Executive Summary

• While there is no common definition of the term "supportive housing" for seniors in Canada, it is used broadly to describe housing options that fill the wide gap between independent living in the community and dependent living in an institutional setting.
• Autonomy and security are considered to be the two cornerstones of supportive housing. Autonomy is usually symbolized by a lockable door, by definable and private personal territory. Security is usually symbolized by the presence of a 24-hour emergency response system, either electronic or social.
• Eleven different models of supportive housing in Canada are described in Appendix A.
• There is no "best" model in Canada -- the best models are those that "fill the bill". They must meet the geographic, physical/design, social, economic, and support needs and characteristics of a diverse senior population seeking supportive living arrangements. They must also meet society's need for affordable and safe solutions for a growing aged population. The "best models" could be described as "many models".
• During the November workshop in Charlottetown, the various options were discussed in terms of their appropriateness for senior veterans with varying characteristics (disabled, not disabled, low income, higher income, married, single, rural, urban). A matrix showing which options seem to "fill the bill" is presented in Appendix C.
• As very few post occupancy evaluations have been conducted in Canada and elsewhere, it is difficult to assess which supportive housing options are most successful. However, success can possibly be measured in terms of resident satisfaction, the amount of public money saved and financial viability.
• Each province in Canada has some common options and each province has some province-specific options. The author is unaware of any published data on the prevalence of housing options in each province nor the assessed need for certain types; however, she did learn anecdotally that there is a shortage of options for seniors in rural areas which is related to the shortage of formal support services and professional providers.
• Numerous partnerships have encouraged, and resulted in, the development of supportive housing options for seniors across Canada. One example is the co-operation and collaboration of provincial government departments to encourage the development of safe, affordable and appropriate supportive housing for seniors; another example is that universities are working with provincial governments to evaluate pilot projects.
• During the November workshop, the Review of Veterans' Care Needs Team discussed the possibility of further developing partnerships with organizations such as The Royal Canadian Legion and veterans' organizations, and creating new partnerships with organizations such as the Alzheimer Society of Canada, universities, community colleges, and the private sector as well as with Health Canada and National Defence, to utilize existing expertise and create awareness and interest in exploring other options for the provision of supportive housing for seniors.
• The author conducted an e-mail survey of contacts in every province and territory to learn of the existence of definitions, standards and evaluations of pilot projects for supportive housing. Of the nine responses received at the time of writing, it was found that five have definitions, four have developed standards, and four have evaluated pilot projects.
• In terms of funding, there are several kinds of costs to be considered: total cost per person to the taxpayer, total cost to the consumer, and cost of the housing/accommodation component versus the cost of the support/service component. Costs to the taxpayer are highest where capital costs are borne by government and where services are delivered by government-subsidized or funded agencies. Costs to the taxpayer are lower when the capital costs are borne by someone else as in the case of satellite homes, home sharing or accessory apartments, or when certain services are paid by the recipient or provided by volunteers/family. Cost savings to the taxpayer increase the longer seniors live in their own homes with support services or in supportive housing rather than in institutional care. However, seniors who have delayed institutionalization by living in a supportive housing arrangement, when placed in institutional environments, usually require a high level of care.
• Any initiative related to endorsing, assisting in the development of, or evaluating supportive housing for senior veterans should embrace the five principles of the National Framework on Aging: A Policy Guide - namely, security, independence, dignity, participation and fairness.
• During the November workshop in Charlottetown, the Review Team agreed that VAC should: act as brokers to encourage the development of supportive housing options for senior veterans, especially those options that keep spouses together; contribute non-capital costs to this development (expertise, networks); ensure that services are provided to veterans wherever they live based on eligibility and need, and not based on housing type; raise awareness of the existence of supportive housing options among veterans, their spouses and family members and VAC staff; increase the knowledge and skills of both family and paid caregivers in relation to dementia care; and recognize that, according to European studies, supportive housing can delay institutionalization.
• There is an urgent need to make available as many supportive options to senior veterans as possible - as soon as possible.