or commonly known as the Care and Construction Project
The Care and Construction study examines different models of care, defined as physical design and staffing approach, in relation to resident quality of life within Nova Scotia nursing homes. The Care and Construction team is both multi-disciplinary and multi-sectoral, representing continuing care research, practice and policy. During the life of the project, multiple methods (e.g., focus group, interview, survey, case study) will be used to gather information on resident quality of life from the perspectives of the resident, family and staff.
The four objectives of this project are:
1) To examine resident quality of life through the residents’ experience with different models of care.
2) To examine resident quality of life through the family’s experience with different models of care.
3) To examine resident quality of life through staff experiences with different models of care.
4) To facilitate the dissemination of knowledge and application of research to strengthen continuing care sectors throughout Canada.
The project is funded through a Partnerships for Health System Improvement grant from the Canadian Institutes of Health Research, in partnership with the Nova Scotia Health Research Foundation.
Across Canada, long-term care providers are responding to the care needs of an aging population while operating with aging buildings, staff challenges and fiscal constraints. In Nova Scotia, the continuing care sector is undergoing significant changes as the Department of Health and Wellness implements its 10-year strategy to enhance and expand its continuing care system. Changes include innovative physical designs (e.g., home-like settings replacing hospital-like wards), an emphasis on resident-centered care and an emphasis on staff scope of practice. These system- and institutional-level innovations will result in nursing home staff providing care differently to older Nova Scotians. However, despite these shifts and increasing support from funders, such innovations have not been thoroughly assessed and, generally, there is a lack of literature regarding nursing home care in Canada. To implement changes without thoroughly understanding their impact can have consequences, including less than optimal delivery of care to older Nova Scotians and their families, and an inefficient use of time and funds.
To meet the four objectives of the research project, a number of activities will take place. Below is a description of the three models of care to be examined in the Care and Construction project followed by a description of the research activities related to each objective.
Back to top
Models of Care:
Model A: Model A nursing homes incorporate the “neighbourhood” physical design (small groupings of residents in self-contained units within larger facilities) with a full-scope staffing model. Within the full scope staffing model, care staff are involved in all aspects of resident care (e.g., personal care, food preparation, housekeeping), and staff work in one “neighbourhood” consistenty to ensure the same staff members are caring for the same residents on a day-to-day basis.
Model B: Model B nursing homes incorporate the “neighbourhood” physical design (small groupings of residents in self-contained units within larger facilities) with an augmented-traditional staffing model. Within the augmented traditional staffing model, care staff are involved in a wider range aspects of resident care (though they are not involved in food preparation or housekeeping) and staff work in one “neighbourhood” consistently to ensure the same staff members are caring for the same residents on a day-to-day basis.
Model C: Model C nursing homes incorporate a traditional physical design, with a traditional staffing model, whereby staff change assignments and units on a rotational basis.
Research Objectives:
Objective One: To examine resident quality of life through the residents’ experience with different models of care.
To achieve objective one, a survey of 300 nursing home residents will be conducted across the three models of care identified in the participating nursing homes in the province (Spring, 2012). Following the survey, in-depth interviews will be conducted with five nursing home residents in each of the three models of care (Fall, 2012). The interviews with residents will add depth to what can be known from the survey results about resident quality of life.
Objective Two: To examine resident quality of life through the family’s experience with different models of care.
To achieve objective two, a survey with 300 family members will be conducted across the three models of care identified in the participating nursing homes in the province (Spring, 2012). Following the survey, focus groups will be held with 8-10 family members across each of the three models of care (Fall, 2012). The focus group will provide an opportunity to ask more in-depth questions of family members regarding the impact of model of care on resident quality of life and will also provide an opportunity to share and discuss findings from the family member survey.
Objective Three: To examine resident quality of life through staff experiences with different models of care.
To achieve objective three, a survey with 2000 staff members in publicly funded nursing homes throughout Nova Scotia will be conducted in Spring 2012. Focus groups will be held in Fall 2011 with staff from select nursing homes to help with the development of the survey.
Objectives One Thru Three:
To achieve objective’s one thru three, a case study methodology will be used to examine the experience of care constellations (a resident, their family member(s), and staff member(s)) in each of the three models of care. Two care constellations in each nursing home will be involved and data will be gathered at three points in time over one year (e.g., January- December, 2012). Individual in-depth interviews with the resident, family member and staff as well as observation of the resident in his/her setting will be conducted. This method will allow us to examine the impact of model of care on resident quality of life from the perspective of each member of the care constellation and make linkages where possible.
In addition, organizational information about the participating nursing homes will be gathered to provide greater understanding on the physical and social aspects of the nursing homes.
Objective Four: To facilitate the dissemination of knowledge and application of research to strengthen continuing care sectors throughout Canada.
To achieve objective four, the project will actively promote project results throughout the life of the project. The full team and method-specific working groups will meet regularly over the 3-year project via teleconference and in person meetings to discuss project design, delivery and results. Project promotion methods will include, but are not limited to, regular website updates, scholarly publication, and conference presentations. In 2013, workshops will be held with research participants (Spring) and continuing care sector representatives (Fall) to share the project results, and discuss how the findings could impact practices in Nova Scotia’s nursing homes.
Participating Nursing Homes as Study Sites
Alderwood Rest Home (Baddeck)
Arbourstone (Halifax)
Bisset Court (Cole Harbour)
Blomidon Court (Greenwich)
Cedarstone Enhanced Care Limited (Truro)
Celtic Court (Sydney)
Debert Court (Debert)
Duncan MacMillan Nursing Home
Harbourview Lodge Continuing Care Centre (Sheet Harbour)
Elk Court (Brookfield)
Glasgow Hall (Dartmouth)
Harbourstone (Sydney)
Ivany Place (Bedford)
Maplestone (Halifax)
Northumberland Hall (Amherst)
Northwoodcare (Halifax)
Orchard Court (Kentville)
Parkstone (Halifax)
Ryan Hall (Bridgewater)
Sagewood Continuing Care Centre (Sackville)
The Magnolia (Enfield)
Tideview Terrace (Digby)
Vimy Court (Bible Hill)
Windsor Elms Village (Windsor)
Time Line for the Care and Construction Study |
| Year One(April, 2011 – March, 2012) | Year Two(April, 2012 – March, 2013 | Year Three(April, 2013 – March, 2014) |
| Staff Member Focus Groups (Sept-Oct, 2011) | | Workshop with Participants (Spring, 2013) |
| Case Studies(Jan – Dec, 2012) | Workshop with Sector Representatives (Fall, 2013) |
| Resident Survey(Spring, 2012) | |
| Family Member Survey (Spring, 2012) |
| Staff Member Survey(Spring, 2012) |
| Resident In-Depth Interviews (Fall, 2012) |
| Family Focus Groups(Fall, 2012) |
Back to top
Back Row from Left: Kevin Kelloway, John O’Keefe, Sonya Stevens, Meghan Donohoe, Donna Dill, Robin Stadnyk, Arlene Morrison, Marie Earl, Ann McInnis, David Haardt, Melissa (and Lila) Andrew. Front Row from Left: Rachel Ogilvie, Lori Weeks, Marian Casey, Chris LaBreche, Janice Keefe, Sherry Keen, Sheila Martin, Margaret McKee
Absent from Photograph: Lloyd Brown, Grace Warner, and Debra Boudreau
Back to top
The Research Team
Principal Applicants:
Janice Keefe, PhD, Professor, Department of Family Studies & Gerontology
Kevin Kelloway, PhD, Professor, Department of Management, Sobey School of Business & Department of Psychology, Faculty of Science, Saint Mary’s Universit
Ann McInnis, Vice President Community & Continuing Care, Northwoodcare Inc.
Co-Applicants:
Melissa Andrew, MD, MSc(PH), FRCPC, Geriatrician, Geriatric Medicine, Faculty of Medicine, Dalhousie University
Marie Earl, PhD, Assistant Professor, Physiotherapy, Faculty of Health Professions, Dalhousie University
David Haardt, PhD, Assistant Professor, School of Health Administration, Faculty of Health Professions, Dalhousie University
Margaret McKee, PhD, Assistant Professor, Management, Sobey School of Business, Saint Mary’s University
Robin Stadnyk, PhD, Assistant Professor, Occupational Therapy, Faculty of Health Professions, Dalhousie University
Grace Warner, PhD, Assistant Professor, Occupational Therapy, Faculty of Health Professions, Dalhousie University
Lori Weeks, PhD, Associate Professor, Department of Family and Nutritional Sciences, Faculty of Science, University of Prince Edward Island
Knowledge Users:
Debra Boudreau, Administrator, Tideview Terrace Nursing Home
Lloyd Brown, Executive Director, Alzheimer Society of Nova Scotia
Donna Dill, Director, Monitoring & Evaluation, Nova Scotia Department of Health, Continuing Care Sherry Keen, CEO, Windsor Elms Nursing Home
Sheila Martin, CEO, Duncan MacMillan Nursing Home
John O’Keefe, Senior Social Worker,Northwoodcare Inc.
Margaret Merlin-Wilson, CEO, Harbourview Lodge Continuing Care Centre.
Partners and Collaborators:
Health Association Nova Scotia, Bernadette Gatien, PhD,
Organizational Research, Measurement & Effectiveness Specialist
Shannex, Chris LaBreche, Vice President of Operations,
Enhanced Care Shannex, Marian Casey, Director of Clinical Services
Alderwood Rest Home, Arlene Morrison, Administrator
The formation of the research team, and the resulting project idea was supported by funding from Mount Saint Vincent University (2009) and the Nova Scotia Health Research Foundation (2010) through development grants. Lessons learned from developing this team were shared as a poster presentation at the 2010, 39thAnnual Scientific and Educational Meeting of the Canadian Association on Gerontology in Montreal, PQ.
Back to top
Project Staff
Rachel Ogilvie - Project Manager - (Maternity Leave: March to November 2012)
Rachel has been working in gerontological research for six years on projects focused on health human resources, caregiving, healthy aging, and retirement. She began working with this research team during the development of the research proposal in May, 2010. Rachel assumed the role of Project Manager in June, 2011. Rachel served as Graduate Student Representative for her Department for two terms, and serves on the Board of Directors for the Gerontology Association of Nova Scotia.
Christy Nickerson Rak – Temporary Project Manager (March – November 2012)
Christy has worked as a research project manager for the past eight years on a variety of research topics including adults with disabilities, families with children with heart problems and family caregiving. She earned her Master’s degree in Sociology from the University of Alberta. While Rachel is on maternity leave, Christy is responsible for implementing the day-to-day administration of the project, working with the partner nursing homes, liaising with research trainees, and assisting with project deliverables. She is the first point of contact for project, and is happy to answer any questions.
Thea Brown – Research Trainee (October 2011 – October 2012)
Thea is the Research Trainee on the Care and Construction Project and will be assisting with the case study component of the study. Thea is a graduate student at Mount Saint Vincent University working towards her MA in Family Studies and Gerontology under the supervision of Dr. Janice Keefe. She has a keen interest in the supportive care environments, particularly as they relate to adult day services. Thea is pleased to be involved in the Care and Construction Project.
Meghan Donohoe – Research Trainee - (July – October 2011)
Meghan, Research Trainee on the Care and Construction Project conducted the staff focus groups. Meghan has her MSc in Industrial/Organizational Psychology and is currently working on her PhD at Saint Mary’s University under the supervision of Dr. Kevin Kelloway. She has a keen interest in the behaviours, attitudes and relationships of individuals at work, particularly as they relate to extended care. Meghan is excited to be involved in the Care and Construction Project.
Are you a resident in a nursing home, a family member to someone in a nursing home or a nursing home staff member? We will be conducting surveys with you to understand what influences nursing home resident quality of life.
In May and June 2012, letters will be sent to all residents, family members and staff at the nursing homes involved in the project (see the list of participating nursing homes here ). Research assistants from the project will make presentations at each participating nursing home throughout May and June to explain more about the project. Residents will be able to arrange interview times with research assistants during these presentations. Family members and staff can complete surveys online or obtain a paper copy from their nursing home or by requesting a copy from our project office. Additionally, staff from other nursing homes across the province can complete the survey online or by requesting a copy from our project office.
Opportunities to participate in the project begin May 2012! Click on the link below to find out about how to be involved or contact the project office .
Nursing Home Residents (CLICK HERE)
Family Members of Nursing Home Residents (CLICK HERE)
Staff Members of Nursing Homes (CLICK HERE)
Back to top
Project Milestones
April 2011- Project received funding from the Canadian Institutes of Health Research
June 2011 - media release on funding of Care and Construction project June 2011- In person meeting of the research team at Mount Saint Vincent University (June 17th, 2011)
July-August, 2011- Project receives ethical clearance to conduct staff focus groups from 4 university research ethics boards (MSVU, SMU, Dal, & UPEI). August 2011 - Rosecrest communities joins project as study sites
September, 2011- Full team teleconference meeting (Sept 29th, 2011)
September – October, 2011- Focus Groups with StaffSeptember – October, 2011- Focus Groups with Staff
January, 2012-Project receives ethical clearance to conduct case studies from 4 university research ethics boards (MSVU, SMU, Dal, UPEI)
January, 2012-Recruitment begins for the case study component of the study
March, 2012 – Project recieves ethical clearance to conduct resident, family member and staff surveys, interviews and focus groups
March 2012 – Pretesting of the surveys with residents, family members and staff
April 2012 – Hiring and training of research trainee and assistants support survey data collection and analysis
Upcoming Events
May – June 2012 – Presentations and recruitment of residents, family members and staff at nursing homes throughout the province
We would like to thank our funders, the Canadian Institutes of Health Research and Nova Scotia Health Research Foundation. We would also like to thank the many individuals and organizations who have supported the development and realization of this research project. We look forward to building these important relationships over the next three years with the goal to improve quality of life for nursing home residents.
Janice Keefe, Kevin Kelloway, Ann McInnis
& other members of the Care and Construction Team
Media Release - view the release created to announce the funding of the Care and Construction project by the Canadian Institutes of Health Research in partnership with the Nova Scotia Health Research Foundation.
Project Overview - view a slide presentation for overview of project, methods and whose involved.
Conceptual Model - view a visual representation of the project's framework.
Media requests - please contact the Communications Coordinator for the Nova Scotia Centre on Aging, Elaine MacFadyen, by T: 902-457-6322 or E: msvu.ca.
Employment and Training Opportunities
Research Assistant (3-4 positions)
Being offered through the research initiative ”Care and Construction: Assessing
Differences in Nursing Home Models of Care on Resident Quality of Life”. Click here for more information.
Master/PhD Student Trainee Position (one year)
Being offered through the research initiative ”Care and Construction: Assessing Differences in
Nursing Home Models of Care on Resident Quality of Life” Click here for more information
Project ManagerChristy Nickerson Rak
Phone: (902) 457-6218
Fax : (902) 457-6508
E-mail: careandconstruction@msvu.ca
Care and Construction Project Office
c/o Nova Scotia Centre on Aging
Mount Saint Vincent University
166 Bedford Highway
Halifax, Nova Scotia B3M 2J6
Click here for Campus Map