This person-centred approach to dementia could revolutionize long-term care in Canada | Canada Voices

Josephine Loukes could no longer live on her own. The 86-year-old’s dementia affected every aspect of her health: She was incontinent. She’d begun wandering at night. She had fallen more than once. During the day, she became increasingly disoriented and, by evening, she was agitated and aggressive.

Three years ago, her daughter Merry Reynolds had moved from Alberta into Loukes’s two-bedroom home in a seniors’ complex in Courtenay, B.C. to care for her. “I was losing sleep,” she says, adding that after a few years she was burnt out. “I’d be up at 3 a.m. cleaning up after my mom and I was trying to juggle work with caregiving. It was 24/7.”

Loukes had been on a waitlist for long-term care for a year-and-a-half when, in April 2026, she landed a spot with Providence Living at The Views in Comox, B.C. “We literally won the lottery,” Reynolds says.

In this case, “winning the lottery” meant gaining access to a dementia village – a residential care community that looks, feels and functions like a regular neighbourhood. Modeled after dementia villages in the Netherlands, there are no locked doors, dead-end hallways or desolate common areas where reruns of I Love Lucy play perpetually on repeat.

Instead, residents at The Views live in 12-person homes and roam freely around the village, which includes a bistro, art studio, salon, cafe, chapel, grocery store, multiple gardens and an Indigenous gathering space. Staff wear street clothes instead of scrubs and dinner is prepared communally in shared kitchens, not served up on hospital trays.

The Views, which opened in 2024, is Canada’s first public, non-profit long-term care village. (The Village Langley, the country’s first private dementia village, opened in 2019 in Langley, B.C.) Providence Living is planning three additional villages in British Columbia, the first of which will open in Prince George in 2028.

Dementia villages are part of a growing movement toward less institutionalized, more person-centred long-term care, says Jennifer Gibson, Providence Living’s interim president and chief executive officer. She describes The View’s approach as social-relational, where the focus is on building a community around what people can still do, instead of what they’ve lost. “It’s a significant difference from an institutional model and it’s an investment that takes courage and persistence.”

A former critical care nurse, Gibson is quick to acknowledge the dedication of everyone working in long-term care, traditional or otherwise. “When I look at the potential of a social-relational model, it’s about building on the efforts that people are already making,” she says. “But I think we’re at a time now when we realize that it’s possible to do this better.”

It’s also necessary, she adds, given the numbers. Every day, more than 414 people in Canada develop dementia. By 2030, nearly 1 million Canadians will be living with Alzheimer’s and other forms of dementia.

Amid this rising need, less institutional approaches to dementia care are gaining traction across the country. The Manitoba government is backing the construction of several household-model long-term care homes, including a residence in Lac du Bonnet designed with seven self-sufficient, 12-person households that will open in 2027. In 2021, Milton, Ont. became home to Canada’s first Green Care Farm (GCF), offering outdoor programming on a working farm, as well as a sensory garden, for people living with dementia.

Sharon Kaasalainen, a professor at McMaster University’s School of Nursing in Hamilton, Ont. and co-lead of the Strengthening a Palliative Approach in Long-Term Care program in Canada, is one of many researchers fighting to bring GCFs to the country’s long-term care landscape.

Although the one in Milton is a day program, in the Netherlands many GCFs are incorporated into long-term residential care, often in conjunction with dementia villages. Studies show residents in GCFs are more physically and socially active and spend more time outdoors than people living in traditional nursing homes. Kaasalainen has witnessed the positive outcomes of GCFs in the Netherlands firsthand and is frustrated by the obstacles – largely funding- and regulatory-related – that are preventing them from becoming commonplace in Canada.

“We’re so afraid that residents are going to fall, but we do more harm thinking that way,” she says. “When we strap people in wheelchairs or lock them indoors, they stop moving. They become deconditioned and end up in pain. So we’re really working to partner with governments to provide some latitude for us to try these new innovations.

“To make long-term care truly person-centred, we need to work together to change the culture.”

Toronto-based Baycrest, recognized globally for its studies on aging and brain health, built its person-centred memory-care model, Possibilities by Baycrest, around customized experiences for its residents, based on input from its clinicians and research by its scientists.

“The losses associated with dementia are real and we can’t pretend that they’re not, but we also know that life doesn’t stop,” say Melissa Turzanski, executive director of residential living at Baycrest’s Jewish Home for the Aged. Turzanski is a co-developer of Possibilities by Baycrest, which now informs the care approach at the Terraces Memory Residence in Toronto.

The goal is to offer autonomy and independence around both routine care tasks and daily programming, Turzanski says. Smart sheets on beds and smart toilets in bathrooms feed key health information to clinical staff, alerting them to potential issues while respecting residents’ dignity. Standardized activities are replaced with personalized plans based on a resident’s history, interests, preferences and abilities. “Everybody has a different plan each day that is meaningful to them personally,” Turzanski says.

In one case, the family of a former artist thought she’d never paint again, but when Terraces staff created a special painting nook and set up cues to help her, she picked up her brush and painted. For a former math teacher, staff completed worksheets she could mark in the evenings when she was feeling restless, restoring a familiar sense of purpose. Another resident believes he still works in an office, so he’s set up with paperwork and invited to meetings in which he can engage and feel valued.

“My grandfather had Alzheimer’s and was in long-term care,” Turzanski says. “They did the best they could, but it hurt my heart to see what was happening. As we look to what’s on the horizon with our aging population, we’re going to have to shift our direction of care to be more personalized, proactive and focused on quality of life, as well as on clinical needs.”

At The Views in Comox, person-centred care has made life better for both Reynolds as a caregiver and Loukes as a long-term-care resident. “Mom was always a very social person, and it has been really interesting to see her re-engage,” Reynolds says.

Reynolds often visits Loukes accompanied by Vinnie, her Australian Shepherd, who is a hit in her mother’s household (dogs are welcome in the village, and staff often bring theirs along, too).

“The whole concept around how the village is built is what makes it so wonderful,” Reynolds says. “There is an amazing amount of freedom. Mom and I will do our shopping together when there’s a farmers’ market in the courtyard and have a hot dog or some popcorn.”

For her part, Loukes says she likes the view from her new “neighbourhood,” which looks over Comox harbour. “I like going on outings to local scenic areas and to bingo and other games for the company,” she says. “And the food is mostly good, much better than a hospital.”