In Canada, long term care is required for seniors and others needing access to 24-hour nursing care and daily support services for an array of physical and/or cognitive conditions. Long term care residents are assessed, and deemed eligible, by social service agencies run at the provincial level. People in the later stages of dementias such as Alzheimer's are among those who require this level of care, as well as those with physical or behavioral problems that render them dependent. In general, long term care is the proper solution for those assessed by medical professionals as needing constant monitoring, nursing supervision or other highly specialized care that cannot be met in their own homes, or by other health services. In select regions throughout the country, there are often waiting lists for these facilities.
Provinces across Canada, including British Columbia, Albert and Ontario, fully fund medical and support services in long term care. Residents are responsible for paying accommodation charges. People assessed by a medical professional as having complex care needs that cannot be met in their own home or by other housing and health services are eligible for long term care. This offers a protective environment staffed by medical and nursing professionals.
Long term care (sometimes abbreviated LTC) will often include a personalized plan of care prepared for each resident. Clients in care receive 24-hour nursing and personal care, with access to a physician or other health-care professionals. Facilities are dedicated entirely to detailed care and are secured for optimal patient safety, medication administered by trained staff and a number of other high level features.
In a number of regions across Canada, waiting lists can be months or even years long. Those in need can avail themselves of other care while they wait, including memory care facilities or assisted living facilities. In some cases, long term care is offered in the same residence or retirement community as other types of care lower on the care continuum. Various short-term stay programs are offered by retirement homes listed here.
When you have, or your loved one has, been assessed as needing long term care, and you begin your search, there are a number of factors to bear in mind. Ideally, you have discussed this before, either with the loved one or within your family, and you know where you want to go and you know what some or all of your options are. Unfortunately, this is not the case for many families, and the situation may be imperative. Any perceived urgency should never cloud your judgement, though; take time to explore your options as a fully as the situation allows for, or as you have time to.
The quality of care offered varies from one facility to another, both within the realm of for-profit and not-for-profit sectors. When you check into the quality of homes, you may read reviews, which can certainly offer some helpful guidelines. Bear in mind, though, that some negative reactions may come from the fact that people's expectations of care staff and their abilities may be too high.
Here are some important things to bear in mind as you begin the search for long-term care:
Ideally, talk about preferences while your loved one's cognitive abilities are still intact. If your loved one is in the early stages of dementia, then get answers from them as soon as possible, when they are optimally lucid. Perhaps even record them, so you remember them later.
On-site tours allow you to get a good "feel" of the community and range of services offered there. Take our checklist, add your own notes and questions. Bring a close relative or a friend — several sets of eyes are better than one.
These are still called "nursing homes"
Long-term care is the preferred term for communities that provide comprehensive personal, medical, and emotional support. That said, it’s more than just terminology. Nursing homes were places that operated, historically, within a specific model, often without attention to needs beyond those that were medically required.
Contemporary long-term care residences have grown away from a hospital model, directly countering the clinical impression many people have. Communities strive to provide a variety of lifestyle options, health services and amenities to make every resident feel safe, welcome and fully supported through any challenges they may be facing. Staffing ratios are high, as is an attention to very personal, consistent care and companionship.
Retirement homes are no different from long-term care homes
There is a world of difference. Long-term care homes are part of our publicly funded and regulated health-care system; retirement homes are a housing option for seniors, and include independent living. Admission to a long-term care home is based on assessed medical need, while retirement living is often a matter of personal choice and resources. People sometimes move into a retirement home because they no longer wish to cook for themselves, drive, or live alone. The move into long term care is more likely based on medical requirements.
Long-term care is not well regulated
With a regulatory framework that includes more than 400 care and service delivery criteria, unannounced annual inspections, a public complaints hotline and a website that identifies each home's compliance and complaint record, long-term care is our most heavily and publicly regulated health care service.
Long-term care services are delivered by a team of health care professionals. The concept of home is pervasive. Residents and their families participate in care planning, and in the life of the home through resident and family councils.
In Ontario, you can discover this reality from a variety of sources. These include Community Care Access Centres and the Ontario Ministry of Health and Long-Term Care website. As well, the website of the Ontario Long Term Care Association contains contact information for over 420 member homes and a checklist for consumers to help find the right fit in choosing a long-term care home. Most importantly, visit a long-term care home to see for yourself.
Putting my loved one into long-term care is going to break the bank
Nobody is refused access to long-term care because of financial difficulty. A government subsidy, based on an income test, is available for residents unable to afford the full amount of the resident co-payment for basic accommodation, currently less than $50 per day.
Compiled with the assistance of the Ontario Long Term Care Association (OLTCA), the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS: re-branded as AdvantAge Ontario, as of 2017), the Ministry of Health and Long-Term Care, and Statistics Canada.