What is Long-Term Care?
The phrase ‘long-term care’ often comes across as a one-size-fits-all category. But the types, services and costs all vary widely, so do your homework before making a final decision.
By Esther Goldstein, B.Sc., B.S.W., RSW
Long-term care homes in Ontario (also called Nursing Homes) are for medically stable people who need 24/7 nursing care, support or supervision. In general, they provide more care and supervision than one would find in a retirement residence. There are more than 75,000 long-term care beds in Ontario.
Long-term care homes are mainly privately owned but some are not- for-profit and either owned by a cultural, ethnic or community organization (Charitable Homes) or a municipality/municipal council (Municipal Homes). Governed by the Long-Term Care Homes Act, 2007, they are licensed, regulated, inspected and funded by the Ministry of Health and Long-Term Care. The type of care they provide can include personal care, feeding, bathing, medication administration and attending to medical/nursing needs.
All homes usually provide basic room furniture (i.e. bed, side table, dressing table), linens, meals, hygiene and medical supplies and laundry services. Accommodation depends on when the home was built and/or renovated and ranges from basic/ward (which usually means 3 to 4 people per room) to semi (2 people per room) to private accommodation. Older homes tend to have more ward rooms while some newer homes were built with many more semi-private rooms. Subsidies are only available for basic accommodation for individuals who have a net income below $21,000.00/year. In this situation, the cost would be reduced so the individual would have a remaining ‘comfort allowance’ of $130.00/month. As of January 1, 2011 changes were made to the rate reduction rules which may impact previously ineligible individuals. For information on the rate reduction program you can visit
www.health.gov.on.ca/english/public/program/ltc/15_facilities_rate_reduction.html.
Long-term care homes usually have a dining room where meals are served, common areas and scheduled activities for residents. There is usually a doctor available with regular on-site hours. The provincial government sets the cost of all long-term care homes. The government pays the ‘care portion’ which goes directly to the home and the resident pays the room and board cost which is called the ‘co-payment’ and is based on pension rates. The home is entitled to charge the resident extra for some services (i.e. cable TV, phone, hairdressing). The co-payment rate as of July 1, 2010 is standard – $1,619.08/month; semi-private – $1,862.41/month; private – $2,166.58/month. The rates generally go up every July and can be verified with your local Community Care Access Centre (CCAC).
All long-term care home applications are submitted to and through the CCAC in your area. CCAC also coordinates the transfer of people to homes when a bed becomes available. There is no cost to apply. The applicant must be over 18 and have a valid health card. They must have care needs as per the criteria set out by the Ministry of Health and Long-Term Care that can be met in a long-term care home, in order to be eligible to enter a home. Once an application form is completed and submitted, CCAC will determine if the criteria is met. Some long-term care homes have very long waiting lists and a person can be on up to 5 waiting lists at any one time. When a bed on your list becomes available, it must be accepted or all of your applications will be cancelled. If this occurs you will have to wait 12 weeks to reapply unless your situation changes. Long-term care homes also offer the option of short-term respite care for up to 90 days/year. For a list of Long-term care homes in your area you can contact your local CCAC. To locate your local CCAC visit www.ccac-ont.ca or call 416-750-1720.
The Ministry of Health does conduct unannounced inspections of homes and has a hotline for consumers to report concerns. The phone number for the Long-Term Care ACTION Line is 1 (866) 434-0144. Inspector reports of Ontario long-term care homes are posted online at www.health.gov.on.ca/english/public/program/ltc/26_reporting.html (Public Reporting on Long-Term Care Homes). A new Quality Inspection Program is currently being phased in through the Ministry and the process is also documented through a link on the above website.
As with any situation where you are seeking out a new living situation for yourself or a loved one – especially one who might be in a vulnerable situation, you are strongly encouraged to investigate your options carefully before making a decision. Visit places, speak to residents and their families of homes you are interested in, view the reports online and talk to others going through the process. Often when people are at the point of making long-term care choices, they are doing so at the time of a crisis. This is truly a situation where being prepared in advance affords you far more choice and far better options. If you have concerns about how a loved one is coping, discussing it early on, is the first step to avoiding an emergency situation that can only result in limited choices and quick decisions that may not always result in an optimal outcome. In order to choose carefully you need time and an opportunity to research the available options. As difficult a process as it may seem, in the long run, having, taking and making the time to plan and investigate the appropriate resources for your loved one will be well worth your efforts.
Esther Goldstein, B.Sc., B.S.W., RSW, is a former acute care hospital social worker and the author of the Comprehensive Guide to Retirement Living®, now in its 14th edition. She also administers the affiliated national website www.senioropolis.com, and lectures on eldercare issues in various venues. For further information on this and other topics related to seniors and relocation, visit www.senioropolis.com.
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