When someone in your family is no longer able to live independently, one alternative is to move that person into a long-term care facility — but picking the right one can be a challenge. The following questions will help you find the facility that best suits your needs:

How much care is needed?

Long-term care facilities, assisted-living facilities and retirement residences provide a range of options for nursing, treatment and assistance with daily living. Long-term care facilities provide the highest level of care; retirement residences provide the lowest (although some have a long-term care or assisted-living wing or adjacent building for residents to move into should they reach a point where they require more care.) Determine what level of care is needed now, or may be needed in the future.

If you’re just looking for some help with meals, laundry and housekeeping, a retirement residence or assisted-living residence may be a better option than a long-term care facility. While it’s possible to get health care at a retirement residence, this will come with a cost and generally won’t include extensive, round-the-clock medical assistance.

What’s the timeframe?

If you’re dealing with a limited-time crisis, such as recovery from illness or surgery, a short-term stay could be just what the doctor ordered. Or perhaps you’re looking to give someone a break from caring for a loved one (or to take a break yourself). Most Canadian long-term care facilities offer short-stay, respite programs of up to 60 days, so consider that possibility if you’re just looking for temporary help.

What to ask when you visit a long-term care facility

Unlike retirement residences which, while subject to industry self-governance, are regulated only as rental apartments under provincial landlord and tenant acts, long-term care facilities — whether private or government-run — are closely regulated by provincial health ministries. They are all required to provide a certain standard of care, but beyond that, they may differ on details such as visitation policies, meals, optional extras, activities provided and communication with the administration.

And while literature can provide a great background for a given place, ultimately the most important thing you can do is observe the facility personally. Try to stay at least an afternoon or hang around over two different mealtimes to see what daily life is like.

  • How does the facility look and feel? Is it clean and well-maintained? Are the hallways and common areas bright and cheerful?Are there any strong odours? Are the accessibility features (handrails, ramps, etc.) adequate and in good repair? 
  • Are all required licences and accreditations up to date? Provincial operating licences should be current and prominently displayed, along with accreditation by Accreditation Canada (formerly the Canadian Council on Health Services Accreditation). You should also ask to see the latest annual inspection report and details of any follow-up actions taken.
  • What are the residents like? Do they look clean and well-cared-for? Talk to current residents and their family members out of earshot of staff to find out about their experiences.
  • What is the staff like? Speak with members of the staff. Is it easy to find a staff member to speak to? Are they cheerful and friendly towards the residents or do they appear stressed-out and overworked? If it’s the latter, you can expect the overall level of care to suffer.
  • How much input will you and your family have? The more control people have over their personal routines, the happier and less-stressed they’re likely to be. Are the residents treated as individuals, or are they subject to rigid group rules? What are the policies on complaints and resolving conflicts? Is there a residents’ council or other means of participating in decisions about life in the home?

Other important considerations

  • Location. Your loved one may prefer to stay in his or her current community or you may want him or her to move closer to you or other relatives, so it will be easier to visit and monitor the care being given.
  • Cost. While your provincial health insurance covers medical care received while living in a long-term care facility, it doesn’t cover the actual cost of living there. The fees are also regulated by the government and set for ward, semi-private and private level rooms. Subsidies are available; levels and eligibility criteria vary greatly from province to province, however, and there can be long waiting lists for subsidized nursing homes and home care. (Fees for medical care in retirement residence are set and residential services are not subsidized at all.)

According to the Canadian Life and Health Insurance Association’s Guide to long-term care insurance, the non-subsidized cost can range from $800 to more than $6,000 per month, depending on the province and type of room. Even with the maximum subsidy, the individual’s share of the cost can be considerable — as much as $1,619 a month for basic accommodation in Ontario, for example, according to figures from the Ontario Long Term Care Association.

Before you choose, remember that the most important considerations in long-term care are needs and wants of the individual who will be receiving that care — so be sure to pick a facility with that in mind.