WEBVTT 00:00:02.670 --> 00:00:05.530 Zannat Reza: When you think of long-term care, what words come to mind? 00:00:05.720 --> 00:00:08.920 Large, institutional, impersonal. 00:00:09.220 --> 00:00:10.750 More hospital than home, right? 00:00:11.160 --> 00:00:15.820 Well, almost a hundred percent of Canadians want to stay in their homes as long as possible. 00:00:16.130 --> 00:00:19.220 But the reality is, some people need a higher level of care. 00:00:19.720 --> 00:00:22.035 What if I told you that there's an alternative? 00:00:22.665 --> 00:00:30.395 There's a growing movement for a culture change that involves a push towards small care homes, where residents can have a more personalized experience. 00:00:30.755 --> 00:00:35.074 This is the basis of the Greenhouse Project in the US, which has pioneered this concept. 00:00:35.680 --> 00:00:41.160 These ideas are starting to take hold in Canada, and today, we'll hear from someone who's put this into practice. 00:00:42.269 --> 00:00:43.309 I'm Zannat Reza. 00:00:43.310 --> 00:00:50.410 Welcome to The Future Age podcast, where we explore bold ideas and creative solutions in reimagining life as we get older. 00:00:50.750 --> 00:01:02.379 If you're new to our podcast, check out some of our earlier episodes on the future of women's health, how caregiving impacts the economy, and designing communities to help us live longer, healthier lives. 00:01:02.795 --> 00:01:09.915 For today's show, I spoke to Dawn Harsch about the company she founded, ExquisiCare, which was recently acquired by SE Health. 00:01:10.385 --> 00:01:15.815 ExquisiCare has three small care homes in Edmonton, Alberta, with plans to expand into Ontario. 00:01:16.275 --> 00:01:21.295 Each home has a small number of residents and focuses on a more comfortable and personalized experience. 00:01:21.645 --> 00:01:24.065 As well as integration into the community. 00:01:24.155 --> 00:01:27.005 Dawn started by explaining how she came up with her vision. 00:01:29.745 --> 00:01:34.505 Dawn Harsch: The inspiration for ExquisiCare started, I guess, when I was a young nurse doing my nursing training. 00:01:34.535 --> 00:01:36.255 And I worked as a healthcare aide. 00:01:36.344 --> 00:01:40.824 And I worked in a hospital and specifically on the dementia unit. 00:01:41.014 --> 00:01:46.434 And that dementia unit at that point in time probably had fifty residents per unit. 00:01:46.854 --> 00:01:48.544 And at that time they were called patients. 00:01:48.884 --> 00:01:57.690 One bathroom, six beds, shared wards, separated by curtains, concrete walls, concrete floor, tattered curtains. 00:01:58.200 --> 00:02:07.990 And I was just really struck by the fact that these are our elders, you know, some of the individuals at that time, this was thirty some years ago, had fought wars, and I just thought this is not okay. 00:02:07.990 --> 00:02:14.079 This is not the way we should be treating our elders, our parents, our grandparents, people that really created this country. 00:02:14.079 --> 00:02:17.734 It just seemed like an institutionalization of our parents. 00:02:17.755 --> 00:02:25.934 And people typically, you see when they go into traditional long-term care, there's a very sharp and rapid decline because it's not a place where people go to live. 00:02:25.964 --> 00:02:27.424 It's a place where people go to die. 00:02:27.685 --> 00:02:29.855 After my nursing degree, I actually did an MBA. 00:02:30.150 --> 00:02:36.050 And created a business plan for what I thought could be an alternative to institutional long-term care. 00:02:36.330 --> 00:02:42.550 At the core of everything we do at ExquisiCare is a belief that we should not be institutionalizing our elders. 00:02:43.049 --> 00:02:44.680 And that's what we do in this country. 00:02:44.809 --> 00:02:50.850 Zannat Reza: And so maybe you could give some examples of what that means, that you don't want to institutionalize our elders. 00:02:50.880 --> 00:02:54.780 What are those features or services that make it more like home? 00:02:54.950 --> 00:02:56.239 Dawn Harsch: It's not even more like a home. 00:02:56.250 --> 00:02:56.750 It is a home. 00:02:56.964 --> 00:03:03.954 It looks, feels, acts, smells completely different from what you would see as a traditional nursing home or traditional long-term care. 00:03:04.515 --> 00:03:08.184 They are custom built, residential, currently ten bedroom. 00:03:08.184 --> 00:03:10.304 You can go up to twelve and still fit the model. 00:03:10.655 --> 00:03:13.174 But these are stand alone residential homes. 00:03:13.175 --> 00:03:20.130 And when I designed them and when I sort of visioned it out, the homes are built with the residents in mind first. 00:03:20.380 --> 00:03:27.220 If you look at traditional long-term care, it's built with what's best for the nurses, what's best for the doctors, what's best for the funders. 00:03:27.250 --> 00:03:41.030 And so that's why you have one hundred bed facilities with one shared RN and these long hallways, because that's better for sight lines so that that one RN can see down the hallway to see her fifty patients here and fifty patients there. 00:03:41.480 --> 00:03:44.720 ExquisiCare homes, again, residential estate homes. 00:03:44.790 --> 00:03:48.340 Every resident has their own bedroom, their own attached en suite bath. 00:03:48.905 --> 00:03:54.234 Which is a privacy and a comfort thing, but it's also infection prevention and control. 00:03:54.455 --> 00:04:01.675 So during the pandemic, we had zero cases of COVID in any of our homes, zero deaths from COVID. 00:04:01.725 --> 00:04:10.025 And that's a testament, not only to the physical setup and the physical design of the homes, but also the ability to control who's coming in and out of that home. 00:04:10.285 --> 00:04:11.815 They look like every other house on the street. 00:04:11.825 --> 00:04:16.605 You walk up, you really wouldn't know the difference between an ExquisiCare home and their neighbor. 00:04:16.985 --> 00:04:21.855 And that sense of belonging that comes to the elders by truly living in a neighborhood. 00:04:21.975 --> 00:04:25.614 And some of our neighbors, they support the homes just like neighbors should. 00:04:25.854 --> 00:04:31.104 Through the years, we've had neighbors that pop over and say, oh, I hear that there's a bunch of seniors who live here and I play the guitar. 00:04:31.104 --> 00:04:31.775 I'm retired. 00:04:31.775 --> 00:04:33.154 Can I come over and play the guitar for them? 00:04:33.470 --> 00:04:34.140 Of course you can. 00:04:34.390 --> 00:04:41.980 Another lady contacted us once and said, my children really don't have access to their grandparents, but I would love for them to interact with the seniors here. 00:04:42.130 --> 00:04:42.940 It was a beautiful thing. 00:04:42.940 --> 00:04:45.380 Of course your children can come play in the yard. 00:04:45.480 --> 00:04:49.889 You know, when you walk into the home, you will often smell the roast or the cinnamon buns cooking. 00:04:49.980 --> 00:04:54.220 And sometimes the elders, who are able to, will even help in preparing that meal. 00:04:54.230 --> 00:04:55.800 So it gives them purpose. 00:04:56.100 --> 00:05:01.110 The nursing station is sort of hidden in what would otherwise be a butler's pantry. 00:05:01.170 --> 00:05:07.690 So there's not this clinical area that's front and center in the homes because it's designed for the senior. 00:05:07.730 --> 00:05:09.950 And then we fit in as care providers. 00:05:10.340 --> 00:05:15.929 Zannat Reza: You've talked about the physical design of the home and that it fits right into a neighborhood. 00:05:16.059 --> 00:05:19.650 So describe a little bit more about, you walk in, what do you see? 00:05:19.789 --> 00:05:26.019 Dawn Harsch: So our homes still meet all the building specifications and codes of those larger care facilities. 00:05:26.049 --> 00:05:30.969 So we are just as fire safe and just as safe as those bigger facilities, but it looks and feels like a home. 00:05:31.059 --> 00:05:35.179 So you walk in, you'll see a staircase, there's a sitting area off to the left. 00:05:35.530 --> 00:05:39.785 Big, beautiful, open concept kitchen with another sitting area. 00:05:40.095 --> 00:05:45.554 All the elders will eat round one, sometimes we separate it into two tables, family style. 00:05:45.944 --> 00:05:49.735 And the staff eat with the residents and they eat what the residents are eating. 00:05:49.745 --> 00:05:54.304 So part of that model is we make our meals together and we enjoy them together. 00:05:54.425 --> 00:06:00.635 So the benefit to the staff eating with the residents is it encourages socialization and that feeling of family. 00:06:01.010 --> 00:06:09.550 But the elders who are suffering with dementia will also mimic or model the behavior that they see in their care providers in terms of how to eat. 00:06:09.790 --> 00:06:20.410 There's a commercial elevator in all the homes, but it looks very residential because there's bedrooms on the upstairs, the main floor, and some of the homes do have bedrooms on the lower level as well. 00:06:20.630 --> 00:06:22.510 Everybody has their own bathing unit. 00:06:22.510 --> 00:06:27.585 And then oftentimes in the lower level there is therapeutic tub as well. 00:06:27.715 --> 00:06:34.025 There's usually an office downstairs, but again, the staff areas, the work areas are hidden because this is the elder's home. 00:06:34.214 --> 00:06:35.944 Zannat Reza: How many staff do you typically have? 00:06:36.044 --> 00:06:40.325 Dawn Harsch: So there's two staff twenty-four seven always, and then there's other staff that come and go. 00:06:40.334 --> 00:06:46.025 So every day during the day, there's two staff for ten clients, one of which is a nurse. 00:06:46.055 --> 00:06:47.275 The other is a healthcare aide. 00:06:47.485 --> 00:06:50.605 Evenings and nights, there's two HCs, but there's always a nurse on call. 00:06:50.655 --> 00:06:55.225 In addition to that staff, there's a nurse manager for each pod. 00:06:55.265 --> 00:06:57.794 And a pod of homes is three to four homes. 00:06:58.175 --> 00:07:01.934 So that nurse manager is another set of eyes on those residents. 00:07:02.619 --> 00:07:05.929 There's also an activity coordinator, so she does recreation therapy. 00:07:05.969 --> 00:07:08.729 We have a physician who visits the home once every other week. 00:07:08.809 --> 00:07:16.089 And some of the homes will have a third staff over the dinner hours, specifically our homes that are for individuals with dementia. 00:07:16.249 --> 00:07:19.820 Zannat Reza: So tell me about some of the other innovations you've made at ExquisiCare. 00:07:19.919 --> 00:07:31.199 Dawn Harsch: I think one of the biggest innovations that we have at ExquisiCare is less of an innovation, and more of a throwback to allowing caregivers to spend their time caring for the client. 00:07:31.239 --> 00:07:43.289 And so when I designed sort of the job descriptions at Exquisite Care and compared that to traditional long-term care, and typically she or he is pushing around a med cart, handing out meds for fifty to a hundred people. 00:07:43.349 --> 00:07:44.909 There's no job satisfaction in that. 00:07:44.969 --> 00:07:52.275 You would have an RN who's doing a lot of paperwork, who spends no time with the residents unless the resident has fallen or has died. 00:07:52.304 --> 00:07:59.114 And so if you look at why people go into health care, and particularly elder care, they do that because they want to spend time with the seniors. 00:07:59.135 --> 00:08:00.264 They want to make a difference. 00:08:00.505 --> 00:08:15.970 And so when I looked at sort of the job description of what it means to work in an ExquisiCare home, I wanted to make sure that we were creating an environment where people can come to work and feel like they did what they wanted to do, they feel like they're making a difference in the lives of their elders. 00:08:16.180 --> 00:08:21.419 So the, the LPN, which we also call the elder guide, she's doing frontline clinical work. 00:08:21.420 --> 00:08:23.730 She's also managing her small team of staff. 00:08:23.830 --> 00:08:25.400 She's interacting with the families. 00:08:25.700 --> 00:08:28.989 And with only ten clients, she's able to truly make a difference. 00:08:28.999 --> 00:08:34.199 She's able to anticipate the needs of that resident and do something about it before it becomes a problem. 00:08:35.084 --> 00:08:38.674 The health care aides, they're doing some meal prep, they're doing some laundry. 00:08:38.674 --> 00:08:42.554 It kind of feels like going from their home to the elder home and helping with them. 00:08:42.554 --> 00:08:45.775 And so because of that, we have very low staff turnover. 00:08:45.834 --> 00:08:48.964 We pay people well, we get them fair market wages. 00:08:48.984 --> 00:08:52.035 We allow them to do what they were meant to do. 00:08:52.105 --> 00:09:00.584 And you have a lot of job dissatisfaction, because the people are terribly overworked, in traditional long-term care, where they become very task based. 00:09:00.675 --> 00:09:06.514 So, you know, feed them, change them, bath them, get them to the dining room to eat, do that all over again. 00:09:06.615 --> 00:09:08.214 We are relationship focused. 00:09:08.254 --> 00:09:10.625 We're focused on the relationship with that elder. 00:09:10.694 --> 00:09:17.964 I love it when I walk into the homes and I see the staff sitting down and looking at a photo album with the resident, that's what we have time to do. 00:09:18.314 --> 00:09:25.260 And having that close relationship with the elders is really, I think the key factor in the ExquisiCare success. 00:09:25.350 --> 00:09:31.139 When we're dealing with people and we're dealing with elders, it's that human connection that they crave. 00:09:31.170 --> 00:09:39.860 And that's what we give them, is that human connection, that physical touch, not only between the staff and the clients, but between the clients themselves too. 00:09:39.869 --> 00:09:46.780 With only ten residents per home, we see some really tight bonds happening with the elders and the families. 00:09:47.100 --> 00:09:47.860 Which is beautiful. 00:09:48.150 --> 00:09:57.339 Zannat Reza: Can you share a memorable success story or moment that exemplifies the positive atmosphere and environment of a small care home? 00:09:57.470 --> 00:10:01.059 Dawn Harsch: You know, there's been so many through the years that it's hard to nail that down. 00:10:01.090 --> 00:10:04.630 The one that sticks in my mind is actually from my very first resident. 00:10:04.659 --> 00:10:09.060 And I think Jack was probably ninety-four when he came to live with us. 00:10:09.080 --> 00:10:13.930 He had been previously living in a big institutional long-term care facility. 00:10:14.285 --> 00:10:16.735 Jack had mild dementia, so he was forgetful. 00:10:16.745 --> 00:10:23.915 He was in a shared room and he ended up unfortunately with a roommate that because of his dementia was quite aggressive. 00:10:23.915 --> 00:10:26.215 And poor Jack got, he got beaten up quite badly. 00:10:26.654 --> 00:10:28.354 And so the family said, you know, that's it. 00:10:28.415 --> 00:10:29.884 We just want what's best for dad. 00:10:29.895 --> 00:10:31.845 We want him to live in a comfortable home. 00:10:31.855 --> 00:10:34.595 So in his other care facility, Jack was losing weight. 00:10:34.655 --> 00:10:35.694 He was in a wheelchair. 00:10:35.944 --> 00:10:39.064 He was in incontinent products because he was deemed incontinent. 00:10:39.074 --> 00:10:44.194 He couldn't walk because of course in this long, long, long hallways at this big facility. 00:10:44.194 --> 00:10:45.375 They just put them in a wheelchair. 00:10:45.464 --> 00:10:50.995 Jack came to us and we parked that wheelchair and he didn't use it until he was about two weeks away from passing. 00:10:51.035 --> 00:10:52.464 And he lived with us for four years. 00:10:52.555 --> 00:10:53.735 He was not incontinent. 00:10:53.745 --> 00:10:57.074 He needed to go to the bathroom every two hours and the staff made that happen. 00:10:57.275 --> 00:11:00.889 He gained twenty pounds within the first two months of living with us. 00:11:01.090 --> 00:11:04.319 Because we sat at the table, we gave him what he wanted to eat. 00:11:04.319 --> 00:11:05.800 We gave him time to eat. 00:11:05.870 --> 00:11:12.660 After two days, the son came to me and he said, you know, if dad lives another week, this move was worth it for us, 'cause like we got our dad back. 00:11:12.689 --> 00:11:17.449 I have many, many stories like that, but Jack really stands out in my mind, 'cause he was our very first resident. 00:11:17.980 --> 00:11:21.300 Zannat Reza: That's such a powerful and memorable and touching story. 00:11:21.390 --> 00:11:21.990 I love that. 00:11:22.160 --> 00:11:26.240 With all the benefits that you've outlined, why aren't we seeing more small care homes? 00:11:26.420 --> 00:11:27.520 Dawn Harsch: That's a great question. 00:11:27.539 --> 00:11:29.229 And you know, it's all about the funding model. 00:11:29.329 --> 00:11:34.789 Because our funding model doesn't fit with traditional long-term care government funding models, that's why. 00:11:34.869 --> 00:11:36.889 I would love for this to be government funded. 00:11:37.179 --> 00:11:40.880 Zannat Reza: Homes like these ones are not yet a funding priority throughout Canada. 00:11:41.225 --> 00:11:54.295 This is evident in Ontario, where the government is developing thirty thousand new long-term care beds by 2028 based on design standards that favor larger institutions of up to thirty-two person units and some shared rooms. 00:11:54.904 --> 00:11:57.775 The good news is that other provinces are making headway. 00:11:58.145 --> 00:12:04.465 Quebec has committed to creating fourty-six new homes called Maison des Années inspired by the Green House model. 00:12:04.925 --> 00:12:15.185 Nova Scotia, PI, the Northwest Territories, and Nunavut have either adopted or are in the process of requesting approval for small care home design principles as a standard. 00:12:15.325 --> 00:12:26.965 Dawn Harsch: I think what needs to happen from a government perspective is really to look at the funding model, because the current funding model fits when you've got a hundred or two hundred bed facilities, and it doesn't fit for small care homes. 00:12:27.335 --> 00:12:32.945 So either we change the funding model so that small care homes are fully funded, that's option A. 00:12:33.245 --> 00:12:35.865 Option B is the funding can follow the patient. 00:12:36.235 --> 00:12:43.934 And what that does is it gives individuals, elders, and their families the option to choose where they want their funding to go. 00:12:43.934 --> 00:12:45.354 And maybe that's a small care home. 00:12:45.994 --> 00:12:53.305 Zannat Reza: In addition to funding models, which are the largest barrier, there are other challenges involved in spreading small care homes across Canada. 00:12:53.765 --> 00:13:01.474 Existing legislation, policy, and regulatory requirements were developed to favor larger and more institutional settings. 00:13:02.109 --> 00:13:10.509 I asked Dawn for her perspective on what it would take to change political will and get governments to accept the benefits of building small care homes more widely. 00:13:11.090 --> 00:13:13.539 We're talking about changing the mindset of government. 00:13:13.609 --> 00:13:14.589 What's it going to take? 00:13:14.630 --> 00:13:20.249 Do people need to rally or lobby in front of the government building to say, hey, listen to us. 00:13:20.249 --> 00:13:21.050 This is what we want. 00:13:21.050 --> 00:13:23.130 We know the benefits of small care homes. 00:13:23.209 --> 00:13:24.199 We want this. 00:13:24.610 --> 00:13:25.040 Dawn Harsch: Maybe. 00:13:25.090 --> 00:13:26.480 Yeah, maybe that is what it's going to take. 00:13:26.480 --> 00:13:29.340 I don't know what it's going to take because I've been lobbying for years. 00:13:29.650 --> 00:13:34.610 And we're getting there, but it takes so long to change something that's so ingrained. 00:13:34.610 --> 00:13:40.019 I mean, we've been institutionalizing our elders in this country since the Second World War. 00:13:40.110 --> 00:13:42.919 And if you look at the history of long-term care, that's when it started. 00:13:42.989 --> 00:13:46.130 You know, individuals were losing their sons to the war. 00:13:46.150 --> 00:13:50.400 So suddenly, what used to happen was the children would take mom and dad in with them. 00:13:50.400 --> 00:13:52.269 Well, that couldn't happen anymore 'cause there was no more children. 00:13:52.290 --> 00:13:58.599 And so it became sort of the way of caring for elders in North America, more so than the rest of the world. 00:13:58.650 --> 00:14:03.470 And so, yeah, lobbying, I think people need to say we're not happy with the status quo. 00:14:03.470 --> 00:14:05.150 And we're seeing that a little bit. 00:14:05.170 --> 00:14:08.170 There certainly is some change to the landscape. 00:14:08.190 --> 00:14:11.440 Alberta did release that small home capital grant, which was great. 00:14:11.540 --> 00:14:12.450 It's a great first step. 00:14:12.894 --> 00:14:17.504 Zannat Reza: What are some challenges in bringing small care homes to residential neighborhoods? 00:14:18.614 --> 00:14:28.784 Dawn Harsch: We've had an issue, I guess, in the past where we've gone into a residential community and that community didn't have a zoning bylaw or a category that fit what we did. 00:14:29.664 --> 00:14:33.964 Some of them would call ExquisiCare or small care homes group homes. 00:14:34.035 --> 00:14:45.869 But what we see with group homes is there's a bit of a negative connotation, that people think group home and they think mental health or they think troubled youth or even a halfway house for individuals coming out of prison. 00:14:45.870 --> 00:14:55.840 And so working with a couple of communities, and they haven't done it yet, but they are in the process of creating a new zoning category for something called a community care home. 00:14:55.960 --> 00:15:04.150 I'm advocating with the province of Alberta to come up with some building codes specific to small care homes. 00:15:04.625 --> 00:15:10.474 The way the building codes work is there's a provincial oversight that says this is the building code for X. 00:15:10.775 --> 00:15:14.875 But then each municipality interpret that building code sometimes differently. 00:15:15.224 --> 00:15:21.114 I'd love to see not only a provincial, but maybe even a national building code, for small care homes. 00:15:21.114 --> 00:15:34.949 Because what that will do is that'll give assurance to the families and the individuals living in those small care homes that you're going to get a standard level of safety and security regardless of where you are in the province or in the country. 00:15:35.230 --> 00:15:39.689 Zannat Reza: When we're thinking about building small care homes, how long does it typically take? 00:15:40.349 --> 00:15:42.870 Dawn Harsch: Building small care homes, we've got it down to about eleven months. 00:15:42.960 --> 00:15:46.379 We used prefab walls in our last build. 00:15:46.409 --> 00:15:50.469 And so the way that works is we used a great company here in Edmonton. 00:15:50.479 --> 00:15:52.139 They kind of built the house off site. 00:15:52.679 --> 00:15:55.859 And we pour the foundation and then the house goes up in three days. 00:15:56.429 --> 00:16:11.089 When you compare that to a larger, more institutional care facility with like five hundred beds, the building code, the design, all the pre work, and then even getting that building up, you're, you're looking at years, like three to five years to build something of that nature. 00:16:11.450 --> 00:16:17.669 We can get our building permit, our design and the home up and running within a year. 00:16:18.039 --> 00:16:24.424 And so it's a much faster way for municipalities and provinces to get care into the communities where it needed. 00:16:24.434 --> 00:16:35.464 Because again, the small care homes are ideally suited, not only for cities, but they can also go out into rural areas where maybe there isn't a huge population, maybe they only need ten or twelve beds. 00:16:35.624 --> 00:16:42.154 We are doing some exploratory work with First Nations as well, and how we can bring the small care home model to First Nation. 00:16:42.614 --> 00:16:51.194 Because it's a very unique situation in First Nations communities, often being very northern with different health, different weather challenges. 00:16:51.224 --> 00:17:03.689 And so working with a specific builder, who would build small care homes in First Nations communities that are windproof, moldproof, waterproof, and movable. 00:17:04.119 --> 00:17:09.649 And so having these small care homes in the First Nation communities, I think is very important. 00:17:09.699 --> 00:17:13.989 Those elders don't want to leave their community and come to the big city. 00:17:14.339 --> 00:17:19.179 But the challenge is how do we build them when sometimes there's only an ice road to get up there. 00:17:19.179 --> 00:17:27.484 And so we're looking at some really unique ways to bring small care homes to very remote communities, including indigenous communities. 00:17:27.494 --> 00:17:28.314 So I'm pretty excited. 00:17:28.864 --> 00:17:30.594 Zannat Reza: And what's your vision for the future? 00:17:30.904 --> 00:17:35.544 Dawn Harsch: I would love to see hundreds of these across Canada in every neighborhood. 00:17:36.239 --> 00:17:39.339 The other thing that I'll say, though, is that they're not the only option. 00:17:39.639 --> 00:17:43.179 I believe in choice, and I think this is a choice that some seniors would love. 00:17:43.189 --> 00:17:46.069 Some people may want that bigger care facility. 00:17:46.229 --> 00:17:52.619 But my vision is for small care homes to be the main way that we provide care to seniors. 00:17:52.669 --> 00:18:00.629 What we give to families is that peace of mind, knowing their mom or dad is only one of ten in this home. 00:18:00.799 --> 00:18:08.019 And if they call that home, they're going to talk to Trish, who is their elder guide, which is that nurse that works Monday to Friday in the home. 00:18:08.109 --> 00:18:11.149 And Trish knows mom and dad exceptionally well. 00:18:11.159 --> 00:18:13.339 She's not going to have to say, Oh, I haven't seen them. 00:18:13.359 --> 00:18:13.849 I don't know. 00:18:13.850 --> 00:18:14.830 Let me check with the staff. 00:18:14.870 --> 00:18:16.589 So that accountability. 00:18:16.909 --> 00:18:18.129 And Trish loves her elders. 00:18:18.574 --> 00:18:23.594 You know, the ten clients that she has in that home, she knows them exceptionally well. 00:18:23.724 --> 00:18:34.594 Zannat Reza: My last question is something that we ask every guest, which is, if you could wave a magic wand and make one radical but realistic change to improve our society's well being, what would it be? 00:18:34.744 --> 00:18:36.484 Dawn Harsch: It's a really hard question. 00:18:36.524 --> 00:18:45.444 What I see in Canada, the US, is there's such polarizing opinions and such polarized sides of the political spectrum, is it's hard to get anything done. 00:18:46.069 --> 00:18:52.019 It's tough with our political processes to actually get meaningful change implemented. 00:18:52.099 --> 00:18:53.879 And you need to look at small care homes. 00:18:54.309 --> 00:18:55.059 It's radical. 00:18:55.139 --> 00:18:55.749 It's different. 00:18:56.089 --> 00:19:05.909 And getting governments to adopt that, takes more than a two or a four year commitment to make these meaningful changes in terms of how we care for seniors. 00:19:05.979 --> 00:19:15.299 So, love to see a government that commits to this and somehow embeds it in their policy, that this is gonna be the way we do things, even if they're no longer in power. 00:19:16.049 --> 00:19:22.859 Zannat Reza: Thanks to Dawn for sharing the story of ExquisiCare and for her efforts to bring more small care homes to communities across Canada. 00:19:23.159 --> 00:19:25.109 Thanks for joining us for this episode. 00:19:25.559 --> 00:19:29.539 To learn more and for transcripts, go to TheFutureAge.ca. 00:19:29.819 --> 00:19:33.839 Listen to new episodes by following us wherever you get your podcasts. 00:19:33.899 --> 00:19:37.769 And if you're liking our podcasts, leave a review on Apple or Spotify. 00:19:38.039 --> 00:19:40.864 And be sure to share it with your friends, family and colleagues. 00:19:41.404 --> 00:19:51.634 The Future Age is brought to you by SE Health, a not for profit social enterprise that provides the best care, inspires innovation, and impacts how people live and age at home.