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Senior holding stairway handrail

Chapter 3 - Understanding your parents’ care options

Right Time, Right Place - Options for retirement living
There’s never been a better time to be old. Yes, old. We know that age doesn’t matter, so let’s really embrace it. Besides, Canada has one of the highest life expectancy rates in the world. Over the last century, we’ve added 25 years to our lives, and now many of us are enjoying vibrant lives well past 80, 90, even 100. You may be able to retire from work, but not from life. How, and where, you spend your time as you get older is more important than ever.

Today, it’s all about independence and choice. Between home care, retirement communities and long term care, the options for senior living have never been bigger and brighter. Or more confusing. That’s why starting your research now, as you’re doing by reading our guide, is key.
Today, it’s all about independence and choice. Between home care, retirement communities and long term care, the options for senior living have never been bigger and brighter.

“It’s never too early to start thinking about retirement,” says Laurie Johnston, chief executive officer of the Ontario Retirement Communities Association. It’s very important to understand how each type of care works in each province, including the different funding models and qualifications. “There’s this expectation that the government will cover your needs as you age, but this is absolutely not the case,” Johnston adds.

But let’s forget about costs for the moment (we’ll dive into them in a later section). Right now, it’s about understanding each option in more detail, so that when you’re ready to dig deeper, you’ve got the basics covered.

Home Care

Home care provides people with support to help them remain in their home. Help may include housekeeping and companionship, to bathing and getting dressed, to more involved care like nursing, physiotherapy or rehab. Along with making some changes to the home if needed, maybe a lift for the stairs, a chair for the tub and some handrails throughout, home care helps people continue to live in their own home more safely and comfortably.

Each province has its own rules and regulations when it comes to eligibility and funding for home care. To receive government or publicly funded home care you need to go through an assessment to qualify and to determine what level of care you will receive. It’s common for someone to need more than they qualify for, so they can top up the care at their own expense. Likewise, you can also simply hire your own private home care service, and forgo the qualifications and funding altogether. There are many private home care providers that let you choose the care you require and the number of hours you need. Of course, you pay for this yourself. Before selecting a home care provider, be sure to do your research and make sure you’re working with a reputable company.

If your mom or dad chooses to move ahead with home care, remember to think about the questions Dr. Barratt shared earlier in this guide and check in regularly to find out can they manage, do they have the care they need, are they supported, do they have friends and social connections in their neighbourhood that make their life rich and rewarding? If the answers to any of these questions are no, then you may wish to consider the other options available.

Retirement Residences

Imagine it: a private suite in a building designed specifically for seniors. Here, it’s all about living in a community, with little to worry about other than how you want to spend your time.

Retirement residences are as varied as they come in terms of design and amenities. Some are individual buildings; others are more like miniature communities. Some offer gourmet meals, on-site shops and other resort-like amenities, whereas others might have vibrant gardens to stroll, book-lined rooms and cafés where you can enjoy an afternoon drink. It’s common to see brilliant gardens and cozy fireplaces. With a host of recreational, cultural and social events and activities to choose from, there is something for everyone. Want to get fit? Join an exercise class. Want to hone your artistic side? Share your creativity at art class. Want to visit the theatre? Take part and enjoy the show. And don’t forget about your furry companions -- many retirement communities are pet-friendly. In general, the overall feel is like a close-knit community, with a lively social atmosphere and camaraderie.

“So many people walk into a retirement home and say, ‘I wish I’d done this earlier,’” says Johnston. This is especially true for people who’ve recently lost a spouse, or who live in neighbourhoods that their friends have moved away from.”

Along with letting someone else do the cooking, cleaning and laundry for a change, there is personal care and attention too. There are a variety of confusing terms used to describe the care offered in retirement communities – assisted living, independent supportive living, memory care, dementia care. Bottom line, in many retirement communities if they need care, it’s available at the level that makes sense. Many provide nursing care, physician services, nutritionists and other health care services your mom or dad may one day need.

Retirement residences are privately run but provincially regulated; generally, you pay all of the costs, including care expenses. If you have private insurance, it may help to cover some costs as well.

“It’s amazing to see how people flourish once they’re here,” says Johnston. “You see them waking up with plans for the day. Meeting up with friends for coffee in the lounge. Getting up and getting out.”

Unlike long term care, you can move in whenever you like, to whichever community you like best, assuming there isn’t a waiting list. But before you commit, make sure to visit a few times: taste the food, talk to the residents, the staff. Get a feel for the place. Can you imagine your mom or dad here?

Long Term Care

Often confused with retirement residences, long term care is for people who require highly structured care, and who can no longer live independently, for physical or cognitive reasons. Along with complex multiple chronic conditions, dementia is common, and there’s a great need for a safe, secure place.

The decision to choose long term care is often a tough one. “There’s a lot of family guilt around sending a parent into long term care,” says Candace Chartier, CEO of the Ontario Long Term Care Association. “But there’s also a great social benefit, and you’re getting around-the-clock care.”

In long term care, highly skilled care teams focus on the individual – developing a personalized care plan that supports comfort, dignity and safety. It’s not just about physical well-being; social, intellectual and spiritual wellness are also important. That’s why many long term care homes offer a variety of recreation activities, including fitness classes, art and creative pursuits such as music therapy and horticultural programs, and access to computers and libraries. There are also outings, cultural and community celebrations, multi-faith spiritual services and volunteer programs. Here, meals are made with both taste and nutrition in mind.

Long term care homes have different room options – some older homes have four-bed wards, while others offer semi-private (two-bed) or private (one bed) rooms. Because long term care is government funded and regulated, the costs often differ from province to province. Typically, you pay for your accommodation (these rates are set by the provincial government, not the operator, and are the same for all residents in a given province), while the government covers the cost of things like care, some medications, food and programming.

To get into a long term care home, there is first a provincial health assessment. This determines the care a person qualifies for. There are often waiting lists, so it’s very important to get your loved one’s name onto them as quickly as possible; it’s also important to remember that in some provinces you may not get your first choice. “The waiting lists are often lengthy,” says Chartier.

As you would if considering a retirement residence, take the time to visit a few long term care homes to see which one you could see your mom or dad in.