Navigating long-term care
When care needs become substantial, a live-in facility such as a retirement home, senior living, assisted living, memory care, nursing or long-term care home may be the best option to keep a loved one safe and professionally supported.
How to select a care home for a loved one:
Assess the needs: Understand what your loved one’s needs are in terms of care, medical attention, and what kind of environment they would feel most comfortable in.
Research your options: Look into different types of long-term care homes, such as assisted living facilities, nursing homes, or memory care facilities. List the pros and cons of each option, and consider what is best for your family.
Visit the facilities: Schedule tours of potential facilities. The differences between them can be vast. Explore the living spaces, meet the staff, and get a sense of the atmosphere, activities, and care.
Check the credentials: Ask for information about the facility's licensing and accreditation and make sure it is up-to-date.
Ask for references: Get references from current or former residents and family members to give you an idea of what it is like to live there and the quality of care provided.
Consider the location: Plan for how easily you and other loved ones will be able to visit.
Look for the details: Ask about all the extra amenities like food options, recreational activities, and transportation services to ensure it matches your loved one’s lifestyle.
Different types of homes provide different levels of support:
A retirement or senior living home is designed for seniors who are mostly independent but need some light support with daily activities. These communities often offer accommodation in apartments or homes, and services like housekeeping, meals, activities, and transportation.
Assisted living homes offer an increased level of care and daily support for those who can no longer live independently. Staff often check in on residents a few times a day and can offer up to a couple hours of personalized care.
Memory care homes offer specialized support for people with memory loss or dementia. These communities offer specialized care and support including more secure environments to help prevent wandering.
Long-term care and nursing homes provide the highest level of support and are best suited for people with difficulty directing their own daily needs. They offer 24-hour personal and nursing care and can help support all activities such as bathing, dressing, and taking medication. These homes are often licensed and regulated by the province or state.
There are public and private options within each type of home. Public options are government-sponsored and usually more affordable (i.e. in Ontario, $1200-3000/month vs. $5000+ for private) but may have long waits or limited availability. Private options will offer more variety and activities but can come at a significant cost.
In Ontario, Home and Community Care Support Services organizations provide province-wide access to home and community care services for Ontario residents and coordinate admission to long-term care homes. The cost is subsidized, and varies depending on the home, location, and private vs. shared accommodation. The wait list for government-sponsored homes can be very long for the most sought-after facilities, so we recommend you get yourself or a loved one on lists in advance of really needing it.
In the U.S., long-term care information can be accessed by the National Institute on Aging site and you can search for a Medicare-certified long-term care home.
For an example of private home pricing, an Amica home we visited in downtown Toronto, Canada in early 2022 started at $5000 a month for the smallest bachelor suite and went up based on size. Then, care is an additional $1000-$5000 a month based on level of need. Amica is, however, one of the more luxury options in Canada and their spaces are lovely.
Something to consider is how quickly the level of care may change, as moving from one home to another can be disruptive. Some homes will offer additional care at an added cost as needs increase or you may need to budget to add in personalized care from a private personal support worker (more on hiring a PSW HERE). If a lower priced home does not offer the level of care you need and you may have to top up with a PSW, then costs can quickly creep up so an all-in solution may help in the long term.