Long-Term Care Homes vs. Retirement Homes vs. Home Care in Ontario
Ontario provides a lot of care options for seniors’ living arrangements, which means that it can take quite a bit of research to decide which option best fits your needs. To help you gather information and make better decisions, we’ve put together this guide about long-term care homes vs. retirement homes vs. home care in Ontario.
- Background
- Long-Term Care Homes
i) What is a Long-Term Care Home?
ii) Costs of Long-Term Care Homes in Ontario - Retirement Homes
i) What is a Retirement Home?
ii) Costs of Retirement Homes in Ontario - Home Care
i) What is Home Care?
ii) Costs of Home Care in Ontario
– Publicly Funded Home Care in Ontario
– Private Home Care in Ontario - Making the Right Choice
- Frequently Asked Questions
i) Long-Term Care Homes FAQs
ii) Retirement Homes FAQs
iii) Home Care Services FAQs - Conclusion
- References
Background
In Ontario, 17% of all people admitted to long-term care homes are assessed as having low, mild or moderate needs.[1] For these people, other options such as retirement homes or home care would have been more suitable, which would result in more free beds at long-term care homes and help shorten wait list time.
This is exceptionally important when about 40% of long-term care homes in Ontario are small homes—with 96 or fewer beds[2]—and when these beds are in such high demand. As of October 2017, there were nearly 34,000 people waiting for a bed in a long-term care home, with an average wait time of 143 days; that’s nearly 5 months![3]
Long-term care homes prove to be vital, especially when it comes to taking care of dementia patients or providing end-of-life care. However, some retirement homes also provide care for people with mild dementia, and home care can be an affordable option for palliative patients.
The question then becomes, which of these three types of living arrangements for seniors is the right choice? Let’s start by comparing long-term care homes vs. retirement homes vs. home care, while looking at the similarities, differences, costs, and frequently asked questions for each.
Long-Term Care Homes
What is a Long-Term Care Home?
A long-term care home, sometimes called a nursing home, is a place where seniors can live and receive help with their daily activities, such as eating or bathing. Long-term care homes also provide 24-hour nursing and personal care, and therefore are best suited for people who have difficulty directing their own care.
According to the Ontario Government website, to be eligible to live in a long-term care home, you must:
- be aged 18 or older
- have a valid Ontario Health Insurance Program (OHIP) card
- have care needs including i) 24-hour nursing care or personal care, ii) frequent assistance with activities of daily living, iii) on-site supervision or monitoring to ensure your safety or well-being
- have care needs which cannot be safely met through publicly-funded community-based services
- have care needs which can be met in a long-term care home
In Ontario, all applications and admission to long-term care homes are arranged by the Local Health Integration Networks (LHINs). If you’re interested in arranging care for yourself or a loved one in a long-term care home, you would start by following these steps.
Costs of Long-Term Care Homes in Ontario
In Ontario, the government covers the costs of all nursing and personal care while living in a long-term care home. What you need to pay for is the accommodation charges, such as room and board. You can also apply for a government subsidy of up to $1,848.73 per month.
Accommodation fees for long-term care homes vary depending on whether it’s a short stay or a long stay, and whether it’s for a basic, private, or semi-private room.
As of July 1, 2018, the maximum accommodation rates[4] (before any subsidies) in Ontario are:
Retirement Homes
What is a Retirement Home?
A retirement home is a privately paid residency for seniors who can direct their own care. This means that unlike long-term care homes, retirement homes are best suited for individuals who want an independent lifestyle but may need a bit more support with their daily living activities. Essentially, retirement homes provide a safe, comfortable, home-like environment.
Anyone can choose to live in a retirement home as long as the home is able to support their medical needs. Retirement homes don’t usually provide 24-hour nursing care, but they do need to provide at least two of the thirteen care services set out in the Retirement Homes Act. Some examples of these services include providing meals, assistance with bathing, providing a dementia care program, administering medicine, providing incontinence care, or making available the services of a doctor, nurse or pharmacist.
There are four main types of care services in retirement homes in Ontario:
- Independent Supported Living: Provides a home-like environment with the option to add extra care services as needed.
- Assisted Living: Provides a home-like environment with care services included in the service fee, such as dressing, bathing, grooming and medication. Additional services can be added if required.
- Specialized Dementia Care or Memory Care: More suitable for people with mild dementia; social, recreational, and fitness activities may be available to support dementia patients.
- Short Term Stays: Suitable for seniors who want to experience what it’s like to live in a retirement home, or for those discharged from the hospital and in need of extra support before returning to their home.
Costs of Retirement Homes in Ontario
Retirement homes in Ontario do not have public funding by the government the same way that home care services and long-term care homes do. This means that the cost of living in a retirement home can be much more expensive vs. the cost of home care services or living in a long-term care home.
The cost of living in a retirement home can vary depending on the type of accommodation and the number of care services provided. In Ontario, the cost of a private room in a retirement home ranges from $1,500 to $6,000 per month.[5]
Here are some examples of accommodation fees in Ontario retirement homes:[6]
Home Care
What is Home Care?
Home care refers to the act of having a care provider visit your home and offer healthcare related services. Home care services include personal support, home support, physiotherapy, occupational therapy, speech language pathology, social work, nursing, dietetics, and more.
Home care is a cost effective alternative to staying in a long-term care home or a retirement home. Individuals can remain in the comfort of their home, preserving their independence while still receiving the care that they need.
Home care can be short-term or long-term, from simple needs such as meal preparation, to more complex needs such as wound dressing or palliative care.
Costs of Home Care in Ontario
Home care in Ontario can be publicly funded by the government or paid for privately by an individual.
Most of the time, the government will cover at least part of the cost of home care services. In fact, figures from Statistics Canada show that 91% of households reported no out-of-pocket costs for home care nursing services, and 79% reported they didn’t have to pay for other home care services (physiotherapy, occupational therapy, speech language pathology, and nutrition counselling).[7]
However, the amount of publicly funded care might not be enough for all of your home care needs, so individuals often supplement by purchasing additional private care.
Publicly Funded Home Care in Ontario
Publicly funded home care in Ontario is coordinated by the LHINs, the government body that decides the level of care needed, as well as frequency. You can follow these steps to apply for publicly funded home care.
The LHINs, however, are just funders and coordinators, and do not actually provide the healthcare services directly. So, if you do qualify for publicly funded home care, the LHINs will assign a certain home care provider to your case, and that provider will then contact you to schedule a home visit.
Private Home Care in Ontario
Private home care is when an individual directly requests healthcare services from a home care service provider. This can be through a home care agency, or directly through an independent healthcare provider.
Individuals may require private care services if:
- They don’t qualify for publicly funded home care
- They want to add more hours or services to their publicly funded care
When paying for private home care in Ontario, you can choose to pay out-of-pocket, through private insurance, or through workplace benefit programs. The cost of home care will differ depending on the type of services needed and the company or individual providing the service.
For example, the average cost of a Personal Support Worker is $25 to $35 per hour, while a Nurse may cost $50 to $70 per hour, and certain therapy services can cost upwards of $100 per hour.
Making the Right Choice
Now that we’ve covered the basic differences between long-term care homes vs. retirement homes vs. home care, it’s time to decide which is most suitable for your needs. This will largely depend on your medical needs, living preferences, and finances, which is summarized in the table below.
Once you’ve decided which type of living arrangement you need, you should also consider some additional factors before making your final decision. For example, does the home/provider have accreditations and awards? How many years have they served your community? Do they have positive reviews and ratings?
Frequently Asked Questions
After you’ve decided whether a long-term care home vs. retirement home vs. home care is right for you, now you need to decide which home or provider to choose. Here are some frequently asked questions about long-term care homes, retirement homes, and home care providers to ensure you’ve considered all of the important factors before making a commitment.
Long-Term Care Homes FAQs
Is there a wait list for long-term care homes in Ontario?
Yes, there is almost always a wait list for long-term care homes in Ontario. The waiting times vary depending on the geography of the home and your individual needs, but average wait times for long-term care home in Ontario is between 4 and 5 months.
How do I make a complaint about the care I’m receiving in a long-term care home?
There are different complaint procedures depending on the urgency of the complaint. If the complaint is urgent, you should call the Long-term Care ACTION Line at 1-866-434-0144. If the complaint is non–urgent, you can report your concern directly to the home. For more information, refer to the long-term care home complaint process here.
What happens when a bed becomes available for me in a long-term care home?
When a bed becomes available for you in a long-term care home, a LHIN staff will contact you to let you know. You then have 24 hours to accept or reject the offer. If you accept the offer, you’ll need to move in by noon of the 5th day after accepting the offer.
What happens if I refuse a bed offer in a long-term care home?
If you refuse a bed offer, your application to all other chosen homes will be cancelled. In this case, you cannot re-apply for 12 weeks after the day you were removed from the waiting list, unless there is a significant change in your condition or circumstances.
If you’re already living in a long-term care home that wasn’t your first choice, you may choose to re-open a separate application the next day. In this case, there is no 12-week wait to re-apply; however, you will start at the bottom of the wait list.
How do I choose a long-term care home in Ontario that is best for my needs?
Choosing a long-term care home that best fits your needs can be a time consuming process. There are several factors to consider, including the quality of care that will be provided, choice of meal services, the activities offered to residents, the general atmosphere of the home, and more. For a complete list of questions to consider when looking for a long-term care home in Ontario, follow this sample checklist.
For more in-depth information about other Frequently Asked Questions for long-term care homes in Ontario, you can refer to this guide.
Retirement Homes FAQs
Is there a wait list for retirement homes in Ontario?
There’s often no wait list for retirement homes in Ontario. If you’re looking to move into a retirement home in Ontario, the process can be done rather quickly.
How do I make a complaint about the care I’m receiving at a retirement home?
The complaints procedure may differ depending on the individual retirement home. However, all retirement homes must have a complaints procedure in place and it must meet the requirements set out in the Retirement Home Act (2010). If you believe that your retirement home is not following the Retirement Home Act, you can file a formal complaint with the Retirement Homes Regulatory Authority (RHRA).
Do I have to sign a lease with my retirement home in Ontario?
Yes, if you are moving into a retirement home in Ontario, you will be required to sign a lease. Retirement homes provide rental accommodations, so you will be required to sign a lease according to the Residential Tenancies Act.
Can I bring my car to my retirement home?
Yes, most retirement homes offer parking accommodations. However, there may be additional fees for parking, so this is something that should be discussed prior to moving in.
Can I bring my pet to my retirement home?
The answer for this question will depend on the specific retirement home. Some retirement homes will allow you to bring your pet as long as you can take care of it; however, there might be some restrictions on the type or size of the animal.
What if I want to move to a different retirement home or to a long-term care home?
You can move at any time as long as you give the notice required under your lease.
What happens if I’m living in a retirement home but need to go to the hospital?
If your hospitalization results in higher care needs, you need to discuss these changes with the retirement home to see if they are able to accommodate these needs. There may be an increase in fees depending on the services required.
How do I choose a retirement home in Ontario that is best for my needs?
If you’ve decided that you want to live in a retirement home, you should start your research by following this list of questions. This will help you create a shortlist from your pool of retirement home options. After that, it’s recommended to book a tour in each home to get a feel of what the living environment is like, and what the home has to offer. You can bring this handy Checklist for a Retirement Home Tour with you while taking the tour.
Home Care Services FAQs
Is there a wait list for home care services in Ontario?
There’s often no wait list for home care services, but this can differ based on the region you live in and the service required. Typically, for both publicly funded home care and private home care in Ontario, you can expect to receive care immediately.
How do I make a complaint about the home care services I’m receiving?
This will depend on whether your home care is publicly funded or privately funded. For both public and privately funded home care, you can try talking directly with your caregiver or the home care agency. For publicly funded home care, if your concern is not resolved after contacting the home care agency, you can contact the LHIN, or make an appeal to the Health Services Appeal and Review Board.
How do I know what kind of home care services I need?
Whether you qualify for publicly funded home care or you are looking to pay privately for home care services, the LHIN or home care agency will have a care representative ready to conduct an initial assessment. From there, they can provide a recommendation and determine the services and support that you need.
Can I hire someone independently to provide my home care services?
Yes, you can hire someone independently to provide your home care services, and you may even be able to obtain a lower rate by hiring someone directly. However, there are several things to consider with this approach. You will have to handle payroll and taxes by yourself, as well as cancellations or rescheduling. It’s also difficult to make sure that you’re hiring a legitimate and experienced caregiver, and if you have any complaints, there won’t be a customer service department available 24/7 to speak with.
How do I choose a home care agency in Ontario that is best for my needs?
If you qualify for publicly funded home care, the LHIN will assign a home care agency to your case. If you are looking to pay privately for home care, you are free to choose any agency that you prefer. You can read our guide Home Care in Ontario: How to Choose a Provider That’s Right for You for more information about the process.
Conclusion
Hopefully, after reading this guide, you’ll be able to decide whether a long-term care home, retirement home, or home care is best for your needs. It’s perfectly fine to spend extra time considering the pros and cons for each of these three options. This is an important decision and you should make sure the option you choose is able to accommodate your medical needs and living preferences. Do lots of research, make your decision wisely, and age gracefully.
References
[1] https://www.homecareontario.ca/home-care-services/facts-figures/publiclyfundedhomecare
[2] https://www.oltca.com/oltca/OLTCA/Public/LongTermCare/FactsFigures.aspx
[3] https://www.oltca.com/OLTCA/Documents/Reports/ThisIsLongTermCare2018.pdf
[4] https://www.ontario.ca/page/get-help-paying-long-term-care#section-0
[5] https://www.ontario.ca/page/find-retirement-home#section-4
[6] https://nelliganlaw.ca/article/wills-and-estates/long-term-care-homes-retirement-homes-whats-difference/
[7] https://www150.statcan.gc.ca/n1/pub/82-003-x/2018009/article/00001-eng.htm