Unlike a retirement home, you do not need to do the ground work yourself for long-term care. Medical agencies and teams are in place to organise this for you. However, there is a very long waiting list for long-term care in Ottawa and Ontario and so being pro-active and putting one or both of your parents on the list ahead of time is
Nursing Homes: Nursing homes or long-term care (LTC) facilities are generally more medically focused and they are regulated by province. They have strict specified standards that they must adhere to and meet. The government can also provide subsidies towards the care costs and therefore a monthly payment to a LTC home can be significantly less than to a private retirement residence. In Ontario the costs range from $1600/mth for a shared room to $2,160 for a private room. If your parent(s) need medical care and/or supervision, then a long-term care facility is probably your better option.
Retirement homes are not provincially regulated and therefore charges can and will run in to the thousands of dollars a month ($4,000 - $7,000+). Services can be minimal or luxurious with suites boasting two bathrooms, limo travel and personal trainers in the gym. However, there are no government subsidies for retirement home living, so the individual or family will have to bear the full cost. If they’re still able to remain in their own home, having a home support carer come in daily, even for 4 hours a time, would be significantly less than residency costs. And just because you’ve found a nice home and your parents are looking to sell their house and move in, doesn’t mean they’ll be able to. Retirement homes often have extensive waiting lists of months or even years for the more popular.
Retirement Residence or Nursing Home?
Retirement Residence: If you think your parents would benefit from retirement home living, you’re going to have to do the ground work yourself when selecting a residence. Or utilize the services of a Retirement Living Consultant, like Amy McConnell at Tea and Toast Ottawa. As with anything, word of mouth referrals are priceless and if your parents have friends or acquaintances who have their own experiences, ask them! Many of the larger chains of retirement homes – Chartwell, Revera, Amica – have sales staff and marketing consultants who are very helpful and very interested in you(!),and they do offer no-obligation tours of the facilities, a complimentary lunch, the opportunity for a ‘respite’ stay for your parent(s), at a very affordable rate (some are as low as $99 a day, all in, which is tremendous). Directors of Care at the residences are also very good contacts for they are medically trained or social work designated individuals who have experience in gerontology and also management. Take time to visit whichever properties you’re interested in to speak to the staff and residents, to see what is going on socially, to taste the food, to understand what is included in your monthly payments. Make up a list of questions and be guided by the answers you’re given: Is there 24 hour care? Is there 24 hr nursing care if needed? Is there a doctor on site? Is medication dispensing supervised? What happens if your mom or dad’s health deteriorates? What does your monthly payment get you? What are the additional charges for and how much (unfortunately things like laundry are invariably an add-on per week; residents that need PSW care usually get one bath or shower a week, any extra you’ll need to pay for.)
If either parent is a Veteran of the Canadian Forces, there is also care provision available. Veterans Affairs also run assessments based on needs but they offer help under their VIP programme, for housekeeping and grounds maintenance, and also have an Attendant Care Programme. Contacting Veterans Affairs directly would be a good place to start in this instance.
Can I get free care support at home? You can, but your parent(s) will have to be assessed through CCAC, the Community Care Access Centre which is the government’s health agency in Ontario. They will arrange for a case worker to come and assess their needs and any ‘free’ care provision is based up on their report and recommendation. Be prepared though that this initial assessment appointment may take weeks to happen. Also, CCAC care in the home usually only covers personal support (bathing, dressing, grooming) and the most hours a week that you can get help with this is 15. That equates to one hour and seven minutes morning and evening. Getting the maximum 15 hours a week however is not common and more often it is three or four hours a week for bathing and personal care. If you do have a CCAC care giver come to help yet they need further assistance with other daily living needs, Home at Heart can help. Plus, Home at Heart will not have to charge HST on the services we provide in this case for they are exempt if you’re also receiving CCAC assistance.
If they have been receiving independence assistance, but you now feel they need more, is a retirement home a good option? Retirement homes are businesses too and unfortunately they can prove to be very expensive. However, they will offer peace of mind where everything is taken care of. Many also have diversified and offer assisted living which includes PSW care, help with meals, activities, day programmes and medication dispensing. There are many too that offer a nursing floor or a medical wing where those seniors needing more personalized care can be happily accommodated. Locked floors for dementia sufferers for instance are becoming increasingly widespread.
What Can I do NOW? Are your parents independent? Are they in their own home and can manage getting up, bathing and dressing? Would they benefit from some house-keeping assistance, or some fresh meal preparation? Can someone come and drive them to appointments, assist with groceries and shopping and generally provide some home support and companion care? If so, a company like Home at Heart would be a great addition, assisting with their daily living needs. Our care-givers can offer as much or as little is needed and increase services if the need arises. Our personal care and attention also means our carers become like family to you too.
Whilst any accident or emergency is never planned, being pro-active in care research will hopefully make any situation that presents itself easier to manage.
And then you’re forced to. Your mom falls in the bathroom and fractures her hip. Your dad is increasingly frail and his previously amusing forgetful episodes are now of real concern. As their child, this is your emergency too but you’re not able to provide any immediate care and you don’t know where to start in enlising the help or services of others. What’s available to you? What are the wait times? Do you need a doctor’s referral? How much will it cost? What will happen to dad while mom is away?
Your parents are aging. You can see that things are becoming difficult for them and you are trying your best to help. But you are being pulled in many directions; you still have a younger family, you’re working full time, you’re the after-school and weekend designated driver. You may have been thinking about talking to them about getting some extra support, but have never found the right time, or know how to broach the subject.
The need for additional care for your parent(s) could happen gradually or within hours if an emergency occurs. The next time you see them, plan to have the chat! Plan to ask them what and where they want to live if they’re unable to stay at home, and what they can afford. Plan to tour retirement residences or research LTC homes. And plan to contact CCAC and talk to them, if nothing else, about how you can plan for their future.
How Do I Register for LTC? In Ottawa, it goes again through CCAC. If you have already contacted them and are awaiting an assessment or have received notification of care, you will be assigned a case worker. Chat to them about the future and the long term care options. If you are past this stage, and your parent(s) need a more immediate placement, you can contact CCAC directly or speak to their family doctor who can provide a medical referral. Anyone can call CCAC and ask for an assessment or help – you do not need a medical referral – but often, the more health care professionals who are involved and who are all singing off the same proverbial hymn sheet, the better! CCAC will ask for three LTC homes that you would like for consideration and then you will be put on the list. Although CCAC will guide you through the LTC process, it’s still important for you to again go and meet staff at your chosen homes and get a feeling for the quality of care provision there. Although provincially regulated, service and quality will still vary! What is your first impression of the staff and the communal areas? The resident’s rooms? What is the quality of food like? What is the nursing/patio ratio for each floor? Is 24 hours nursing care available? What programmes are run for those who are mobility challenged/cognitively impaired? Is there feeding available if needed? Do residents all eat together despite their level of awareness and ability? Also make sure the residence meets the accreditation standards established by Accreditation Canada.
By Caroline Inman, founder of Ottawa based Home at Heart – Seniors Caregiving Solutions
If you are looking in to this option, be prepared for a wait! As mentioned above, wait times for a LTC bed are long. The average Ontario wait is 106 days and even for a crisis bed, the wait can be weeks. This is where the respite wings or assisted living/care facilities in a retirement home are very beneficial. If you can’t get an immediate LTC bed, then short term, your parent will be well looked after in a residence. However, bear in mind that if you are offered a bed at a LTC home and you turn it down because you feel your mom or dad are doing OK at that moment, you will have lost your place and your file will be closed for six months.
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