A Guide to Senior's Aging at Home

Remaining in the comfort and safety of home

A no-nonsense look at what’s at stake for Ontario seniors and families

What to know about this topic:

• What assistance is covered by OHIP?
• What services are available through private care?
• Comparing assisted living to home care
• Where seniors and families should start

Over 90% of seniors want to remain in their homes for as long as possible, according to a survey by Home Care Ontario. This fits with most seniors’ ideals in terms of independence, comfort, and a need for community and familiarity, even as they adapt to changing health and safety needs.  Although, many will require some type of support to make that wish a reality. Aging at home becomes a greater challenge if they must stop driving, when stairs become difficult, or when cognitive or physical decline hinders their ability to manage a household. Plan as soon as you can, considering family support, community-based healthcare, and a private home care service like In-home Assisted Living Inc.

“The most common hurdle is getting started,” says Steve Jones, President of In-Home Assisted Living. “That hinges on mom and dad acknowledging that they’re vulnerable or that they require assistance. Then they need to accept help.” Unfortunately, too many seniors wait until a health crisis or the loss of a loved one before accepting help. 

When you’re researching care needs, there are four basic questions you need to deal with.

What assistance is covered by OHIP?

In Ontario, there is free basic government home care service provided by an organization called Home and Community Care Support Services (HCCSS). This service is covered by our healthcare system and is available to anyone with a health card. HCCSS is free for seniors, people with disabilities, injuries, and illnesses to get assistance with Activities of Daily Living (ADLs). ADLs include tasks like personal hygiene, toileting, dressing, bathing, and feeding.  While these personal care services are critical to our healthcare continuum of hospital-to-home or to help reduce the frequency of rehospitalization, the government service is typically limited to three, seven, or fourteen short visits per week depending upon the severity of the patient’s condition. 

HCCSS is part of our Healthcare system, so it’s limited in scope and does not include safety supervision, housekeeping, meal preparation, medication management, household management, companionship, or escort services to appointments. There’s also not much flexibility in scheduling. For those things, you need a private homecare service like In-home Assisted Living Inc. 

What services are available through private care?

Jones says many families receiving private home care services are also receiving some form of government HCCSS services which they augment or supplement with private care to ensure that all needs are met 24/7.

In-Home Assisted Living employs over 300 qualified Personal Support Workers as well as Registered Practical Nurses across the GTA. 

Private caregivers visit clients according to a customized care plan with a predetermined schedule that can be from one to seven days per week, day or night, and from four hours to twelve hours per visit. A personal care plan is designed for every family member which includes daily routines, meals, medications, transfers and mobility safety, meal planning, personal care, exercise, housekeeping, laundry, linens, social engagement, and reporting.

Every situation is unique, ranging from needs for basic housekeeping to complex medical care—including palliative care. To get a sense of the types of tasks and services that can be included in a personal care plan, a caregiver checklist is available for download here. You can also call Steve Jones to discuss home care options at (416) 595-5888

Comparing assisted living to home care

Despite their wish, there is a one in three chance that seniors aged 85 or older may need to move into some form of seniors’ residence or assisted living facility if they can’t arrange enough support at home. Residences for seniors range from condo-like independent living communities to hospital-like long-term care settings depending on health, abilities, and needs. 

Assisted living residences are typically appropriate for seniors with some degree of independence, and do not require constant care or constant supervision. Assisted living residences range from the most basic to ultra-luxurious and prices range from $4000 to $9000 per month depending upon the facility, its services, and the selected support package.

Retirement Residences can include meal plans, housekeeping, and other conveniences such as social activities, laundry, and even onsite medical appointments. Assisted Living or Senior Residences are typically not subsidized by our governmental healthcare system except for specialty facilities for those who qualify through social welfare. 

It's also common for seniors to choose an Assisted Living Residence because of the facilities, focus on language or culture, or location, yet they still augment the facility services with some degree of Private Home Care because some Senior Residences are not designed to provide persistent one-on-one services. An Assisted Living residence may be perfect for one spouse but my not be suitable for both spouses who have significantly different health conditions. 

Long-Term Care Facilities (LTCs) are more hospital-like or sometimes hybrid semi-private rooms and private rooms with additional medical and meal support. LTCs cater to people who would not benefit from remaining in a hospital or when it’s not cost-effective to remain in a hospital and yet they require assistance with the activities of daily living. Long-term care patients (or residents) require constant supervision or monitoring to ensure their safety or well-being and their needs cannot be met through publicly funded community-based services and other care-giving support in the community.   

Long-term care facilities are either government-run or contracted by them. The medical care portions in an LTC are covered by OHIP however there is an accommodation or room and board charge that will range from $2,000 and $3,000 per month depending upon the room type. 

Referrals to Long-term care facilities are arranged by the same case managers who work with HCCSS for government-funded home care services.   Long-term Care facilities are not suitable for married couples. 

Home Care allows seniors, people with disabilities or recovering from illness to remain in the safety and comfort of their own home.   Home care offers seniors a greater feeling of independence, familiarity and the flexibility to adapt and change services as health and needs change.  Personal support workers are selected and assigned based upon required skills, tasks, personalities, languages, location, schedules and family preferences.   Home care is also an optimal solution when one spouse requires more care than the other, relieving one spouse from the stress and physical challenges of providing constant care to their loved one.

Where seniors and families should start....

Understand what independence means to you.  Every person’s health needs, family support situation, financial circumstances, and wishes are unique.  And, your personal understanding of what it means to be independent will also change as health and family circumstances evolve.  Things are not going to remain as they are now, so its important to have a plan that is flexible.   Professional support from In-Home Assisted Living will provide the flexibility to ensure the best possible outcome.

There’s no one-size-fits-all solution and the decision process can be overwhelming especially if selling a family home or moving to an assisted living residence flies in the face of lifelong assumptions.   That's why professional home care support can be the perfect solution, even if its just to capture a few extra years of living out a life goal of remaining at home.

Start with the first big hurdle which requires a conversation where mom and dad acknowledge that they might be (or become) vulnerable and need assistance.  Making the decision to accept help can sometimes be the biggest challenge.  Then do some research and call In-Home Assisted Living to discuss options, costs and care plans. 

In-Home Assisted Living has four GTA locations covering all of Toronto, Mississauga, North York, Scarborough, Brampton and Vaughan.

Call: (416) 595-5888 or Email: care@ihal.ca