Smaller homes face different challenges: Gourlie
There are both advantages and challenges in operating a smaller long-term care home, says Rick Gourlie, administrator at the 82-bed Almonte Country Haven.

Smaller homes don’t have as many staff as larger homes and that means there is no one to delegate to, says Gourlie. But a smaller home lends itself to much more intimate dynamics than a large home because of its size.

Gourlie was responding to a question from OMNIway about the particular challenges faced by smaller homes in rural settings while discussing the value of more funding for nursing care in long-term care. Residents in all homes would benefit greatly from more funding, he says.

Smaller homes in small communities are well known in their communities, he says. “Staff are known in this community and everyone knows someone who has a relative who has gone to live at Almonte Country Haven.”

In larger urban centres, nobody knows anybody and this makes it more difficult on some levels for homes in those larger centres, he says.

The challenges for smaller homes include the fact that the portfolio of responsibility is as huge in a small home as in a large home but the support group is not as large, he says

Where a larger home might have an assistant director of care for example, a smaller home does not, he points out. “Having an assistant makes it easier.”

All homes must deal with managing areas ranging from occupational safety and palliative care to skin and wound care and supportive measures, Gourlie points out. “The support in managing these areas is much smaller than in a large home.”

Almonte does not have a clinical co-ordinator and there is not a full-time maintenance position, he says. “Smaller homes are usually older and need more repairs and maintenance.”

An administrator in smaller homes spends a lot of time on family dynamics and social work, Gourlie says. “Families are pushed by the behaviors of a loved one. They have to leave that person here and walk away. It is not easy for them and the support we give them is needed,” he says.