Don Tow's Website

A surprise awaited me when recently I and others were given a tour of the Yee Hong Centre for Geriatric Care (YHC) while attending a conference in Toronto, Canada.  Completely unexpected, I was actually touring one of the world’s best geriatric centers, and witnessing an example of the power of one.

The life expectancy of the residents of the YHC’s nursing homes after admission is 7 years, while the provincial average of nursing homes for Ontario, Canada is 2.5 years.  Another way of presenting this is that in 2007, 15.8% of YHC’s nursing home residents passed away, as compared to Ontario’s average of 40%.  This is even more impressive when considering that the new residents at YHC are on the average more frail and require about 9% more care than the Ontario average because of the longer waiting time for admission.  The YHC has the longest waiting list, with all 805 beds occupied and a waiting list of over 2,000 people, and the projected waiting time for a standard bed in their Scarborough centers is about six years.  The skin ulcer rate is 3%, while the provincial average is 30%.  The use of restraints by residents is 1.2%, while the provincial average is 18.3%.  The fall rate of residents is 8.9%, while the provincial average is 12.5%.

Besides the statistics, during the tour I also saw certain characteristics that make the YHC stand out among nursing homes.  The first thing that impressed me was the cleanliness of every room and every floor of the place, and they didn’t do anything special before our visit, because we were not a VIP tour group.   All the rooms were well lit, the halls were wide, the air was clean and fresh, and the rooms were spacious.  More importantly, I saw the serenity and happiness on the faces of the residents.  Such characteristics just reflect and support the numerical statistics quoted earlier.

How Was YHC Started?

The Yee Hong Centre for Geriatric Care, formerly called the Chinese Community Nursing Home for Greater Toronto, came about when Dr. Joseph Wong witnessed the lack of emotional support and difficulty in communicating for Chinese seniors within mainstream medical facilities. So in 1987, Dr. Wong, spearheading the cause, gathered a group of 30 Chinese Canadian friends who shared his vision of building a nursing home to care for parents and grandparents with respect and dignity in their last years.  Out of that vision and seven years of dedication, commitment, and hard work, Dr. Wong and his collaborators were able to mobilize thousands of others at the grassroots level to contribute time and money, and in October 1994 realized their dream by opening a nursing home which turned out to be the first of four (and counting) Yee Hong Centres for Geriatric Care.   They were able to generate an attitude adopted at the grassroots level that they must give back to the community and that no challenge is too great to overcome.

The YHC has repeatedly received the highest praise from the Canadian government.  For example, in 1999 the Canadian Council on Health Services Accreditation praised YHC for providing “stellar care” to elderly members of the Chinese population, and found YHC to be so perfect that “no recommendations have been made herein,” which is an amazing ringing endorsement from a national body that scrutinizes and gives accreditation to health facilities all over Canada.  Since 1997, the Ontario Long Term Care Association has thrice selected YHC as the Grand Prize winner in their Occupational Health and Safety Week Competition.  The Canadian Ministry of Health and Long-Term Care is always referring delegates and media to YHC as the shining example and the model of continuum of care for seniors. The May 31, 1999 issue of Time Magazine in its “Special Report:  Canada 2005” had an article about YHC together with a full page of pictorial coverage.

Expansion of YHC

In ten years’ time, the YHC has expanded from one nursing home to four nursing homes in the Greater Toronto area with 805 beds.  Besides nursing homes, the YHC has also enlarged its scope by providing 308 life lease housing units (housing units with some support services) and 131 private condominiums, so that seniors can go from independent living to assisted living and then to nursing home as they age and require more health-care assistance.  YHC has also extended its services to non-Chinese seniors, particularly those from the South Asian, Filipino and Japanese communities, while attuning to the cultural values and traditions of those ethnic groups.  YHC has added a full program of community-based services serving their residents as well as non-residents.

Many of these community-based services are not funded by the government, and rely solely or mostly on their own fundraising.  Even many basic nursing home services are only partially funded by the government.  As a result, in order for YHC to continue to provide top-quality care and to expand in size and in services, it has required large and continuous fundraising, and a large number of volunteers.  During the roughly 20 years of existence starting from the seed of a vision, Dr. Joseph Wong and his many collaborators and their army of volunteers have raised about $200 million.  Their largest regular single fund raising event is their annual Dragon Ball, which in 2008 raised a net proceed of $900,000.

Not only there is a long waiting list to move into one of YHC’s nursing home beds or housing units, almost unprecedented there is also a waiting list of volunteers to contribute their services to YHC!

Why was YHC so successful?  I think that there are several reasons:

• There was and still is a need for language and cultural attuned nursing homes in the Toronto area
• The YHC nursing homes were planned with top quality care in mind from the very beginning and so executed at every stage of implementation
• Someone had the vision, courage, and long-term dedication to initiate and lead a series of ambitious projects
• The leaders were able to mobilize thousands of volunteers at the grassroots level to adopt the attitude that they must give back to the community and that no challenge is too great to overcome
• Besides benefiting from residing in the YHC, many residents also became volunteers to help others
• There was synergy between private and government organizations and between the East culture and the West culture

Ongoing Challenges Faced by YHC

• Yee Hong Centres’ exemplary service and continuum of care are under serious challenges due to increasing financial constraints.  There are several contributing factors:
• The gap between government funding and nursing home costs is widening.  The annual operating cost increased by 6% while government funding only increased by about 3%
• Government cutbacks in hospitals, e.g., elimination of special wards for dementia patients, have resulted in more frail seniors and those with dementia and mental illness being sent into nursing homes
• With an increasing aging population, the number of seniors who require services like those provided by YHC continues to increase
• As with other long-term care centers in Ontario, the number of residents with behavioral problems is on the rise and therefore requires more resources to manage them
• A number of YHC’s much-needed community programs are not funded by the government and rely completely on donation dollars
• By its very nature of providing care that is attuned to the language and cultural needs of its residents, YHC requires specialized skills that are not required in other nursing homes, e.g., YHC is experiencing increasing difficulties in recruiting Chinese speaking nursing staff, social workers, and dieticians.

To sustain their current level of care, YHC needs to raise a net of $2.5 million every year.  Due to the increasingly competitive fundraising environment and the economic downturn, this is difficult to achieve, and YHC has not met its fundraising target for the past three years.  That was why they had to reduce or eliminate certain services, an example of the latter is their in-home Cancer and Palliative Care Service.  A long-term solution would probably need to rely on an overhaul of the whole healthcare industry on a national level.

Power of One

The Yee Hong Centre for Geriatric Care is definitely a great success story.  Such a great success of course was due to the contributions of many people.  However, if it weren’t for the vision, passion, dedication, commitment, and hard work of one person, Dr. Joseph Wong, spanning more than two decades, there would not be the Yee Hong Centre success story.

In June 1998 on the occasion of receiving the Max Beberman Award from her high school in Urbana, Illinois, Iris Chang, the award-winning author of the best seller book The Rape of Nanking:  The Forgotten Holocaust of World War II said in her acceptance speech to the high school graduates, “Please believe in THE POWER OF ONE. One person can make an enormous difference in the world. One person — actually, one idea— can start a war, or end one, or subvert an entire power structure. One discovery can cure a disease or spawn new technology to benefit or annihilate the human race. You as ONE individual can change millions of lives. Think big. Do not limit your vision and do not ever compromise your dreams or ideals….”

The impact of Dr. Joseph Wong for providing geriatric care in Toronto and beyond is a shining example of “THE POWER OF ONE.”

More information about the Yee Hong Centre for Geriatric Care can be found at: http://www.yeehong.com/.