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Universal Access to Healthcare: Tackling the Unique Callenges of Canadians with Disabilities as Seniors Population Rises

Small space. Big idea.

With the cost of seniors residences rising and wait-lists for long-term facilities growing longer, an Ottawa-based company has turned an old concept into a new alternative.

Remises or carriage houses were familiar sights in the 19th century, but integrated garages now dominate contemporary housing plans, and backyards have become the preserve of decks, play structures and pools. Those carriage houses that are still standing have become quaint relics.

But in the past several years — driven by skyrocketing house prices in markets like Vancouver and Toronto — several provinces and municipalities have begun to adopt new legislation and bylaws to allow small houses to be built adjacent to existing homes. In Ottawa, the city government began to move toward allowing secondary housing in 2016, and it has now put the necessary bylaws and guidelines in place.

That change in regulations spurred Coach Homes of Ottawa Inc. to develop models ranging in size between 404 and 634 square feet and to form a unique partnership with health care service providers to create living spaces designed specifically for seniors. The small houses come with extra-wide doorways to accommodate wheelchairs, accessible showers and a full set of apartment-sized appliances. The company assembles the homes off site, prepares the foundation and lowers the house into place by crane. All permits, bylaw clearances and utility hookups are managed by the company as well.

Custom houses and larger units are also available.

“There is a huge push for people to age in place,” says Susan Hagar, the owner and principal advocate of Nurse On Board, one of the nine service partners in Coach Homes of Ottawa. “It’s a return to a natural life, where seniors can live alongside other family members, children and pets, yet still maintain their independence.”

Nurse on Board has designed a package of services to help people live in the coach homes even if they have serious medical problems. Clients get access to a registered nurse to coordinate their care, which includes in-home physiotherapy, foot care and dental hygiene. They also hope to offer on-site telemedicine in the future. Coach houses would include the technology to allow the dweller to consult with specialists; the nurse would provide support during the consultation and deliver follow-up on the physician’s recommendations. In Ontario, putting this into practice will require a change to the province’s health insurance program.

Whether a coach house is purchased outright or leased, monthly payments will typically be significantly less than those for standard accommodations at most seniors residences. If dwellers require more intensive care or die, the coach houses can be removed when they’re sold or the lease is terminated.

When the coach houses and the in-home care concept were introduced at the 2017 Ottawa Fall Home Show, Hagar says the company was stunned by the enthusiastic response.

Looking further ahead, she says Coach Homes of Ottawa foresees building small coach house communities, positioned around a community centre with services, in rural areas.

“We think our concept addresses a lot of needs,” say Hagar. “It lowers the financial risk and anxiety level for the people involved, ensures that seniors get good nutrition and health care, and reduces the loneliness many seniors experience.”

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