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Care & Support - Housing Options

  • 1) Available housing options
  • 2) Supportive Housing
  • 3) Retirement homes
  • 4) Long term care homes
  • 5) Deciding to move into a long term care home and choosing a home
  • 6) Preparing to move into a long term care home

1) Available housing options

It is a good idea to think about your options for housing and accommodations early in your journey with Alzheimer's disease or a related dementia. This will give you some time to have discussions with your family and friends and will relieve some of the stress of decision making for both persons with dementia and their family members.

As your journey progresses, you may find you require more assistance in living with dementia.  Several care and housing options(1) you can explore include:

  • Supportive housing
  • Retirement facilities
  • Long term care homes

 

Frequently Asked Questions

What should I do if I am considering moving into a long term care home or other type of housing?
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If you are considering moving into a long term care home, or any other type of housing (e.g., supportive or retirement), it would be a good idea to visit multiple homes first. Ask a family member or a friend to go with you. When considering different housing options, it is important to familiarize yourself with policies related to applying for care and housing options, since government regulations often change.

Long term care home placement in Ontario is coordinated through the Community Care Access Centre. In order to qualify for a long term care home, you must meet the following criteria(2):

  • Be 18 years of age or older
  • Have a valid Ontario Health Card
  • Have health care needs that cannot be met with any combination of caregiving, care in your home or care in your community
  • Have health care needs that can be met in a Long-Term Care Home

For more information, please visit the Community Care Access Centre website.

The Ontario Ministry of Health and Long-Term Care website contains detailed information on helping you determine what types of care and housing you need, the types of long term care home services available along with costs, and eligibility requirements. You can visit their website for more information. Each province will have its own policies and regulations around long term care homes. Please visit the Ministry of Health and Long-Term Care website for your own province.

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Sources:

The information above comes from the following source(s):

(1) Ontario Ministry of Health and Long-Term Care. (2011). Seniors' Care: Home, Community and Residential Care Services for Seniors. (c) Queen's Printer for Ontario. Retrieved from http://www.health.gov.on.ca/english/public/program/ltc/ltc_mn.html

(2) Ontario Association of Community Care Access Centres. (n.d.). Eligibility and Admission. Retrieved from http://www.ccac-ont.ca/Content.aspx?EnterpriseID=15&LanguageID=1&MenuID=23

Helpful Links and Resources

Title of Resource What it Offers? Access to the Resource
Community Care Access Centre Information about long term care homes in your area and the application process Website: www.ccac-ont.ca/ or Telephone: 310-2222
Ontario Ministry of Health and Long- Term Care Information on determining what types of care you need; describing the types of long term care services available in Ontario along with costs; and eligibility requirements http://www.health.gov.on.ca/en/ public/programs

2) Supportive Housing

Supportive Housing is intended for people who want to live independently and only need minimal to moderate support (e.g., homemaking or personal care and support). Accommodations usually consist of rental units within an apartment building. Accommodations can also be in a small group residence.

Frequently Asked Questions

How do I know if supportive housing is right for me?
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Supportive housing is a good option if you are looking for(1):

  • Your own apartment near other people who have similar lifestyles and/or social interests
  • Rental housing with possible government rent-geared-to-income subsidy
  • Government-funded personal care services
  • 24-hour availability of personal care and support
  • Other optional services (e.g. meals or social activities)

What accommodations are available in supportive housing?
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Singles or couples can live in fully equipped bachelor, or one or two bedroom apartments. In some buildings all of the residents are receiving care, whereas in others, only a small number of residents receive care.

Most supportive housing offers amenities such as meeting rooms, lounges and tuck shops. This housing is sometimes located on the grounds of a long-term care home, allowing tenants to take advantage of some of the programs offered by that home(2).

What services are available in supportive housing?
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Services typically include on-site personal care and support such as routine hygiene, dressing and washing, daily visits or phone check-ins and can include services like shopping, meals, and transportation.

Residents can also apply for visiting health professional services through the Community Care Access Centre if required(2).

What is the cost of supportive housing?
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Accommodation costs are based on market rent for similar apartments. They can range from $600 to $1200 per month. If you are eligible, the government may subsidize your rent so that you only pay up to 30% of your household's monthly income. To be eligible for a rent subsidy, you must be a Canadian citizen, landed immigrant or refugee claimant. If you own your own home and apply for a rent subsidy, you are obliged to sell it within six months of moving into supportive housing. Local governments may set additional eligibility requirements for rent subsidies. There is usually a waiting list for subsidized units.

Personal care and support costs are funded by the Ministry of Health and Long-Term Care. You may have to pay an additional fee for optional services such as transportation, recreational outings or hairdressing(2).

How is supportive housing regulated?
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The housing portion of supportive housing is covered by the Residential Tenancies Act, 2006. If you move into supportive housing, the provider becomes your landlord. In some cases, the service portion is funded by the Ministry of Health and Long-Term Care (MOHLTC) and is covered by the Home Care and Community Services Act, 1994. In such cases, quality is monitored by the MOHLTC(2).

How do I apply for supportive housing?
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You can apply directly to the supportive housing provider (e.g. municipal housing authority or individual landlord) that you have chosen. Your local Community Care Access Centre (CCAC) can get you started by providing you with a list of supportive housing providers in your area, information about the eligibility criteria and, if applicable, the waiting times(2).

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Sources:

The information above comes from the following source(s):

(1) Ontario Ministry of Health and Long-Term Care. (2011). Seniors' Care: Residences Offering Care. (c) Queen's Printer for Ontario. Retrieved from
http://www.health.gov.on.ca/en/public/programs/ltc/12_residential_mn.aspx

(2) Ontario Ministry of Health and Long-Term Care. (2011). Seniors' Care: Supportive Housing. (c) Queen's Printer for Ontario. Retrieved from http://www.health.gov.on.ca/en/public/programs/ltc/13_housing.aspx

Helpful Links and Resources

Title of Resource What it Offers? Access to the Resource
Community Care Access Centre Information about long term care homes in your area and the application process Website: www.ccac-ont.ca/ or Telephone: 310-2222
Ontario Ministry of Health and Long- Term Care Information on determining what types of care you need; describing the types of long term care services available in Ontario along with costs; and eligibility requirements http://www.health.gov.on.ca/en/public/ programs/

3) Retirement homes

Deciding whether a retirement home is right for you will be easier if you consider some key questions.

  • How much help do I need with everyday tasks (e.g., bathing, dressing, or cooking)?
  • How much can I afford to pay for accommodations?
  • Do I need access to regular nursing care?
  • How much independence is reasonable?

A retirement home might be a good option for you if you do not need regular nursing care, prefer to live independently and can afford to pay for your accommodations. Below are some frequently asked questions about retirement homes.

Frequently Asked Questions

How will I know if a retirement home is the right place for me?
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Retirement homes usually offer a shared bedroom option, or a bachelor, one-bedroom or two-bedroom apartments to choose from. A retirement home might be the right place for you if:

  • You need minimal to moderate support
  • You can pay for your own care
  • You need some help with daily living activities
  • You would like to live with a roommate or in a bachelor, one-bedroom or 2 bedroom apartment
  • You would like the option of having a dining room, common area, lounge, library or a garden, swimming pool or a room for social events
  • You would like to have the option of common meals, housekeeping, laundry, or  recreational and social programs
  • You like to take extended vacations

Who manages retirement homes?
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Retirement homes are not regulated by the Ministry of Health and Long-Term Care however; the Ontario Residential Care Association (ORCA) does set standards for retirement homes in Ontario. If you move into a retirement home, the owner of the retirement home becomes your landlord. The accommodation and food preparation in retirement homes are regulated by the Health Protection and Promotion Act. All the kitchen facilities are inspected by the Public Health department and there are standards set by the provincial government for retirement home performance.

For a list of retirement homes in Ontario and other provinces in Canada, please visit http://torontoretirementhomes.com/ or www.senioropolis.com).

How can I apply to live in a retirement home?
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You can apply directly to the retirement home of your choosing. The Community Care Access Centre can also get you started by providing a list of retirement homes in your area.

What happens next if I choose to move into a retirement home?
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Several things will occur once you decide to move into a retirement home.

  • The retirement home may conduct an assessment to see how much support you need and if they can accommodate you.
  • The retirement home must provide you with a lease or a 'Written Tenancy Agreement' that outlines the rent you will pay and a Care Home Information Package (CHIP)
    • These two documents will describe your accommodation, and service package, fees for services, the home's staffing levels and qualifications, the emergency response system, and the complaints procedure.
  • You should sign the Care Home Information Package before you move in.

What happens if I need to move out of the retirement home?
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If you are hospitalized for a long period of time, or require more care than the retirement home can offer, in accordance with the Tenant Protection Act , you must give 60 days' written notice before leaving your accommodations.

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Source:

The information above comes from the following source(s):

(1) Government of Ontario. (1999). A Guide to Advance Care Planning. (c) Queen's Printer for Ontario, 1999.

Helpful Links and Resources

Title of Resource What it Offers? Access to the Resource
Community Care Access Centre Information about long term care homes in your area and the application process Website: www.ccac-ont.ca/ or Telephone: 310-2222
Toronto Retirement Homes Canada's long term care home service portal http://torontoretirementhomes.com/
Senioropolis (seniors virtual community for Canadians) Provides information and support to seniors in Canada related to housing options, financial www.senioropolis.com
Ontario Residential Care Association (ORCA) Sets standards for retirement homes in Ontario http://www.orcaretirement.com/
Tenant Protection Act, 1997 Regulations for tenancy in Supportive housing and Retirement homes http://www.e-laws.gov.on.ca/html/repealedstatutes/

4) Long term care homes

The idea of moving to a long term care home often ignites fear in those affected by dementia. Yet, in many instances, the care one receives in a long term care home can ensure the health and safety of persons with dementia in later stages of the disease and reduce the stress some care partners experience in their care roles.

Moving to a long term care home is a good option for you if you need more help with your daily living tasks, and prefer living in a secure setting with nursing care available to you 24 hours a day. There are a number of services offered by a long term care home including:

  • Furnishing
  • Meals
  • Housekeeping
  • Medical and personal care
  • Activities

Frequently Asked Questions

What is a long term care home?
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A long term care home is for people who need the availability of 24-hour nursing care and supervision. It is also for people who would like to live in a secure setting. Those interested in moving to a long term care home must first be assessed for eligibility through the Community Care Access Centre.

Who owns long term care homes?
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Although the Ministry of Health and Long-Term Care funds and also regulates long term care homes, the homes are owned by various organizations including:

  • Nursing homes operated by private companies.
  • Municipal homes for the aged built and owned by municipal councils who may be required to build facilities to support older adults.
  • Charitable homes owned by non-profit corporations (for example, faith, community, ethnic or cultural groups).

Who regulates long term care homes?
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The Ministry of Health and Long-Term Care sets standards for care and inspects homes annually. The Ministry also sets rules about eligibility and waiting lists. All homes must post and follow a Resident's Bill of Rights. The Ministry of Health also encourages homes to get accredited by Accreditation Canada.

What kinds of accommodations are offered in a long term care home?
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here are several types of accommodations offered in a long term care home. The fee for a long term care home, which is standardized across the province, is based on the type of accommodations you choose. They include:

  • Private or semi private accommodation (a private room with special features)
  • Basic or Standard Accommodations (various style depending on when the home was built)

All long term care homes have dining rooms and common rooms and may also have features such as a lounge, gift shop, beauty salon/barber shop, chapel and garden.

What services are provided in a long term care home?
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All long term care homes provide 24 hour supervision and nursing care. The basic package includes the following services:

  • Furnishings (e.g. bed, chair)
  • Meals (including special diets)
  • Medical/clinical supplies and devices (e.g., walkers, wheelchairs)
  • Housekeeping services
  • Pastoral services
  • Social and Recreational programs
  • Medication administration
  • Assistance with the essential activities of daily living
  • Nursing care and access to a physician and other health professionals

Optional services include: hairdressing, cable TV, telephone services and transportation

How will I know which long term care home services might be appropriate for me?
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A long term care home must prepare a "plan of care" for each resident outlining which services are needed for you. These plans should be developed in consultation with the resident and/or family partner in care. The plan must be reviewed at least every three months and adapted as your needs change.

How long can I stay in a long term care home?
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Long Stay refers to accommodations obtained for as long as a person requires care. In most cases, those that apply for a long term care home are applying for long stay.

Another less common option provided by long term care homes however is Short Stay, which refers to a temporary stay at a home. The maximum number of days a person can stay per year is 90 days. Short Term Stay is also divided into two categories:

  • Respite care can provide a break for care partners
  • Supportive care provides you with support to regain strength after a hospital stay

What does it cost to live in a long term care home?
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The Ministry of Health and Long-Term Care provides funding for care homes. The amount that you will have to pay is called a "co-payment". The co-payment rates are standardized across the province, meaning that you pay the same amount for the same services regardless of the long term care home. For those who cannot afford a long term care home, there is an option for financial support.

For the most up-to-date information on the cost of long term care home and subsidy options, contact your local Community Care Access Centre.

How will I know if I am eligible for a rate reduction for the cost of long term care home accommodation?
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If you require some help to pay for your accommodations, there is a subsidy available to reduce your costs. Subsidies are not available if you are staying in preferred accommodations (e.g., private or semi-private).

If you are moving into a long term care home and your spouse requires financial assistance to remain in his or her home, there is a government benefit called the "Exceptional Circumstances" for people with lower incomes or couples who have to live separately. The Community Care Access Centre can provide you with information about this benefit.

How can I apply to a long term care home?
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All applications to long term care homes are coordinated by your local Community Care Access Centre. Once the Community Care Access Centre determines your eligibility (see eligibility requirements above), the next steps are:

  • Review the list of homes available in your area provided by your local Community Care Access Centre
  • Visit the home(s) you are most interested in
  • Choose the home(s) you wish to apply to
  • Apply to the CCAC for residential care in the home(s) you are most interested in (you can apply to a maximum of three homes)

If you require a "short-stay", or if you need to be admitted to a long term care home immediately, than this process will be different. Please contact your local Community Care Access Centre for information.

After visiting a number of homes and deciding which are best suited for you, and you apply through CCAC, it becomes a waiting game. When a bed becomes available in one of the homes you have selected, you will be contacted by your Case Manager at CCAC and offered the bed. At that time you will have 24 hours to make a decision. You then have 5 days to move in to the long term care home.

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Source:

The information above comes from the following source(s):

(1) Government of Ontario. (1999). A Guide to Advance Care Planning. (c) Queen's Printer for Ontario, 1999.

Helpful Links and Resources

Title of Resource What it Offers? Access to the Resource
Community Care Access Centre Information about long term care homes in your area and the application process Website: www.ccac-ont.ca/ or Telephone: 310-2222
Ontario Ministry of Health and Long- Term Care Information on determining what types of care you need; describing the types of long term care services available in Ontario along with costs; and eligibility requirements http://www.health.gov.on.ca/en/public/ programs/
Long-Term Care Homes Act Regulations for long term care homes in Ontario http://www.e-laws.gov.on.ca/html/statutes/

5) Deciding to move into a long term care home and choosing a home

Making a decision about moving from community living into a long term care home can be challenging. However, there are some things that you can think about to make your decision easier. Some questions you might want to ask yourself are:

  • Am I having difficulty with toileting?
  • Am I having difficulty with walking around the house?
  • Do I have more disturbed sleep than usual?
  • Do I find myself having angry outbursts more often?
  • Do I need more help with washing or bathing?
  • Am I having difficulty eating properly or preparing meals?
  • Do I have health issues that might be better monitored in a long term care home?(1)

If you are answering yes to the majority of these questions you may want to discuss long term care home options with a family member, friend or health practitioner. You will also need to contact the Community Care Access Centre to find out if you are eligible for placement in a long term care home.

Frequently Asked Questions

As a person with dementia, what are signs that it may be risky to stay in my own home?
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If you are a person with dementia and are worried staying in your home is dangerous, despite all of you and your family member’s efforts to ensure that safety measures are in place (see Safety section of the website for how to be safe in your home and in the community) and you are accessing all the community supports that are available to you (see Community Supports and Services section of the website), you may want to consider a move to a long term care home. Some signs to watch out for include:

  • Fires from cooking or smoking
  • Falling when you are alone
  • Getting lost
  • Taking your medications incorrectly
  • Physically hurting others
  • Not eating or drinking when you should
  • Becoming socially isolated, feeling more forgetful and frightened
  • Having symptoms that are difficult to manage, like problems with bowel or bladder control, or diabetes(1)

If you are experiencing some of these warning signs or risks, you might want to talk to a care partner or family member about increasing community supports at home, or your long term care home options.

As a care partner of a person with dementia, how will I know when my care role is more than I can handle, and I need to talk with my family about other housing options, for example, long term care home?
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As a care partner, there are certain signs you can look out for as you make decisions with your family member or friend. If your family member needs more help with daily tasks and/or is becoming a risk to themselves because of accidents, taking medication incorrectly, or wandering outside, it might be time for you both to consider a long term care home option.  This would also be a good time to consider how you are feeling as a care partner. Questions to ask yourself includes:

  • Can any of the extra care required be addressed with community supports or services?
  • Can any of the risks my family member poses to themselves be reduced with a community support or service?
  • How physically well am I?
  • Am I showing signs of depression (feeling helpless and hopeless; losing interest in activities; experiencing changes in appetite or weight; sleeping patterns have changes; feeling angry or irritable; having no energy; engaging in self-loathing; engaging in reckless behaviours; having problems concentrating; experiencing unexpected aches and pains)?
  • Has my health changed over the past few months?
  • Are the legal decision makers and my family in agreement with the long term home care placement options?
  • If needed, is my family member or the family able to pay for additional community services or supports?
  • Is my family member's house suitable to their physical abilities?
  • Is the house accessible?
  • Is there a crisis plan or back up plan in place for my family member?(1)

If these questions raise any worrying issues for you, it might be time to have a conversation with your family and your health care professional about living options for the person with dementia for who you care.

The move to a long term care home is always a better experience when the person with dementia is involved in the decision making process. This may not always be possible but family care partners should try their best to include the person with dementia in the process. Ensuring the person with dementia is supported emotionally throughout this process is also important.

Be aware that you will need to ensure that all of the proper legal documents are in place to have conversations with other health professionals about the care of your family member living with dementia (see Planning Ahead section).

As a person with dementia, what questions should I ask when I visit a long term care home or retirement home to help me determine which three long term care homes to apply to?
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Determining if staff is interacting with residents in a caring and respectful way will be important in your search for a home that will be right for you. There are several questions you should ask to determine if a residence is Alzheimer or dementia-friendly, such as (Questions to determine if home is dementia friendly PDF) / (Questions to determine home preference PDF):

  • Are staff trained to care for people with Alzheimer's disease and other related dementias? What training do they receive?
  • Can I walk safely indoors and outdoors?
  • Does it have a home-like environment?
  • Does it focus on my personal needs? How does the home learn about and meet my personal needs?
  • Can it accommodate my personal preferences for food, routines and activities? How does it do this?
  • Is there an operating resident counsel? How often does the counsel meet? How is the counsel supported by the home?(2)

What questions should I ask to find out what medical care is provided at a long term care home?
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There are several questions you should ask to find out the kinds of medical care provided. Some examples include (Questions to determine home preference PDF):

  • If possible, can I continue to see my own doctor after I move?
  • Is there a doctor on call?
  • How often does the doctor visit the home?
  • Can I meet the doctor?
  • How are medical emergencies handled?
  • Is there a registered nurse on duty for 24 hours?(2)

What other questions should I ask a long term care home before making a decision on your long term care home preferences?
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You may also want to consider asking questions surrounding the specific types of care they can provide for you, as a person living with dementia (Questions to determine home preference PDF).

  • Can I choose my own menu?
  • Can I bring my pet with me?
  • Can I bring my own furniture with me?
  • What is the schedule for activities?
  • What are the guidelines for having visitors?(3)

There are also several practical things you might want to find out before making a decision on which long term care home to consider:

  • Find out about electrical outlets, cables and telephone access in resident rooms
  • Ask if there are rules about bringing in food or drink when you visit
  • Ask the staff for a list of items that your family member can bring to the home. This will help you to know which items to label before the day of the move. Items may include:
    • Clothes, shoes, toiletries, bedspread, furnishings, assistive devices, photos, pets, wall hangings
  • Find out if the home prefers to put their own labels on clothes, since their labels might stay on better in washers and dryers
  • Find out if there is a special and secure place for belongings (e.g., photographs and mementos)
  • Ask about storage space for seasonal clothing(4)

Other things you might want to consider doing before the day of the move include:

  • Making a list of assistive devices that your family member uses and will be taking with them (e.g., wheelchair, walker, cane, glasses, hearing aid, dentures and current medications)
  • Decide what to do with items that are not being taken to the long term care home(4)

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Sources:

The information above comes from the following source(s):

(1) List adapted with permission from Ward- Moser, S. (2009). Moving to a Home?...Next Month?...When is it Time?, in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.

(2) List adapted with permission from Alzheimer Society of Canada. (n.d.). Shared Experiences: Suggestions for those with Alzheimer Disease. Toronto, Ontario, Canada: Alzheimer Society of Canada.

(3) List reprinted with permission from Alzheimer Society of Canada. (n.d.). Shared Experiences: Suggestions for those with Alzheimer Disease. Toronto, Ontario, Canada: Alzheimer Society of Canada.

(4) List adapted with permission from from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the Move into Long-Term Care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.

Helpful Links and Resources

Title of Resource What it Offers? Access to the Resource
Community Care Access Centre Information about long term care homes in your area and the application process Website: www.ccac-ont.ca/ or Telephone: 310-2222

6) Preparing to move into a long term care home

Preparing to move into your new home can be an exciting yet stressful transition. Be sure to write down any questions you have about your care for the staff in the long term care home. It might also be a good idea to write a 'Personal Care Book' either on your own or with help from a care partner. This book can be given to the staff at the long term care home and will help them to get to know your likes and dislikes.

Some other things to think about before moving into a long term care home are:

  • Notifying family and friends about your address change
  • Ensuring you have all your documents collected (health card, personal identification, bank card)
  • Arranging transportation on the day of your move
  • Surrounding yourself with family and friends who will support you during this time of transition

Frequently Asked Questions

What should I do while I am waiting for the bed offer from a long term care home?
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It is a good idea to prepare for your move in order to reduce your stress. Preparing early will also help you to have more free time later to spend with your family and friends after you move.

One suggestion is to complete a 'Life Story' or a 'Personal Care Book'. A 'Life Story' or 'Personal Care Book' is like a biography and can be very simple. You can include:

  • Photos
  • Your characteristics
  • Your likes and dislikes
  • Your accomplishments
  • Major life events (both happy and sad)
  • Memories
  • Experiences that have made you the person you are today(1)

This book can be given to the staff in the long term care home so they can get to know you better. This will help your care team to better understand your needs. You can also use the "Getting to Know Me" section of the guide "My Guide for Living with Dementia ."

What legal and financial things do my care partner and I need to think about before I move into a long term care home?
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It is helpful to gather all important documents together before making the move. If you find this an overwhelming task, have a family member or friend help you.

It is important for you or your care partner to ask the Director of Care or Administrator of the long term care home about government subsidies that may cover the cost of your basic accommodations. Other documents you should bring with you or ensure your family partner in care has before you move are listed below:

  • Power of Attorney for Property
    • This legal document appoints a person who can make financial decisions for you now, or in the future, if you are unable to make these decisions yourself.
  • Power of Attorney for Personal Care
    • This is a legal document that appoints a person who can make decisions about your personal care (for example, medical treatment or where you live)
  • Health card
  • Banking Information
  • Personal Identification
  • Cheque book
  • Insurance benefit information or veterans benefit information that may cover additional services
  • Locate Notice of Assessment for Revenue Canada if your family member is applying for basic accommodations. Take this with you on the day of admission to the home
  • Money for the first month's accommodation. Inquire about the cost of extra services (telephone, cable, hair care and assistive devices)
  • Prepare change of address notices for the bank, Revenue Canada, your pension, physician, place of worship, friends and family(1)

What happens when I accept the offer from a long term care home?
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When a bed becomes available at one of your selected long term care homes, you will receive a call from your case manager at the CCAC. You must make a decision within 24 hours. You can then take up to five days to move into the long term care home. After you accept the offer of the bed, you, or your care partner, should consider the following steps:

  • Review the Personal Care book with your life story
  • Make any changes or additions to the Personal Care Book
  • Call friends and family to assist you with the details and to support you
  • Determine the date and time of arrival at the new home
  • Determine who will meet you at the home
  • Consider arranging to have a social worker or other staff person meet you after the move to provide you and your care partner with support(1)

As a care partner, what can I do to help cope with the transition of my family member into a long term care home?
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Preparing to move a loved one into a care home is never easy. It is important to surround yourself with people who you can talk to about your fears, feelings and concerns. Talk to family or friends. You can also consider joining a support group through the Alzheimer Society. There are many things you can do to cope with this difficult period including:

  • Use a journal to write down questions or concerns that you have about the long term care home. Use this in your discussion with staff.
  • Find out whether the long term care home has a buddy system that can connect you to a family member who has already been through the move.
  • Think about the kind of care your family member would want to receive. You will want to think about it ahead of time if these choices have not already been made by your family member in their Power of Attorney for Personal Care or 'living will'.
  • Talk to your family, close friends and the attending physician about care choices.
  • Make a list of utilities that need to be cancelled after the move. You should also consider making a list of mail that needs to be re-directed to the new address.
  • Prepare change of address notices for the bank, Revenue Canada, your family member's pension, physician, place of worship, friends and family. Ensure that you also notify Canada Post of your change of address so that mail can be redirected.
  • Find out information about involuntary separation for couples who live in separate locations. Involuntary separation is only for people who receive GIS (Guaranteed Income Supplement) benefits or those who receive CPP income. You can get this information from the long term care home or the Community Care Access Centre.
  • Arrange a transportation plan for the day of the move and decide who will help you on the day of the move(1).

What happens on the day of the move into a long term care home?
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Your experience on the day you move to a long term care home will vary depending where you go. Before you move, you may have been involved in a preadmission meeting where you would have been given information about when to arrive, what to bring with you, policies around labeling clothing and what personal furnishings you will be allowed to bring with you.

When you first arrive, the home will take you through the admissions process that will likely take several hours. During this time the following may happen:

  • A staff person will meet you and take you to your room
  • You will meet the Charge Nurse, who'll help you complete your medical and consent forms.
  • You will meet other residents.
  • You will meet members of your Care Team.
  • You will unpack your personal items and set up your room.
  • Arrange for phone, cable and Internet service.
  • You will meet with a dietary supervisor to discuss your dietary needs and be assigned a dining table.
  • Someone will review with you the safety and security features in the home(2).

It will take time to adjust to your new home. For some new residents it takes six weeks, but for others, it could take several months. Families and friends play an important role in helping new residents settle in.

What should I bring with me when I move into a long term care home?
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Here is a list of items that you should bring with you when you move into the long term care home.

  • The Personal Care book
  • A list of clothing, belongings and assistive devices
  • Copies of all the completed legal and financial documents
  • Your calendar of upcoming appointments
  • All of your current medication in the original labelled containers (including over the counter vitamins, herbals, or any other "pill" that you take, regardless of whether or not your doctor prescribed it). If the directions on prescription bottles do not match how you are taking a particular medication, be certain to make staff aware of this discrepancy.
  • Advance care choices or copies of your wishes for medical interventions if you have put these into writing(1).

After your move, consider contacting some of your close friends and family. Moving can be emotionally and physically exhausting for you and for your care partner. It is normal to feel a sense of loss. Having friends and family around you will help with this transition.

What kinds of questions should I ask the Care Team at the long term care home?
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It is helpful for you, or your care partner, to have some questions prepared for your meeting with the Care Team. Below are some items to think about.

  • Physical health – What is my medical history and current health issues (e.g., walking, eyesight, hearing and sleep)? What do I need to support my physical well-being?
  • Intellectual ability – What is the skill I have regarding date and time? What are my abilities in terms of memory, speech, problem solving and decision making? What do I need to support my continued intellectual abilities and cognitive well-being?
  • Emotional well-being – Do I have strong feelings about certain life events or losses? Are some of my memories triggered by music, photographs or personal care? What do I need to support my emotional well-being?
  • Capabilities – How much help do I need with daily living skills (e.g., bathing, dressing, grooming)? What do I need to support my independence in these areas?
  • Environment – What would make my new surroundings more comfortable for me? Is there anything in the home that will upset me (e.g., noises, lighting levels, temperature)? What do I need to feel safe and comfortable in my new environment?
  • Social – The Personal Care book or life story will describe your likes, dislikes, happy and sad memories and life accomplishments. How can the home support your social needs? What activities or experiences are most meaningful to you now? What aspirations do you have?(1)

What should I expect in the weeks following my move into a long term care home?
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In about six weeks following your move, a Care Conference will help to bring you together with your family and the staff to share valuable information. Write down your questions and bring them with you to the Care Conference. This is a good opportunity to talk about your adjustment to the move with your family and the staff.

Other things to consider include:

  • Is there anything that hasn't been done yet? For example, any items that were not moved to the home?
  • Sending out change of address cards to family and friends to let them know you have moved and they are welcome to visit.
  • Think about getting involved in the home's resident council.
  • Take time to speak with a family member or friend about your transition to your new home(1).

How can I have quality visits with my family member after a move to a long term care home?
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Visits from family and friends in the early days after a move, even if only for a short time, can provide valuable reassurance and support to the new resident. Also, visiting is essential to staying connected, now that you are no longer providing care on a daily basis. Visits can be as simple as sitting holding hands, listening to quiet music, or looking at pictures. Encourage your family member to meet other residents; maybe join your family member for a meal, or attend a group activity together. Make visits meaningful; give your family member an update on other people in your family. Even better, encourage other family members to join you for a visit(3).

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Sources:

The information above comes from the following source(s):

(1) List adapted from Mobile Interprofessional Coaching Team (MICT): Focus on Seniors Mental Health. (2009). Preparing for the Move into Long-Term Care; "A Checklist", in Living with Dementia: a Guidebook for Families. Kingston, Ontario, Canada: MICT.

(2) List adapted from Peel Long Term Care Home. (July 20, 2010). Moving and Settling Into Our Homes. Retrieved from http://www.peelregion.ca/ltc/programs/moving-settling.htm.

(3) Compiled from Alzheimer Society of Canada. (March 2010). Long-Term Care: Visiting. Retrieved from http://www.alzheimer.ca/en/Living-with-dementia/Caring-for-someone/Long-term-care/Visiting, and Peel Long Term Care Home (July 20, 2010). Moving and Settling Into Our Homes. Retrieved from http://www.peelregion.ca/ltc/programs/moving-settling.htm.

Helpful Links and Resources

Title of Resource What it Offers? Access to the Resource
Community Care Access Centre Information about long term care homes in your area and the application process Website: www.ccac-ont.ca/ or Telephone: 310-2222
My Guide for Living with Dementia A resource guide for persons with dementia and family partners in care to improve communicate and enhance the quality of lives for all involved. www.dementianetworksc.org/myguide
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[This page updated on December 13, 2012]
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