CHSLD de Saint-Michel | Like a home with Italian accents

Seniors from the CHSLD of Saint-Michel, many of whom come from the Boot, have at their disposal a market, a pet store and picturesque landscapes to put a smile back on their faces

It’s a sunny Tuesday afternoon. An elderly man is tending the vegetable garden. Next to him, another man is playing the piano, to the delight of the people walking nearby. We are on the fifth floor of the Saint-Michel CHSLD, which houses about twenty residents with severe neurocognitive disorders. Far from being a sterile care environment, the unit has a market, a pet store, a park and a bakery. The goal: to give its residents a semblance of normal life.

Sure, there are no real cats and dogs—the pet store is populated with stuffed animals—and the bakery isn’t really a bakery. But this non-medical facility brightens up the residents’ lives.

“We didn’t want to purify the environment. On the contrary, we wanted it to look like a home where they can go about their business,” says Nadine Zeidan, accommodation coordinator responsible for the CHSLD in Saint-Michel.

Landscape murals of Italy line the walls and elevator doors. A market with various snacks is accessible at all times. Dolls lie in small beds waiting to be rocked by residents. Interactive robot cats and dogs are also at their disposal.

The fifth floor of the CHSLD de Saint-Michel accommodates 22 seniors with severe neurocognitive disorders and a history of aggression and violence. The layout imitating active life aims to provide a sense of well-being and déjà vu among residents.

The layout is not just aesthetic. “Several studies show that there is an advantage to such a design for residents,” explains Philippe Voyer, professor and vice-dean of undergraduate studies and continuing education at the Faculty of Nursing at Université Laval.

Medical equipment and supplies are also hidden. “When a resident with a major neurocognitive disorder is in a large corridor with medical equipment, he is not able to know that it is for his care and he wants to leave, so it leads to behavioral problems,” explains Mr. Voyer, who collaborated on the project.

Uncorking wine

The unit opened in January 2023. The fifth floor had been vacant since the start of the pandemic. Looking for a purpose for the unit, staff decided to open a unit there for seniors with severe behavioural problems. “There was a fairly long waiting list for this type of accommodation,” says Brigitte Brabant, director of accommodation, long-term care.

Seniors’ homes do not accommodate people with serious behavioural disorders, and adapted units in CHSLDs are rare. Due to a lack of space in an environment adapted to their needs, many patients end up in hospital. “Unfortunately, people who wait months in hospital for a place tend to decondition themselves and lose their abilities,” says M^me Brabant.

Over the course of two months, staff have been busy renovating the unit, making sure to adapt the environment to the clientele, more than 80% of whom are residents from the Italian community. “We created a station where we cork and uncork the wine,” says M.^me Zeidan. They named the unit “the SEDAR star,” referring to the words health, empathy, dignity, autonomy and respect.

Respect for the rhythm

At the SEDAR star, there is no rigid schedule. “The resident can get up at whatever time he wants. Disturbing his sleep can upset his mood and he may react negatively,” explains M.^me Zeidan. He can eat lunch at a time that suits him, and if he prefers not to shower, the task can be postponed to another time in the day. “The employees are very accommodating.”

The goal is to entertain seniors as much as possible to reduce their unwanted behaviors. “Many residents want to leave the unit around 3 p.m. because they think it’s time to leave work and go home. These are habits they’ve always kept,” says M.^me Zeidan: The facilitator must then direct the resident’s attention to an activity that interests him. “Within a few minutes, the resident has forgotten that he was trying to leave.”

Each room was chosen based on the resident’s temperament. “If a person doesn’t like being disturbed too much, we can put them in one end of the unit,” says the attending physician, Dr.^D Said Cherigui.

“Not everyone wants to work with a clientele that has behavioral problems, that can be aggressive and that is unpredictable,” says Mr.^me Brabant. This is why the management of the CHSLD ensured that only employees who volunteered to work with this clientele were assigned there.

An incredible experience

Salvatore Volpato will long remember his first visit to the unit, with his father, one of the first residents of the SEDAR star. “My father comes from Padua, in northern Italy. When he arrived at the unit, he pointed to the murals and said, ‘Look, this is where I come from.’ It was an incredible experience for him.”

His father had been hospitalized for nearly a year at the Jewish General Hospital, waiting for a place to stay. His condition was deteriorating. “He wasn’t doing well, he looked comatose. I thought I was going to have to do everything for my father.”

The septuagenarian is happy in his new surroundings.

The benefits of the unit are also being felt by other residents. “These were people who had a lot of seizures, who fell regularly and who were heavily medicated,” says M.^me Zeidan. A few months after their arrival, the change is noticeable. “The residents are very calm and we have few crises compared to before.”

“I was overwhelmed by what I saw and by the peacefulness in the unity,” he said. The Press Minister responsible for Seniors and Minister Delegate for Health, Sonia Bélanger, who visited the unit in recent months. With the aging of the population, cases of Alzheimer’s and dementia are increasing. “This poses a challenge in our current CHSLDs.” She hopes to draw inspiration from the SEDAR star for her future national policy on Alzheimer’s.