Independence Now: The Ethics of Young Adults Living in Geriatric Care Facilities

Sarah Chapple argues that young adults who are living with a disability need access to a variety of appropriate housing and care options

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It may be surprising to learn that one of the most rapidly growing populations in geriatric care facilities is not the elderly, but young adults with disabilities. An estimated 10-15% of residents living in geriatric care homes throughout Canada are young adults with disabilities.

Lack of financial resources, inadequate community resources, and limited family support can force some adults with disabilities to move into a geriatric care facility. The current care and housing options for young adults with disabilities are insufficient.

Living in geriatric care facilities can be challenging for young adults with disabilities. Food, music and recreational activities are all geared towards a much older generation, and living in a setting in which your neighbours continually pass away can be difficult for a young person who may be facing decades of institutional living. For example, 33 year-old Peter Farrah, who lives in an Ottawa geriatric care facility, claims it has adversely affected his mental health, saying he often gets “stressed out about being here,” one time getting into an “angry fit.” Others have also shared their experiences of moving into geriatric care due to lack of other housing options.

The move into a geriatric care facility often results in the separation of young adults with disabilities from their families and home community. Families may need to drive significant distances or use toll bridges and unreliable transit options to visit their loved ones, even in relatively well-serviced areas. This can lead to isolation and lack of support for those who reside in a care facility if family visits are less frequent.

Two Houses

Eddie Arning, Two Houses (1967)

Some adults maintain that moving out of a care facility environment significantly enriched their lives, and many young adults have fought to avoid living in a geriatric care facility in the first place. For example, one commentary outlines a battle with Alberta Health Services to maintain her home support. This support helped her to continue her employment as a university professor and prevented the need for a care facility.

The allocation of resources and services available to young adults living with disabilities vary both within and across the provinces. However, there are signs some provinces are beginning to recognize the need to improve the status quo. For example, in Alberta a task force noted the need for more housing and service options for young adults with disabilities. The task force found that young people may be entering facilities prematurely due to lack of other options, that current services are not the same across the province, and that the services do not meet the needs of adults with disabilities such as multiple sclerosis and brain injury. It also determined that citizens in rural areas are significantly under-serviced; although many are unable to access services in their home community, they prefer to remain there to be close to family and friends.

In British Columbia, Vancouver is presently undergoing a community consultation process to build housing that meets the needs of a wide variety of citizens. The current proposal includes individual accessible apartments, clustered apartments, enhanced apartments, and transitional housing. There are also plans for a complex residential care setting with “houses” of 10-15 residents, but several disability advocacy groups have stated that this new housing model should not include any institutional options. In 1996, British Columbia became the first province in Canada to close all its large institutions for people who have a developmental disability, but institutional options remain for those who have complex physical and medical needs. The community living movement supports people who have a disability and closing institutions so citizens can live and work in the community and participate in family life.

Advocacy groups are also calling for change. Arguably, it is a human right to live in safety and dignity, preferably in a place of one’s choosing. Civil Rights Now, a British Columbia advocacy group, has been pushing for new provincial legislation that would further protect these rights. This proposed legislation would serve as a model for other provinces across Canada and help to promote individualized care funding for people with disabilities. In Nova Scotia, where 127 young adults live in geriatric care homes, Melanie Gaunt and Victoria Levack recently formed an advocacy group, Independence Now Nova Scotia, that aims to improve the quality of life for young adults with disabilities through better housing options. Additionally, the MS Society of Canada recommends that community partnerships should help to fund and develop age-appropriate care options for young adults with disabilities.

The provincial governments must develop appropriate housing and care options for young adults with disabilities. These options ought to include the choice to continue living in their communities.

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Sarah Chapple is a Critical Care Social Worker in Vancouver and Graduate Student in the Interdisciplinary Studies Graduate Program at the University of British Columbia @sarah_chapple 

3 comments

  1. Heidi Presslein MSW LICSW · · Reply

    Great work Sarah!

  2. Sarah Chapple · · Reply

    Thank you so much for the kind comment and for passing along that article, I will be sure to check out your research.

  3. Barbara Secker · · Reply

    Thanks for this important piece, Sarah! You might be interested in this related piece (if you haven’t seen it already): Gibson BE, Secker B, Rolfe D, Wagner F, Parke B, Mistry, B. Disability and Dignity-Enabling Home Environments. Social Science & Medicine 74(2): 211-19. http://dx.doi.org/10.1016/j.socscimed.2011.10.006

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