Harsch Has Blueprint for Better Care for Seniors

Harsch is the owner of ExquisiCare, the first private, boutique-style long-term care home for seniors in Alberta.

Dawn Harsch


Dawn Harsch tells the story of a pivotal moment when she was a nursing student and working as a psychiatric aide in the dementia ward at Alberta Hospital. The conditions were austere – concrete floors and walls, run-down furniture, six-bed wards separated by a curtain, and one bathroom.  Many of the residents she met had lived there for years. One, in particular, she will never forget.

“He seemed lonely,” says Harsch. “So I struck up a conversation with him.  He asked me if I knew who Emilia Earhart (the first female pilot to fly solo across the Atlantic) was. ‘I worked on her plane,’ he said, ‘And they can’t find it.  I don’t know what happened.’ I thought, he’s in the dementia ward. He’s making this up. But when I asked the nurses, they said his family had told them that he was one of the last people to see Earhart alive.” 

Harsch pauses to reach for a tissue. She gets emotional talking about the vulnerability of aging seniors. Their care is something she feels strongly about, and she sees a huge gap once seniors need round-the-clock care. Their options are limited.

“That institutional model of care that looks, feels and smells like hospital has been the accepted way of providing for seniors since it started in the 1940s for those who had no family to take care of them,” says the 40-year old, who was part of Avenue’s Top 40 Under 40 in 2011. “And I don't know how many seminars and workshops and conferences I've been to where the facilitator has asked ‘Who wants to live in a long term care facility when they need 7/24 long term care?’ And nobody puts up their hand, because nobody wants to live in one and receive care in that method.” 

Harsch is the owner of ExquisiCare, the first private, boutique-style long-term care home for seniors in Alberta. The 7,000 square foot, 10-bedroom home, which opened in May 2012, looks like every other new home in a southwest Edmonton residential neighbourhood. There are no signs and no pay-for-parking lots. Even the staff don’t wear uniforms.   

“Our average age right now is 92. We have a 98-year-old and our youngest is 82. Most of our folks need a significant amount of help, so 24/7 care and monitoring. We do all levels of care, including dementia, physical, even palliative, so up to and including those final moments, they stay here,” says Harsch. “But what happens here on any day is not that much different from what happens in my home or your home. People get up whenever they want and have whatever they want for breakfast.  Some read the paper and some go on outings, which we facilitate. We have homemade lunches, homemade dinners, lots of family visiting. We watch TV. We do whatever makes them happy because it is a home and we want it to look and feel like a home.”

Harsch’s concept for ExquisiCare developed as she grew up in the small town of Davidson, Saskatchewan, where everyone knew each other. There was respect for one’s elders and a sense of accountability. 

“Everybody knew my grandfather, Lorne Fryer. Everybody knew my grandmother. The caregivers there also knew them. So they wouldn't dream of not treating them with the utmost respect and dignity. And furthermore, if they did, they would run into my mom at the IGA.”

She knew from an early age that she wanted to be a nurse, following in the footsteps of her paternal grandmother.  After getting her undergraduate Degree in Nursing, she then got her Masters of Business Administration. With both nursing and business skills, she moved quickly through the ranks of Capital Health, and later Alberta Health. She was director of the Northern Alberta Renal Program, bringing treatment to patients in rural areas on a large retrofitted passenger bus, and oversaw the opening of nine new dialysis units. After leaving to have twins, she returned to neuro-sciences.  When there was a lot of restructuring and change under CEO Stephen Duckett, she took a package and left.

“During my MBA, I wrote a business plan for ExquisiCare and then it literally sat on a shelf for 10 years,” says Harsch.  “And I would talk to my husband about it constantly. Thank goodness I have a supportive husband, because when there was an opportunity, he said, ‘Just do it.’”

Harsch considers herself to be an old-style nurse, just like her grandmother, who died the day Harsch got her nursing degree. 

“We do everything. We cook, we clean, we take care of the whole person,” says Harsch.  “And I don’t have people here who do it for a paycheque. They do it because they love the seniors and they love the model.”

She calls her model a community care home because of the close-knit environment it creates with the seniors, their families and the staff. The model is expensive. It took an investment of $2 million to build the home, and she maintains a staff of 10, including a nurse and a care aide, plus an activities director and herself, for 10 patients. 

“The staffing costs seem higher,” says Harsch. “But, when you factor in overall care, which results in fewer falls, fewer bed sores, better nutrition, less use of anti-psychotics because of happier patients, and the big one, fewer trips to the emergency department, I believe this model of care is actually less expensive to the system as a whole.”

Construction has now begun on her next home, also in a southwest Edmonton neighbourhood, and there’s already a waiting list.