TCH launches system to help seniors in rentals age in place
There’s an elderly woman who lives alone in a seniors’ rental tower on Eglinton West.
In the grips of dementia, she wanders. She sets out on what neighbours believe is a route from her past, ambling west towards Yonge Street. The building’s superintendent, Richard Andrade, says its become a regular occurrence for police to find her, disoriented, and bring her back.
A few floors above her, there’s a man in his 70s, his memory also addled with age. Bedbugs recently infested his unit, Andrade said, but the man had no one to help him remove his belongings in order to spray the place, so the problem has lingered. He’s one of at least 30 residents Andrade believes need a great deal more support.
“Do you know how many people we have here on a waiting list for a nursing home?” Andrade asked, one recent morning. “There’s no space.”
As Canada rapidly ages, triggering warnings from experts about looming care shortages, the housing agency that operates the Eglinton tower — along with 82 other seniors’ residences in the city — has been grappling with how to help its tenants grow old safely in their homes.
Over the last two years, Toronto Community Housing has been rolling out a new system in its seniors buildings, including hiring staff to co-ordinate with health-care organizations, personal support workers and other agencies that work with its tenants.
But a glimpse inside the Eglinton tower reveals the hurdles the agency is up against. Even if staff members know what problems elderly tenants are facing, and connect them with the right agencies, those agencies don’t necessarily have the capacity to step in.
“This is a reality that’s happening for people living in a ton of buildings,” said Toronto geriatrician Samir Sinha. “Whether they’re Toronto Community Housing buildings or not.”
Rita John, 78, has lived in the Eglinton tower for the better part of two decades. Over the years, John has relied on informal support networks in the building to get by. She made an arrangement with her next-door neighbour, where she’ll pound on their shared wall if she’s facing a medical emergency. That neighbour wears an emergency alert button, John said, and would press it if she heard the noise.
John often gets spasms in her legs that leave her immobilized, so she leaves her front door unlocked for when help arrives, with a shopping cart against the door as a safeguard. If someone tried to come in during the night, she reasons the rattling sound would wake her. Building security is a major concern for John, as well as other residents who spoke to the Star; they described non-residents coming into the building and pounding on people’s doors.
Vernon Smellie, a nearly 70-year-old neighbour and John’s fellow tenant representative to TCH, has seen the extreme consequences of neighbours living isolated lives. After one man died, no loved ones or support workers came to check on him, he said, so his body went undiscovered, deteriorating until the odour started to leak through the walls into Smellie’s neighbouring unit.
When the body was discovered, the stench in Smellie’s unit was unbearable, he said. He called TCH to find somewhere else to stay for a while, but didn’t get a solution. So, Smellie waited at a nearby underground parking garage, until Andrade called to say the body was gone.
That was about two years ago, Smellie said, just before the housing agency started rolling out its new system.
That system requires a senior services co-ordinator work out of each building, as well as a “care co-ordinator” that can liaise between health-care providers and their patients that live in that residence. Other pieces of the overhaul include new training, administrative roles, a closer look at policies, and the creation of regional health “hubs” to concentrate access to services.
One part of the overhaul that’s still in its infancy is the creation of a “complex tenancies team,” which will take referrals to handle the most difficult cases, such as hoarding. All the changes come as TCH moves toward transferring control of its seniors homes to the new Toronto Seniors Housing Corp.
Smellie doesn’t believe the new service model will be an easy or immediate fix. But its given him some hope.
Small actions strengthen his faith. He gestured to clear coverings screwed over fire alarms, a new addition to the building that came out of complaints of people pulling them erratically.
“A lot of people in the building don’t believe in it — but from what I see, it’s working,” he said.
But the challenges ahead can still feel mountainous.
Tenant Maria Tellez, who spoke in Spanish as Andrade translated, is living below a resident with dementia who rearranges his furniture through the night, and across from one whose visitors bang the doors at all hours. She struggled each night to get a proper sleep.
Andrade is frustrated by tenants being placed in the building who he doesn’t believe are adequately supported, or equipped to handle living there. TCH tenant engagement and services supervisor Renee Sauer noted one of their biggest challenges was getting mental health support.
Sinha, the geriatrician, is seeing the squeeze on care providers on a daily basis. The need for home care in Toronto is vast, he said, and services are spread thin. “The whole system is strapped right now,” he said.
The most effective way to ensure people could age at home was to intervene in health-related issues early, he said. He sees the new TCH model as a good step, though he said it would be most effective if each building had a budget for a variety of dedicated health workers.
Grant Coffey, general manager of TCH’s Seniors Housing Unit, says the agency isn’t currently looking to become a health provider.
“We are trying to look at, holistically, what are the needs of our tenants, and how can we do things to support addressing those needs?”
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