Long Term Care HomesLong Term Care Homes

Long-term care is a hot topic, and a complex one. As Canada’s senior population booms, the demand for nursing home care is outpacing the available facilities, which means wait times are a real and growing concern. Canadians also worry about how they will pay for long-term care, and the majority of Canadians (79%) don’t realize they will be expected to pay the room and board cost of long term care. If you’ve wondered what to expect if you need long term care or are researching LTC for a family member, here’s an overview of what’s available nationwide and in selected provinces.

What is long term care?

Long term care (LTC) is Canada’s program of skilled nursing home care for seniors who need more daily help and medical supervision than they can get at home, but who do not need to be in hospital. Unlike seniors in retirement living communities, supportive housing, or assisted living facilities, those in LTC require a high level of daily support, possibly including help with feeding, dressing, mobility, and medication management, as well as help with chronic, severe conditions such as advanced diabetes, heart or lung disease, dementia, and other illnesses.

Who runs the long-term care program?

Each provincial and territorial health ministry oversees the long-term care facilities within its boundaries. That includes licensing homes, inspecting them for quality and rules compliance, and setting room and board rates for residents. Health ministries and their care coordinators are also responsible for determining who’s eligible for LTC placement.

Who is eligible for long term care?

The LTC program is open to residents in each province or territory who hold a valid insurance card and exhibit certain needs. The biggest indicator that a senior needs LTC services is complexity of care. If you or someone you care for has a complicated medication, therapy, or other treatment regimen that must be followed carefully, LTC placement may be the best option. Likewise, seniors with dementia, mobility issues or balance programs who need constant supervision may do best in a long term care setting.

Seniors may also be eligible for long term care if they can’t find a home caregiver, have a home caregiver who’s retiring or changing jobs, or have behavioral issues (such as dementia-related agitation) and heavy care needs that are putting the caregiver’s wellbeing at risk.

What services are included in long term care?

Standard services in long term care homes include nursing and personal care available around the clock, an individualized healthcare plan that’s reviewed quarterly, medical and therapy services, hot meals, housekeeping and linen laundry, religious and social programs, and supplies for medical and personal care. You may be able to add extra services if you wish, such as a telephone landline, a cable television subscription, on-site salon services, and other amenities at additional cost.

What are the facilities like?

Long term care communities are structured to balance the need for privacy with social contact and group interaction. Each resident has a private or shared room with a bed, clothing storage, a chair, and a small table. Residents and their families are encouraged to personalize these spaces with small items from home, especially photos of family and friends, keepsakes, and blankets or throws.

Residents have access to a group dining room, recreation and TV lounge areas, and a chapel for meditation and worship. Individual LTC homes may offer other amenities such as on-site hair and nail salons, libraries, internet cafes, craft rooms, enclosed courtyards, special events rooms for family gatherings, and game rooms.

Who pays for long term care?

When you live in a long term care home, the medical and personal care services outlined in your personal health care plan are fully covered by insurance. You pay for any services not included in your plan. Residents and their families are also responsible for paying the facility’s monthly accommodation rate, which includes the room, meals, and housekeeping services. Accommodation rates are set by each health ministry and usually change each year to reflect changes in the cost of living. (Detailed information is provided below.) If you choose to add extra services like hair coloring, massage therapy not prescribed in your care plan, or transportation, you are responsible for those costs as well.

To support seniors and families who cannot afford the full accommodation fee, there are subsidies and rate reductions available based on income. See below for information by province (Ontario, British Columbia, and Alberta).

How do I apply for long term care?

If you’re already in a care setting like an assisted living facility, or if you are in hospital, the social workers on site can make a referral and help you with the application process. If you or a loved one are at home and need long term care, contact your local health authority or community care access centre (CCAC) to get started.

Be ready to provide detailed information about your health status, home situation, home caregiver availability, and income. Let the caseworker know if you are a veteran, because he or she will need to verify and coordinate your long term care benefits through Veterans Affairs Canada. And be ready to take notes or have someone else make note of information the caseworker gives you about LTC options and costs in your area.

How do I decide which LTC homes to apply to?

Once you’re approved for long term care, you or your family and friends should visit several homes in your area to find out which ones have the services and setting you prefer. Nature lovers, for instance, may prefer homes with a park view or a courtyard as opposed to towers in the city center. You can select up to 5 homes for your application list, and you’ll be moved in when one has an available bed.

If you have cultural or religious traditions you’d like to follow in long term care, ask your caseworker about ethnic long term care options in your area. In Toronto and other major cities, there’s a growing number of LTC homes that offer culturally competent care—including meals and language—for Chinese, Jewish, Russian, and Greek seniors as well as for many other European, Caribbean, and Asian ethnic groups. Long term care facilities that offer culturally competent services to Aboriginal seniors are harder to find; your caseworker or your region’s First Nations and Inuit Health Branch executive can let you know what’s available.

How long can I expect to wait for placement?

Wait times depend on several factors, including the number of LTC beds in your area and the homes you select for your application list. Priority is given to seniors who need immediate care, those with spouses or partners who are already living at a particular LTC home, and seniors requesting ethnic or religious long term care. It’s a good idea to factor in wait times when you’re selecting the LTC facilities for your list.

What if I don’t get placed in my first choice facility?

Once you are in a long term care home, you can ask your caseworker or a social worker at the home to help you get your name on a transfer list to the facility you’d prefer. As with your original placement, there may be a waiting list. If you decide to take your name off the list later on, let your care team know you’ve changed your mind.

Ontario long term care placement

Seniors with a valid Ontario Health Insurance Plan card, their caregivers and their healthcare providers can begin the application process by getting in touch with the local Community Care Access Centre, which processes all LTC placements. The provincial health ministry recommends that seniors and their families visit multiple LTCs in their area using a checklist to make comparisons and decision-making easier.

Pro tip: you can search a full directory of Ontario long-term care homes and read reviews on SeniorAdvisor.com – get started here. For a helpful checklist (including a printable version) to take along with you, click here.

As of September 2015, Ontario LTC accommodation costs are currently set at a maximum of $1,775 per month for basic accommodation, $2,140 for a semi-private room, and $2,535 for a private room. Income-based subsidies are available to seniors who cannot afford the basic accommodation rate. Your care coordinator can help with the subsidy application process, and you can apply for a subsidy later if your income decreases after you move into the LTC facility.

Wait times across the province vary. Each CCAC posts long-term care wait time information on its site, including recent wait times for each LTC in its service area. For example, the Toronto Central CCAC lists basic-accommodation wait times ranging from 6 to 908 days among its 36 long term care homes.

British Columbia long term care placement

Long term care applicants in BC must be Canadian citizens, permanent residents, or temporary resident permit holders who have lived in the province for at least 3 months. Referrals can come from your physician or another healthcare provider, or you or a family member can talk to your local home and community care office to begin the process.

BC Health recommends that before your eligibility assessment, you or a family member gather your health or services card, the contact information for your doctor (or doctors), emergency contact information for a family member or friend, a list of all prescription and over the counter medications you take, income and pension figures, and income tax or assessment notice documents.

The ministry also recommends that you have a friend of family member with you to help with note-taking and information-gathering; it’s also a good idea to write a list of your questions before the assessment so you can recall them during the interview. Once you’re declared eligible, you can visit area LTC homes and choose up to 5 homes to apply to. As with LTC services in Ontario, your placement priority will depend on several factors, including your overall health, the home care that’s available to you, whether you’re at risk of (or have experienced) abuse or neglect, and your caregiver’s wellbeing.

Pro tip: you can search a full directory of Ontario long-term care homes and read reviews on SeniorAdvisor.com – get started here. For a helpful checklist (including a printable version) to take along with you, click here.

Accommodation rates in BC in 2015 are based on a percentage of your after-tax income, and they run from a minimum of $991 per month to a maximum of $3,158. (Discounted rates are available for married couples sharing a long term care room.) For seniors whose after-tax yearly income is less than $19,500, the monthly rate is set at the annual income minus $3,900 and divided by 12. Those with incomes over $19,500 after taxes can determine their rate by multiplying their income figure by 80 percent and dividing by 12.

Alberta long term care placement

Alberta residents with a valid Alberta Health Care number or pending Alberta Health Care coverage are eligible for LTC placement. You can get a referral from your primary care doctor, the Home Care Program in your area, or by contacting Health Link Alberta at 811.

Alberta Health Services covers the cost of the services outlined in your healthcare plan. Maximum accommodation rates for 2015 are $1,554 per month for a standard room, $1,638 for a semi-private room, and $1,893 for a private room. Those rates are projected to rise in 2016 by 3% or by the increase in the Alberta Consumer Price Index, whichever is larger. Partial and total subsidies for the accommodation rate are available to Alberta Seniors Benefit recipients and those who receive Assured Income for the Severely Handicapped. For information based on your situation, contact the Alberta Supports Seniors program.

Pro tip: you can search a full directory of Ontario long-term care homes and read reviews on SeniorAdvisor.com – get started here. For a helpful checklist (including a printable version) to take along with you, click here.

If you live in another part of Canada, contact your regional health ministry, your doctor, your tribal government, or the local senior centre for help finding care and navigating the LTC application process. Make sure to take careful notes, ask all the questions you have, and provide as much information as possible to ensure you get the care that’s best for you or your loved one. Making the move to a long term care facility is a major transition that takes time and effort, but LTC around the clock care and medical supervision can provide better health and peace of mind for you and the people you love.

Casey Kelly-Barton is an Austin-based freelance writer whose childhood was made awesome by her grandmothers, great-grandmother, great-aunts and -uncles, and their friends.

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