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In Canada, we have deinstitutionalized impoverished people by ending forced placement in poorhouse facilities. We have deinstitutionalized people with intellectual disabilities, people who are deaf or blind, orphans, physically disabled and those with mental-health issues.
The last groups to be 'placed' in facilities where they do not choose to live are older Canadians and prisoners. There is nobody on this list of marginalized Canadians who desired life in an institution; they were placed there and, due to limited personal resources and inhumane legislation, they were forced to stay.
The research is very clear that these segregated, large congregate care facilities put people at high risk of abuse, poor health outcomes and a lower quality of life.
Those facts, and the great expense of operating institutions, supported the depopulation so people could return to their home communities and have normalized lives.
In all these previous depopulations of facilities, there were several stages.
The first step was acknowledging that institutions trample on human rights and people should not be segregated according to personal characteristics such as a disability, health or behavioural challenges. Initially, this was met with confusion and fear that vulnerable people would be unsafe outside an institution.
We then gradually moved people back to their home communities as a result of the progressive champions and self advocates, who spoke out against confining people to facilities.
As a first step in repatriation, there were group homes, day programs, family homes and respite options which still perpetrated separation and lack of choice. That still exists today and generic services continue to exclude many marginalized groups in both health and education.
In most examples, we remain at that point in our progress, with day programs slowly closing and self-directed, individualized living options very slowly expanding.
However, there is now a greater awareness that previously institutionalized people are not part of homogenous groups but individuals with the same basic human needs for love, safety and connection. They don't need to be deemed "special."
Older Canadians can live in apartments or homes, with young people, able-bodied people, students, families and single folks just like everyone else.
Community supports can provide care, even 24/7, as those models for medically fragile people exist now. Small group living without choice of housemates is not the final goal, but it is an improvement from large facilities. Each person needs supports tailored to their choices, just like the rest of us.
We are all citizens who deserve to direct our own lives. People who have been marginalized in these groups have their own voices and need to be part of creative solutions that will afford them with dignity of choice and quality care.
We can't be fooled by language that tries to soften institutional care and make it palatable. Long-term care facilities and nursing homes are institutions that segregate, disabuse people of their rights and places them at greater risk of harm. Let's begin depopulating segregated congregate care facilities for older Canadians and establish a full range of community supports so people can age where they wish to live.
Brenda Quinlan, MEd
Barrie and District Canadian Federation of University Women (CFUW), vice-president
