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by and

Seniors are the fastest growing age group in Canada. As a result many people are considering residential care for their aging relatives. Few, however, understand the services available or the differences, say, between nursing homes and retirement homes. This article attempts to describe the differences between both.  

Nursing Homes

Long Term Care (LTC) facilities, also known as nursing homes, are licensed and authorized as government regulated residences.  They have controlled admission policies and programs and set standards of care.  
Some nursing homes are privately owned and managed on a for-profit basis. Others are public and are operated by municipalities. Some, mostly private non-profits, specialize in providing care tailored to the needs of specific cultural or religious communities.

The Application Process
The application process involves the completion of forms, including a Long Term Care application form, to determine if the applicant is eligible for nursing home placement.

Applications are submitted to, and eligibility is determined by, a Community Care Access Centre (CCAC). To be eligible, the applicant must:

  • Have a valid Ontario health card,
  • Be 18 years of age or older, and
  • Have care needs that cannot be met by community-based programs.

Those who are eligible may apply to a maximum of five homes, in order of priority. If one of these homes offers a bed, the applicant has 24 hours to accept it.  If he or she declines, the applicant is removed from all waiting lists and must wait six months to reapply for placement. He or she applicant may reapply sooner if his/her health significantly deteriorates.

Should a bed become available, but it is not on the preferred list, the applicant can decline it without losing his/her position in the queue.

Once accommodation is accepted, the resident can move in immediately or request that the bed be held for a maximum of five days (a bed holding fee will apply). After the move has taken place, the person may apply to relocate to another home.

Individuals with the highest health care needs and those in hospital are given first priority in the allocation of nursing home beds.

Cost
The cost of living in a nursing home is subsidized by the government with the subsidy covering all daily living activities, medication administration, personal and nursing care, etc.  Residents are however required to make “co-payment” towards their meal and accommodation expenses.  Co-payment rates, which are standardized at all nursing homes, are as follows:

  • Standard Room – $1,707.54 per month (three or more beds per room)
  • Semi Private Room – $2,011.76 (two beds per room)
  • Private Room – $2,361.55 per month (one bed)

Optional services such as telephone, hairdressing and cable TV are available for additional fees.

Pros and Cons of Nursing Homes
Nursing homes are generally designed for people who require round-the-clock monitoring and supervision in a secure setting.

  • Despite having certain rights and privileges, residents are living in an institution and must therefore conform to the schedule, lifestyle, food choices and activities it offers.
  • When seniors, especially those suffering from dementia, are relocated from their own homes, which are generally familiar and filled with memories, to an institution populated by strangers, they often feel a profound sense of loneliness.
  • Even with government regulations and evaluations almost everyone has heard horror stories regarding nursing home neglect, staff or resident abuse.
  • Many seniors become depressed from constantly hearing the screams and moans of other residents or observing people in far poorer health.

Nursing homes are best suited for seniors who:

  • Are restricted in their ability to perform the tasks of daily living;
  • Require round-the-clock monitoring; and
  • Have limited private resources to fund their care.  

Deciding to put a loved one in a nursing home is tough. If you choose this option, research and tour the specific homes you are considering to evaluate the pros and cons of each and to facilitate an informed decision.

Retirement Homes

Retirement homes are private businesses that are neither funded nor regulated by the Ministry of Health.  However, since July 1, 2012, every retirement home in Ontario must have a license to operate.

Eligibility
Anyone can apply to live in a retirement home though the facility may assess the needs of the applicant to ensure that it can provide appropriate support.

Costs
As private businesses, retirement home can stipulate how much they charge, what types of services they offer, and even how they define these services. Generally, however, retirement homes provide either:

  • Independent living; or
  • A combination of independent and assisted living.  

Independent living facilities are generally suited for seniors who can perform daily tasks on their own. These homes typically offer residents some form of meal plan, social activities, household maintenance, limited laundry and housekeeping, and 24-hour emergency response.  

In addition, some retirement homes provide assisted living services such as personal care, medication administration and supervised care.

Prices for retirement homes can range from $3,000 to $10,000 per month. Meals and limited housekeeping are typically included in the accommodation fees, but they may also cost extra. Residents are usually charged on a user-pay basis for services, such as, personal care, help with daily living activities and medical assistance.

Pros and Cons of Retirement Homes
Retirement Homes are ideal for seniors who can live independently with minimal to moderate support. They usually have lots of social activities and are best suited for gregarious people.  Though they offer more flexibility than nursing homes, there is still some amount of structure in terms of food choices, meal times, etc.  

  • Given that retirement homes operate on a user-pay basis for some services, monthly costs are often higher than those quoted during the initial enquiry and are not always predictable. This could be problematic for seniors with fixed income and/or limited financial resources.
  • As the level of care required affects costs, retirement homes are generally not economical for seniors with multiple medical problems. Moreover, since seniors’ health status may change suddenly, they may face astronomical care costs or having to relocate to a nursing home (pending availability).
  • Since retirement homes are considered residential tenancies, seniors may be asked to vacate the premises with one or two month notice if their health declines to the extent that they require greater care than the home can, or is prepared to, provide.
  • Personal assistance and advanced care is not generally included in the monthly rent. These services may be obtained by paying the home an additional fee, hiring a home care agency or a private caregiver or relocating to a nursing home.

Home Care

Adapting to a changed environment can be difficult at any stage in life and can be even more so for the elderly. A recent national survey indicates that 70 percent of Canadian seniors would prefer to stay in their homes. There is also evidence that seniors respond positively to remaining in familiar surroundings where they can relive pleasant memories.  Home care is a flexible solution for seniors who wish to continue living independently and for those who require assistance with a range of daily living activities. It is an alternative for seniors who are ineligible for nursing homes or are awaiting placement in a nursing home. Finally, home care may complement nursing home services or be an option for residents in a retirement home who need care that is not included in their package or not offered by the home.

Opal Rowe, MSc, MBA, CPCA is Director of Living Assistance Services, GTA North.

 

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