Raymond Applebaum has been the CEO at Peel Senior Link for 26 years and has worked in health and human services for 50 years. In June, he will retire from the organization.
By Arianne Robinson. This interview has been condensed and edited for clarity.
Is there one thing that’s been crucial to what you enjoy about Peel Senior Link, and has it kind of changed over time?
One common thing over time is the agency’s ability to deliver services and enable seniors to live independently in the way that they choose. That was really important to me when I came here, and I have continued to build a culture that has respected and provided the ability for seniors to live independently in the community.
Why is that something that you’ve appreciated personally?
I supported two sets of grandparents who unfortunately ended up living in nursing and long-term care homes, and I felt that the quality of life could be better as they got older and experienced frail health. At those times, we didn’t have community services to the degree that we have them now, and so their options were very limited. That relationship was a huge motivation that inspired me to get into social work and gerontology, which I did as a result of that. At Peel Senior Link, I’ve worked for over 26 years to build a program that enables seniors to do just that – to live independently with support in the community.
How much did that relationship with your grandparents impact your career?
I was around 15,16 years old and pretty young to be doing that kind of support and care, but I felt obliged to my grandparents, who did so much for me when I was growing up. I felt it was my way to pay back. I used to visit my grandparents after school, and I would help my grandfather shave. He was in a private nursing home, and they just didn’t have the time to care for him in a way that I thought was going to give him dignity. They might have thought, well, you know, you can go three days without a shave. That’s not at the end of the world. Well, for somebody who shaved every day, that was important to him. I went pretty much every day after school. I’d stop at the nursing home on the way home and drop in to see how he was doing. If he was still in bed, I would get him up and help him in the wheelchair, and get him out to the lounge so he could relax, have some stimulation, watch TV, and be around other people. The staff were just running from room to room, doing what they felt was critical care. And I would come and be that social person. I did the same for my grandmother.
How do services at Peel Senior Link work?
The client’s perspective and the family caregiver’s perspective are critical to us. We can do all kinds of things, but is that what people want or need? And I think that’s the big key to our success, that we listen to people. We provide a pretty exclusive program. We operate 24/7. It’s around-the-clock care in our designated buildings and in the neighborhoods, and that’s a pretty unique program. We started from a psychosocial model, and we’ve maintained it.
What do you think is the value for service recipients?
Certainly, in terms of their sense of themselves and their well-being as an individual, I think it has a tremendous bearing on their mental health. I think that people who benefit from our program are, comparatively, individuals who potentially end up prematurely in an institution or in a hospital setting. They’re living in a situation where they no longer require acute care services, but they have nowhere to go. They’re deteriorating because every day they sit in the hospital, and they may experience atrophy. They’re not being challenged or getting rehab. Hospitals aren’t set up to care for aging seniors who no longer require acute care support. So we’ve got thousands of seniors across Ontario literally sitting in hospitals in what we call ‘alternate level of care’ beds. They’ve been discharged from the hospital program, the acute care side of their recovery, but they have nowhere to go. We have huge weight lists – 150-200 people are waiting to get into the program.
Who qualifies for the program?
People first need to qualify for housing through the Region of Peel in one of the rent-geared-to-income buildings, social housing. Once you’re on the waitlist for housing and you qualify for Peel Senior Link support services, then we can bring you into the program and move you to the top of the waitlist. It’s probably sitting around 1500 people right now in the region of Peel. It’s a real
problem. Why did we start and continue to operate in social housing buildings? Because of affordability. Because only in those social housing buildings, we have rent-geared-to-income units, where you would only pay up to a third of your disposable income. So that enables low income seniors to be able to afford the rent. Our program is covered by the Ministry of Health for eligibleclients. It’s an OHIP-insured program.
It sounds like the program makes a pretty drastic difference in terms of quality of life?
Night and day. The majority of the client population we serve are female. By far, the majority of them are single women. Many have multiple chronic illnesses, and they’re in need of medication assistance and toileting, bathing, dressing, and meal preparation. My staff help with all of that. These are not individuals who would typically be able to live independently in the community, in a safe environment, and that’s the problem. People can live that way, but they’re not going to be safe living independently. We do security checks three times a day, every eight hours. We do a visual check, not a telephone call or just a knock on the door. I want to know ‘are they okay? ‘because sometimes we find people lying on the floor. They’ve had a fall or can’t communicate with us, so visual checks are vital.
What’s one thing that you love doing in your job every day?
Visiting clients. I do get out to the sites. Not just one-on-ones, but I hold town halls where families, both clients and family members, can come and talk to me. I don’t have staff in the room. I just do it on my own. And I do take notes to give my team, but they’re scrubbe,d so nobody knows names.I will share my comments. We also do an annual client satisfaction survey, and our rating is very high. You know, we had an 86% overall client satisfaction and 72% return rates this past year, which are phenomenal results, and that’s coming directly from the people we serve.
Can you provide examples of a “people first” or “bottom up” approach?
Our family and client caregiver advisory panel is an opportunity for us to engage clients, caregivers and staff together in the development of programs and services three times a year at minimum. We hold meetings with clients and caregivers from across our 11 service locations. Those meetings are to inform and provide knowledge and information to everybody about the upgrades and new programs and services being offered, and also to engage the clients and caregivers in decision-making around the organization. We’ll bring new program ideas to the table and get them to give us feedback.
What’s an example of something you’re most proud of?
In terms of improvements or performance enhancements for the agency and the services to the client, I guess two areas that I can mention quickly. We developed a policy for what we call the Hub and Spoke service model. Prior to 2008, assisted living programs like our services did not have the ability to serve clients living independently in the community. We could only serve people in designated buildings. Home Care had the exclusivity to that population, which never made sense, but that’s the way it was. I argued through my funder, who supported me in presentations to the Ministry of Health, to establish a new policy and a new model. The hub is a building, and we would serve and use that location as our service base, and then we would emanate out about three to five kilometers around that building into the community. This meant it didn’t matter the form of the housing; it could be a private, semi-private, or an apartment building, but as long as it was in about a three to five kilometer radius of the building, we were able to safely serve everybody. And so I almost doubled the service capacity. We’ve been doing that ever since 2009 when the new policy for assisted living was adopted by Queen’s Park. I was a pretty active player in that, helping to write some of that thinking.
What’s your advice to other nonprofit-like providers, CEOs, around advocacy? Anything is possible. If you’re proposing something that’s going to have the benefit of the community and at the heart of it, then that’s always possible and I wouldn’t give up on it. There’s going to be challenges. You’re always going to have pushback when you come up with innovations and new ideas. People aren’t crazy about change, and the way that I sell change or advocate for change, is with a focus always on the client and the community. The focus of this discussion should always come back to the heart of it, which is, who are we doing this for? Why are we doing it for them? What are the benefits people are going to derive from me making this change over time? And the other thing is, engaging everybody in the process. Don’t try to go italone. If you can engage your senior team, your client and caregiver population, your partners –partnerships are critical as far as I’m concerned. It’s all about relationship building. You accept that you can’t offer everything to everybody. You just can’t. And so you’re going to have to figure out where the priorities are. And that’s not easy. But once you’ve established the priorities, you want to make them realistic and doable. So don’t reach for the stars when you can’t get to them. Usually execution is the downfall for most people. A lot of people have good ideas. They come up with great program thinking and services, but can they execute them on the ground? That’s really where the rubber meets the road in my mind. Don’t let frustration stop you from achieving what you believe to be right.
Is there anything else that I haven’t asked you about, that you want to talk about?
I’m thinking of some of the newer CEOs and executive directors coming into the game and trying to help them through what is a challenging and difficult job at best, never mind all the other stuff going on right now. I mean the tariffs and everything I’ve seen that impacts my staff. People are not worried about their immediate job, but they’re worried about affordability and worried about housing and buying groceries and the basics of life, which are going to get impacted. And so I have to try to work with the staff to give them the confidence that ‘you know we’re going to get through this together. We need to work with each other. If you have concerns, you know, talk to your supervisor. Talk to our EAP program that we provide.’ Because we know that people are really being challenged right now. I’m a person that doesn’t wait to find those problems, so I want o get ahead of the curve and give my staff the confidence that we’re going to work together onthis and do whatever we can within our means. Or the other way I go is advocacy. I’ll run through fire for my staff if I have to, and they know that, like they know I’m serious and I’ll take this to places that might have influence like the provincial and federal government. I mean, here we are, Metamorphosis Network is advocating for issues related to tariff impact with the impending election. Part of that is my staff. I’ve got 200 people who rely on us.
