................................... 2
Executive Summary ........................................................................................................ 3
Housing ................................................................................................................................................. 3
Care and Supports ................................................................................................................................. 4
Potential Housing Solutions .................................................................................................................. 4
Integrated Models................................................................................................................................. 4
Supportive Living Community Models .................................................................................................. 5
Enhanced Group Home Model ............................................................................................................. 5
Introduction ..................................................................................................................... 6
Progress .................................................................................................................................................. 7
Standata ................................................................................................................................................ 7
Barrier Free Design Guide ..................................................................................................................... 8
Access Design Standards ....................................................................................................................... 8
Universal Design Handbook .................................................................................................................. 8
Supportive Living Accommodations Architectural Design Requirements ............................................ 8
Commonalities Identified ....................................................................................................................... 9
Barriers .................................................................................................................................................... 9
Inventory ............................................................................................................................................... 9
Care in Community ............................................................................................................................. 10
Combined Needs and Cross Ministry Funding .................................................................................... 10
Trends .................................................................................................................................................... 10
Parallel Initiatives ................................................................................................................................. 11
Home for Life ...................................................................................................................................... 11
ADF (Alberta Disabilities Forum) ......................................................................................................... 12
Age-friendly cities movement ............................................................................................................. 12
Accessible and Affordable Housing Working Group (Calgary) ............................................................ 12
Innovative Housing Partnership .......................................................................................................... 13
Global Accessibility Initiative .............................................................................................................. 14
Other Related SCI Initiatives ............................................................................................................... 14
Environmental Scan ...................................................................................................... 15
Supportive Living for Younger Adults ................................................................................................ 15
Long-Term Care Settings for Younger Adults .................................................................................. 16
An Examination of Best Practices Research on Supportive Living ................................ 17
Best Practices Alberta – Tours ........................................................................................................... 17
Alice Bissett Place – Calgary ................................................................................................................ 17
Artspace - Edmonton .......................................................................................................................... 22
Abby Road - Edmonton ....................................................................................................................... 25
Creekside - Edmonton ......................................................................................................................... 27
Devonshire Village - Edmonton .......................................................................................................... 30
Capital Care Adult Duplexes – Edmonton ........................................................................................... 34
Fourth Dimension Group Home – Calgary .......................................................................................... 36
Foundation Place Group Home - Calgary ............................................................................................ 38
Garrison Green Long-Term Care – Calgary ......................................................................................... 40
Easter Seals McQueen Residence ....................................................................................................... 42
Sir Douglas Bader Towers – Edmonton ............................................................................................... 43
More Best and Promising Practices - Alberta .................................................................................. 45
Accessible Housing Society ................................................................................................................. 45
Promising Practices for Housing and Care: Independent, Transitional and Long-Term Care ............. 46
Boyle Renaissance Project .................................................................................................................. 48
Beyond Alberta ..................................................................................................................................... 49
Movements Abroad ............................................................................................................................ 53
Team Analysis and Discussion ..................................................................................... 55
Important Elements for Supportive Living Models ................................................................................. 55
Common important elements – Prioritized by SCI initiative working group ...................................... 56
Supplemental important elements ......................................................................................................... 57
Thoughts on Integration ......................................................................................................................... 58
Potential Alberta Supportive Living Concepts ............................................................... 59
Housing Model Discussion ................................................................................................................. 59
Integrated Models ............................................................................................................................. 59
Supportive Living Communities ......................................................................................................... 73
ENHANCED GROUP HOME SETTING ........................................................................................... 80
Next Steps ..................................................................................................................... 84
Appendix I – Best Practice Tour Summary Table .......................................................... 86
Appendix II – Team Analysis and Discussion ................................................................ 93
Important Elements for Supportive Living Model .................................................................................. 93
Appendix III – Housing Models Resource Page ............................................................ 98
Integrated Housing ............................................................................................................................. 98
Co-operative Housing ......................................................................................................................... 99
Life Equity ............................................................................................................................................ 99
Green House™ Model ....................................................................................................................... 100
Appendix IV – References ........................................................................................... 101
This document is a project of the Alberta Spinal Cord Injury Initiative, a collaborative
effort by Albertans with SCI, service providers, researchers and decision-makers
committed to improving the lives of people affected by SCI and similar physical
disabilities.
We gratefully acknowledge the Government of Alberta who recognized the value of the
vision for the Alberta SCI community.
For more information on the AB SCI Initiative, contact the Canadian Paraplegic Association
(Alberta) at [phone] or go to www.cpa-ab.org.

Prepared by:

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Acknowledgements

Sincere thanks go to the Supportive Living Working Group who guided the development
of this project:
 Carrie Field - Program Manager, Residential Care and Support Services, Accessible
Housing Society
 Ralph Hubele - Senior Manager, Health and Housing Initiatives, Government of
Alberta
 Heather Lissel – Project Manager, Alberta SCI Action Strategy
 Larry Pempeit – Director of Community Development, Canadian Paraplegic
Association (Alberta)
 Neil Pierce – President, MS Society of Canada
 Soraya Saliba – Executive Director, Accessible Housing Society
 Dale Williams – Chair, Canadian Paraplegic Association (Alberta)
 Jason Yule – Manager, Development and Communications, Accessible Housing
Society
Special thanks, as well to additional integral contributors:
 Gordon Branson - Consultant
 Teren Clarke – Executive Director, Canadian Paraplegic Association (Alberta)
 Ava Czymoch – Consultant
 Mark Iantkow – Researcher/Consultant – Libertas Adult Education
 Grace Maier - Director, Geriatrics, Alberta Health Services – Glenrose
Rehabilitation Hospital
 Kerry Nagata – Project Manager, MTA Architects
 Fred Schleich – Care Planning Partners
 Cal Schuler – Community Development Coordinator, Canadian Paraplegic
Association (Alberta)
 Nancy Singer – Executive Director, Kehilla Foundation

Suggested citation: Kirk, Deanna. (2012). Supportive Living Models for Younger Adults
with Physical Disabilities: A Review and Proposed Best Practice Models. Edmonton:
Canadian Paraplegic Association (Alberta).

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Executive Summary

The purpose of this research project is to identify best practices in current supportive
living options for young adults with physical disabilities in Alberta and beyond. Supportive
living is defined as accessible, affordable housing that has some form of care or support
attached. The reflections of the Supportive Living Working Group on the findings
culminated in a list of desired features which were then incorporated into three potential
models of supportive living. Two pre-existing models of supportive living are also
presented.
Also discussed are notable current and parallel initiatives with regard to supportive living
for persons with physical disabilities.
Alberta is currently in a situation where the demand for affordable supportive living by
persons with disabilities and a great many seniors far outnumbers the current
accommodations available. Housing younger adults with disabilities in long-term care
institutions designed for the elderly is not acceptable or conducive to a good quality of
life.
With respect to seniors’ health, care and accommodations, recent cross-ministry
endeavours have begun to examine current and future needs of the younger adult
population and are encouraging a collaborative approach to mapping future strategies.
The examination of current best practice in supportive living which took place as a part of
this research helped to identify important elements that promote optimal environments
for adults with disabilities.
Housing
As supportive living challenges mount, a complete shift in the way communities are
designed and built must take place. Barrier-free design and visitability are not novel
concepts. Rather, they are vital applications that should be implemented as required
elements in our future communities. The cost of not putting this in place will be a
constant and increasing demand on infrastructure budgets to create new housing for
those who can no longer live in their current, inaccessible homes.
Sustainability is a key factor in the development of a number of the models discussed in
this review. This has been a challenge for some current providers of supportive living,

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including housing cooperatives such as Abby Road and ArtSpace. Aging building costs are
mounting without sufficient reserves to keep up with costs.
Explored further within this overview is the new and innovative use of assistive
technologies in living environments. Such technology goes a long way to promoting and
prolonging independent function and choice for people with physical disabilities.
Care and Supports
Successful supportive living relies on the flexible and appropriate delivery of care support
services. The best practice care models discussed in this review, along with the proposed
housing models, describe support models that are cost-effective and allow individuals to
thrive at optimal independence. Such models allow for younger disabled individuals to
stay out of inappropriate long-term care environments and participate in community,
work, university, etc.
Other elements discussed included:
 The availability of skilled caregivers in the community (e.g., training,
staff shortages, etc.)
 The need to provide supportive living environments where families can
remain together and collaboratively provide care and supports.
Potential Housing Solutions
The Supportive Living Working Group’s discussion of the research and review of
supportive living models led to five unique solutions, designed to suit varying community
sizes and population needs. Three of the models were developed in collaboration with
Marshall Tittemore Architects (Calgary) who prepared conceptual floor plans for each.
Two were existing concepts, contributed by working group members. The proposed
models are:
Integrated Models
The “InFocus” Model – Integrated Focus on Community, Universalism and Sustainability –
developed in collaboration with MTA Architects
The Affordable, Accessible Housing Highrise – with non-profit supportive service
organizations on the ground floor – developed by Larry Pempeit – CPA Alberta

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Supportive Living Community Models
The Flexible “Stacked” Model – which allows communities of varying sizes to choose to
incorporate up to three floors of supportive living through this unique design –
incorporating key elements of Green House™ models (see Appendix III) – developed in
collaboration with MTA Architects
A Neurological Disorder Enhanced Assisted Living Community – a joint collaborative effort
including MS Society and Excel Society
Enhanced Group Home Model
Also modeled utilizing essential elements of Green House™ design, this model facilitates
supportive living in either smaller Alberta communities or within neighbourhood settings
in larger communities – developed in collaboration with MTA Architects.

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Introduction

Approximately one quarter of all long-term care residents in Alberta are under the age of
75 (Alberta Health Services, March 2012). For some of these residents, long-term care
may be the most suitable supportive living environment, however, in facilities which are
primarily focused on providing end-of-life care for the elderly, younger adult residents
face situations of social isolation and little opportunity for community involvement and
inclusion.1
Such situations are often the only setting s in Alberta where supportive care is available ,
leaving little choice for younger individuals with disabilities requiring such assistance . For
this reason , this initiative, along with other concurrent initiatives, is striving to identify
and crea te a lternatives to long - term care for this sector of the population . Alberta Health
Services is also currently undertaking a research initiative in order to identify issues and
service gaps with regard to supportive care for individuals age 19 to 64.
The options presently a vailable to younger adults with disabilities are very limited and
largely unacceptable . This has contributed to increased efforts among individuals,
families, and organizations to encourage new housing solutions tha t offer choice,
incre ased independence, and operational options that are both affordable and
sustainable.
The search for solutions is timely and is also a matter under examination locally,
nationally and internationally. Following an extensive review of care and quality of life
conditions for younger disabled nursing home residents in Victoria, Australia, Winkler,
Farnworth and Sloan conclude d :
“ ... younger people in aged care are effectively excluded from life in our
community. Most younger residents are socially isolated and have limited

1 Egg, Jackie. What Factors Contribute to Quality of Life for Young Disabled Adults Who Live in Long Term
Care? Local Research Project, SEARCH Canada, September 2008.

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