In 2014, the Government of Nunavut — a sparsely populated territory of northern Canada, forming most of the Canadian Arctic Archipelago — initiated an assessment of long-term care that described the situation in the territory as beyond capacity, and not meeting the needs of the Nunavimmiut (Ungava Inuit) community. The study outlined the need for long-term care facilities in Nunavut, and particularly the Kivalliq region — the selected location of the first modern facility planned for Rankin Inlet on the western shore of Hudson Bay. The project strategised to retain elders in the community and region, closer to family, their culture, and home, reducing the current strain and issues related to out-of-territory care.
The design and construction of the 24-bed centre, named the Kivalliq Long Term Care Facility, and completed last December, was challenging. When the project commenced design so did pandemic lockdowns, creating an extraordinary task that required both a shift and adjustment to the project design process, and taking into account emerging findings/perspectives on long-term care facility design in Canada.
Unique complexities
While there were unique complexities, the design team (with contributions from across Canada) remained focused on the paramount need for the new elders’ centre to be reflective of and responsive to Inuit culture, values, history and traditions. The design team brought experience from Manitoba, Ontario, Alberta, Saskatchewan, Quebec, and Nunavut, through an online collaboration not unlike most other remote community project developments during the initial lockdown. The nature of the design process meant that all consultants and stakeholders needed to work together in a new way, adapting to remote and digital sharing of complex ideas. This proved to be a challenge, with technology limitations related to the Internet, and power issues often presented in northern communities.
An important strategy that was embedded in the project’s design process was the diverse nature of the team, which included expertise in Inuit design, infection control, accessibility, and long-term care design, along with various uniquely northern civil, geotechnical, and environmental inputs that formed the initial site strategies and analysis. This team was challenged to bring together the greater context while incorporating concepts and details that reflected the site, community, region, and requirements of the territorial government.
Maintaining Inuit traditions
The selected site is nestled between Kivalliq Health Centre and Agnico Eagle Centre, neighboured by nearby Nunavut Arctic College and other cultural facilities in the heart of the hamlet of Rankin Inlet. The location, although challenging from a drainage, site services, and terrain perspective, is well-suited as a place for generations to connect — where elders can live, and Inuit traditions can be shared, maintained, and enhanced.
The design of the facility focuses on a community space and a welcome centre for family and visitors. The orientation of this public space facing Tupirvik Avenue sets the aerodynamic form that enables persistent north-west winds to scour the site beneath the raised structure and around the building perimeter. As with most buildings in the arctic with ice or ice-rich permafrost conditions, the building required being raised on a platform of steel piles that are drilled into bedrock. This raised architecture sets the stage for mechanical and electrical systems to enter from below through an insulated subfloor system, while protecting the existing permafrost condition on the site. Access to the facility is created through sloped granular areas that terminate near entrances by gabion stone retaining walls.
Assisted residential care
The site informed the design, orientation, and layout, as well as the programme, with two neighbourhoods/houses of 12 resident rooms. This approach enabled the more private home experience to be facing the sloping terrain of the site, with views to the immediate landscape and neighbouring community facilities. These houses are set up to provide both Level 2 and Level 3 assisted living residential care, while designed for Level 4 or Level 5 care for those individuals with more complex needs, such as dementia, when the programme and training develops.
While modern long-term care design trends are embedded within the programme and concept, this facility is designed to embrace local and regional culture, with a number of features that include community gathering and a kitchen in each house that accommodates the preparation of country food — the traditional diet of Inuit, that can include caribou, musk ox, bear, whale, seal, arctic char, shellfish, berries, and other foods that are hunted, fished, or gathered locally.
The setting encourages family members to be actively involved with elders through programming and design features that are inclusive and community-focused. Each unit design includes spaces for activities that promote being with other residents in the home. They include a living room and ‘den’, each with exceptional views to the site, and a secure elevated deck to experience the seasonal changes.
The design of a community spine creates the setting for bringing residents together while providing important amenities and services. The main multi-purpose room is near the main entry of the facility. It is a large, round room with views to the street, extending toward the community as the most public space in the design. In this area at the entrance zone, the design includes a family lounge, telehealth room, and a quiet room — all important in remote northern centres. The spine connects this more public space with a rotunda flanked by resident spaces that mimic a community setting, with a coffee shop, workshop, haircare, and exercise and prayer room that connect the two households. These centralised services are offset by the support service spaces that include administration, laundry, food services with additional freezer space for country foods, systems areas, and an indoor garage for ambulance transfers.
Architectural response
The resulting form is in direct response to culture and climate, with orientation to manage prevailing north-west winds, summer and winter solstice impacts, and site conditions, all balanced with human factors and community values. The design aims to respond to and connect with these unique features associated with life in Rankin Inlet and Kivalliq in general. It strives to be a sustainable and efficient response, while ensuring the deeper expression of Inuit culture in a place that elders and the community can both benefit from today and for years to come.
Acknowledgment
- This article, titled ‘Aging in the arctic’, first appeared in the Winter 2024 issue of Canadian Healthcare Facilities, the official magazine of the Canadian Healthcare Engineering Society (CHES). HEJ thanks the author, CHES, and the magazine’s publisher, MediaEdge, for allowing its reproduction, in slightly edited form, here.
Jeff Penner
Jeff Penner, MAA, OAA, MRAIC, LEED, AP, Principal and Community Architect at Verne Reimer Architecture (VRA) in Winnipeg, Manitoba, is leading communitybased projects across Canada, with a focus on the northern territory of Nunavut. His passion for the north stems from time spent in northern Finland (Lapland), where he studied community design. Although he has extensive experience in healthcare design, many of his projects tend to be in the area of community wellness. Jeff is ‘a recognised leader in sport and recreation facility design’, with his expertise in multi-use community recreation design instrumental in creating new relationships with rural and remote communities, indigenous communities, and agencies that provide services for elders, families, and youth. Living in rural Manitoba, Jeff has always been an advocate for communities having access to design.