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The Senior Care Advisor is designed to help you find the care you need.
To begin, please select what best describes your current health status:
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Active & Independentclick here
The average life expectancy in Canada is 78 for men and 81 for women and many Canadians will be retired for longer than they were employed. The key to a happy, healthy and successful retirement is maintaining a balance of physical, mental, social and spiritual connection with others. Healthy aging includes lifelong learning, fitness, travel and volunteering in the community.
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Increasing Health
Challengesclick here
Aging often brings illness, including 'chronic diseases' which have no cure and which cause persistent and recurring health consequences over a prolonged period. Some 82% of Canadians live with chronic disease. Most chronic diseases can be managed with medication and lifestyle adjustments, and seniors may live well for many years with conditions that would have been deadly for their grandparents.
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Health Crisisclick here
A health crisis may occur suddenly for a senior, or as an expected result of a chronic illness. Its effect on the patient and family can be catastrophic. If the ill person has been filling the role of caregiver to a spouse or family member, the illness may create the need for a quick response from private, community and overnment-funded services.
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Active and independent
The average life expectancy in Canada is 78 for men and 81 for women and many Canadians will be retired for longer than they were employed. The key to a happy, healthy and successful retirement is a maintaining a balance of physical, mental, social and spiritual connection with others in the community. Healthy adult aging will include lifelong learning, volunteering, fitness, travel, community involvement and taking time to help others.
To learn about activities for seniors, check your local Yellow Pages and local community and provincial websites under "Senior Citizens" or "Services and Programs for Seniors".
For information on federal programs for seniors, visit www.canada.gc.ca, www.seniors.gc.ca, www.canadabenefits.gc.ca
Developed by Comfort Life with help from ElderCareCanada
Increasing health challenges
Aging often brings illnesses, many of which are termed 'chronic diseases'. A disease is 'chronic' if it has no cure and causes persistent and recurring health consequences over a prolonged period. Some 82% of Canadians live with chronic disease. Most chronic diseases can be managed with medication and lifestyle adjustments, and seniors may live well for many years with chronic conditions that may have been deadly in their grandparent's generation.
Here are some useful resources regarding chronic diseases:
Developed by Comfort Life with help from ElderCareCanada
Family doctor/family health care team
Seniors experiencing health challenges are usually under the care of a family doctor, who will refer to specialists as required.
Family health care team
Increasingly, family physicians are grouping into family health care teams, which consist of doctors, nurses, nurse practitioners and other health care professionals who work collaboratively, each utilizing their experience and skills to manage your health.
This group approach is used for disease management and prevention, disease cure, palliative care and health promotion.
Family health care teams are usually the first point of contact for a senior who is experiencing health challenges. They can be especially helpful to older adults who need to navigate the health care system.
Options for your care include:
- Your family doctor will continue to see you during regular office hours.
- You will have access to other health care professionals within that family health care team, such as nurse practitioners, nurses, dieticians and pharmacists.
- You will have access to a family health care team doctor during extended evening and weekend hours for urgent problems.
- If you see another doctor in you family health care team for treatment, your own doctor will receive documentation about the nature of your problem so that he or she will always be up-to date about your medical condition.
- If you need assistance after-hours, you will be able to telephone the family health care team "telephone health advisory service" where a registered nurse will provide advice about your urgent health care concerns.
- With your permission, your doctor will receive a written summary of your call the next day, so that your doctor is informed of the nature of the problem and the advice you received.
Your health information
Family health care teams will also be able to take advantage of specially funded information technology to organize your health information and share it securely with other health professionals.
Find out more about health care teams
For more information contact your provincial Ministry of Health.
Developed by Comfort Life with help from ElderCareCanada
Health Crisis
A health crisis may occur suddenly for a senior, or as an expected result of a chronic illness; either way, its effect on the patient and family can be catastrophic. If the ill person has been filling the role of caregiver to a spouse or family member, the illness may create the need for a quick response from private, community and government-funded services.
A health crisis can be addressed by a number of services:
- Family health care team
- Walk-in clinic
- EMS via 911
- Hospital emergency room
Developed by Comfort Life with help from ElderCareCanada
Hospital
It's important to understand how Emergency departments are run, the alternatives, and some tips for preventing a health crisis.
Be Prepared
Be sure emergency information is collected, updated and accessible, including medications, pharmacy name, family doctor's name, medical history, valid health card (photo-ID health cards have expiry dates) and updated contact names and phone numbers. Families often post these lists on the refrigerator.
Attend medical appointments with your parents, meet their doctors and learn about their medical conditions. Become a partner in your parents' wellness; it will pay off when emergencies do arise.
Visiting Emergency
Medical professionals advise a visit to Emergency when any acute change occurs; in the case of the elderly, this might include trouble breathing, decline in cognition, a bad fall or perhaps excessive bleeding when taking blood-thinning medication such as aspirin.
Rather than driving your parent yourself, you may wish to call 911. The Emergency Medical Services will arrive quickly, assess and stabilize your parent, and advise whether an Emergency visit is required.
Making the Most of Your Visits
Emergency room staff strongly advise that patients bring an advocate, ideally a close friend or family member. That person should have a list of the patient's current medications and dosage, provide information as requested by the staff as to how their behaviour or condition compares to their normal state, and generally act as an advocate for the patient, who is usually confused, in pain and fearful. The advocate should also make notes about findings and recommendations.
When all patients enter Emergency, they are seen by a triage nurse who determines the urgency of their condition using a 5-level assessment tool known as the Canadian Emergency Department Triage and Acuity Scale. For example, Level 1 patients, in critical, unstable condition, such as cardiac arrest, must be seen immediately. Patients are therefore seen based on the acuity of their condition, not arrival time, nor the fact that they arrived by ambulance.
Geriatric Emergency Nurses:
A new innovation in many Emergency departments is the Geriatric Emergency Management, or GEM, nurse. This is a practitioner who will make a full geriatric assessment, including physical condition, cognitive level and home support. GEM nurses can diagnose, order tests and prescribe, working in consultation with the physician and emergency team. Their goal is to treat seniors, and to discharge them with a care plan that will ensure better long-term health and prevent future Emergency visits.
Alternatives for Emergency Care
Urgent Care Centres are clinics designed for low-acuity emergency patients, usually with a referral relationship to major hospitals. Check your Yellow Pages and/or your local hospital to learn if there is an urgent care centre in your area.
Telephone information lines such as Telehealth Ontario (1-866-797-0000) allows 24/7 telephone access to a registered nurse, who can help assess the seriousness of symptoms and suggest your options. MedicAlert bracelets, which contain medical history and contact information, and personal emergency response systems such as Lifeline allow 2-way communication to help guide your parents in assessing their problem and receiving help. Developed by Comfort Life with help from ElderCareCanada
Admission
A health crisis will often result in admission to the hospital. Depending on the treatment, a patient may be eligible for a stay in a rehabilitation unit, either within, or affiliated with, the hospital.
Most hospitals have adopted a team approach to patient care. Hospital units contain a team of professionals including a social worker, dietician, speech/language therapist, physiotherapist, occupational therapist, psychogeriatrician, as well as doctors, nurses and specialists. Patient care is the result of the efforts and input of the team, and decisions regarding treatment, admission to rehab and discharge are made in accordance with insight from each member of the team.
Discharge
Once the patient has been deemed as an alternate level of care (ALC), they are no longer considered to require hospitalization, and are ready for discharge.
Alternative Level of Care
ALC is defined as when a physician (or designated other) has indicated that the patient occupying an acute care hospital bed is well enough to be cared for elsewhere and therefore they are awaiting admission to a long term care, designated assisted living (DAL) or personal care home (PCH). This indicator is designed to assess the processes that ensure the placement of patients in the most appropriate care setting. It identifies the proportion of patients who are occupying acute care beds due to the unavailability of services in another more appropriate setting. Maintaining a lower percent of ALC days requires aggressive management and placement of the most complex patients.
Physical medicine and rehabilitation
Physical medicine and rehabilitation is a branch of medicine, which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities, often caused by brain injury or stroke. A physician who has completed training in this field is referred to as a physiatrist or rehab medicine specialist. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (such as stroke patients). Patients are referred to rehab programs from acute-care hospitals, remain a maximum of 90 days (usually 30-45 days) and return to an appropriate level of care in their homes and communities. Developed by Comfort Life with help from ElderCareCanada
Palliative care is an approach to care for people who are living with a life-threatening illness, no matter how old they are. The focus of care is on achieving comfort and ensuring respect for the person nearing death and maximizing quality of life for the patient, family and loved ones.
Palliative care addresses different aspects of end-of-life care by:
- Managing pain and other symptoms
- Providing social, psychological, cultural, emotional, spiritual and practical support
- Supporting caregivers
- Providing support for bereavement
Palliative care may also be called hospice palliative care or end-of-life care. In some cases, these terms are used interchangeably or in combination. The field of palliative and end-of-life care includes providing care services directly to the patient, family and loved ones. It also includes the education and training of care providers, research, surveillance and advocacy. Individuals, families, communities, the private sector and governments all play important roles in the field of palliative and end-of-life care.
More information is available on palliative and end-of-life care in Canada, including information on service delivery and the involvement of the federal government at Health Canada's website, www.hc-sc.gc.ca Developed by Comfort Life with help from ElderCareCanada
Hospital social worker / discharge planner
A key player in this process is the social worker, who often assumes the role of discharge planner. In this role, the social worker is responsible for discharging the patient back to the community with the appropriate level of care. This may entail counseling the patient on options for housing, care and other services, since returning to the former home and lifestyle may no longer be viable for the level of care now needed. The discharge planner works with social work counterparts in the community to set up services in the home, source housing such as respite or retirement residence stays, or admission to a long-term care home. In some cases, admission to palliative care is recommended. Developed by Comfort Life with help from ElderCareCanada
Support Services
Support services include privately-funded support from agencies and community-funded support from provincial, municipal and non-profit organizations to help seniors stay as independent as possible. Services can be medical or non-medical and can range from physiotherapy to respite care and from home maintenance to hairdressing. Privately-funded agency costs range from $15-$75 per hour while community-funded support fees are generally 50% -60% less.
What are they?
Community-funded support provides you with services such as adult day programs, lawn and snow care, Meals on Wheels and home cleaning. They are provided in local communities and often funded by a combination of provincial, municipal and non-profit funding from organizations such as United Way.
What kinds of services are covered?
Services typically covered by community-funded support include:
- Adult day programs
- Transportation
- Grocery shopping
- Lawn and snow care
- Telephone assurance
- Meals on Wheels
- Wheels to Meals / Congregate Dining
- Friendly visiting
- In-home foot care
- In-home lab testing
- Home-making
- Home cleaning
- Senior's advocacy services
- Elder abuse support
- Support for immigrant seniors
- Hospice care
How do I use the program?
Getting started with a community-funded program begins with an informal referral or phone call from the family doctor, a family member, neighbour, or a senior may call directly. An assessment will be made by phone or by a home visit, usually by a social worker employed by the community agency.
Is there a cost?
While community support agencies are subsidized, they are not free, and are not covered by provincial health insurance programs. The fees are usually hourly, at about 50%-60% of the cost of privately-funded support services.
Many seniors augment these subsidized services with privately-funded care to allow them to remain independently in their homes.
How do I find a community-funded support program in my area?
Check your province's ministry of health website for these programs.
Developed by Comfort Life with help from ElderCareCanada
What is included?
Privately-funded support services may be medical or non-medical in nature, and are designed to assist seniors to maintain their independence. Medical support may include in-home services such as doctor visits, nursing, foot care, physiotherapy, dentistry, wound care and respite care / caregiver relief. Non-medical services would include assistance with driving, errands and appointments, meal preparation, house cleaning, home maintenance, visiting hairdressing and aesthetics.
What do they cost?
These services are usually offered by agencies that recruit, train and manage the staff, and are priced by the hour, often with a minimum number of hours. Costs could range from $15-$75 per hour, depending on the type of service being provided. The senior or their family usually arranges these services privately.
Are they covered by my health plan?
These services may by covered by private health-care plans. Families should check their policies. Privately-funded support services are not covered by provincial health programs or community-funded services, so many seniors will want to investigate these services as well.
Aging in place is a popular trend but should be considered from a number of angles. Learn more about aging at home.
Developed by Comfort Life with help from ElderCareCanada.
Retirement Communities
Retirement communities offer a safe, stimulating environment for healthy seniors who have moderate care needs. If you choose to make a retirement community your new home you can rent, own or purchase a life lease. If you are recuperating from surgery or illness you can enjoy a short-term stay including medical care, meals and activities.
Active adult retirement residences
Active adult retirement residences are also called resort communities, 55 plus or adult lifestyle communities. They are ideal for boomers and older adults who are very independent. Most active adult communities are age-exclusive and the age of exclusion can be 50, 60 or 65. There are also communities that do not exclude people on the basis of age.
Accommodations
Accommodation may include suites or condominiums in a tower, detached units, town houses, or bungalows. Communities are often gated and may include on-site security.
Amenities
Amenities include country clubs, golf courses, trails, swimming pools, tennis courts, spas and fitness centres. This allows baby boomers and young seniors to continue their hobbies while relaxing and interacting with their peers. Amenities may also include on-site health care.
Independent retirement residences
Independent living retirement homes are for seniors who are in good general health and can look after most of their own needs. They may need help with things like meals, housekeeping, transportation and recreational and fitness activities.
Accommodations
Accommodations can include apartments or suites in a condo-style tower or townhouses, bungalows or even mobile homes. Most suites and apartments have their own kitchens or kitchenettes so residents can prepare their own meals and snacks.
Amenities and medical assistance
There are a variety of communal areas and amenities so that residents can interact such as libraries, gyms, craft rooms, pools and media rooms. There is usually a doctor's office on-site and further medical help is also available. There may also be handrails, pull cords and other assistive devices in the suites and common areas.
Residents can rent, own or purchase a life lease. Communities may be privately owned by small or large corporations or managed as subsidized housing.
Developed by Comfort Life with help from ElderCareCanada
Assisted living retirement residences
Assisted living residences are suitable for people who need more help than those who live in independent living communities but less than those living in long-term care or nursing homes. This may include assistance with things like bathing or dressing, mobility or eating.
Amenities and programs and medical
Amenities and programs may include scheduled outings, wellness programs, arts and crafts, movie nights and brain fitness. Residents benefit from health and medical services such as a doctor's office, 24/7 nursing, occupational and physical therapy, and medication assistance.
Accommodations
Assisted living suites feature such personal care devices as call bells, walk-in showers and emergency phone systems.
Retirement residences and communities offer a safe and stimulating environment for seniors who are in good health with moderate care needs. Retirement residences provide private suites where residents bring their own furniture and can make their own meals and snacks. They also provide common areas such as libraries, swimming pools, gardens, home theatres and dining rooms where seniors can socialize in a community of their peers.
Services and amenities:
Many services and amenities are available including walking trails, room service, volunteer and lifelong learning opportunities, fitness facilities, personal trainers and wellness centres. Medical services can include 24/7 nursing, a regular visiting doctor and medication management.
Care offered:
The typical retirement residence offers a maximum of three hours of care per day; if more care is required, residents may pay for additional care. In some retirement residences, heavy care is not provided, and management will assist in applying for a long-term care placement.
Costs:
Care may be charged hourly, as a monthly package or be included in the monthly rent. Some residences offer specific floors or areas for heavy care or secure floors for dementia clients. Retirement residences can vary greatly in size, amenities and pricing, and may be privately run, often by large national chains. They may also be run as non-profit operations by community or religious organizations.
Rent, own or life lease:
Retirement residences can be a landlord / tenant arrangement where rent is paid monthly and can be discontinued after a notice period. Residents can also own their suites or maintain a life lease. Retirement residences are regulated under provincial regulations and landlord-tenant legislation. Rent is not usually subsidized and is not covered by provincial health care plans.
To find out more about residence life or to locate a retirement residence in your community visit www.comfortlife.ca for complete listings of homes across Canada.
For a comprehensive checklist of things to look for when you tour a retirement residence, download your copy of the Comfort Life Residence Tour Checklist e-book.
Developed by Comfort Life with help from ElderCareCanada
Many retirement residences offer short-stays or respite programs for seniors who are recuperating from surgery or illness, recently widowed, in a life transition or coping with a chronic illness. This enables a senior to 'test-drive' a residence and provides medical care, meal preparation and access to activities, without the necessity of making a permanent commitment to a lease agreement. Developed by Comfort Life with help from ElderCareCanada
Community Social Worker / Case Manager
What is a social worker / case manager?
Social workers (also known as case managers) are trained professionals who work with citizens in the community as well as in institutions. They assist them in resolving health or other issues, often by accessing various social assistance programs.
What training do social workers /case managers have?
Social workers usually major in sociology, psychology, or another social science and take courses in related fields, such as economics, child studies, education, and political science. Graduate study often covers human growth and development, social welfare policies, and methods of social work. Most graduate schools offer work-study programs that give students experience in agencies, hospitals, or schools.
What is a geriatric case manager?
When working with seniors, social workers often assume the role of a geriatric case manager, assisting elders and their families with long term care issues.
Geriatric case manager duties include:
- Conducting care planning assessments to identify problems, eligibility for assistance and need for services
- Screening, arranging and monitoring in-home help and additional health and mental health services
- Reviewing financial, legal and medical issues and offering referrals to other professionals for dealing with problems and conserving assets
- Providing crisis intervention
- Acting as a liaison to families and long-distance care givers
- Offering guidance in identifying alternative housing options and facilitating transitions
- Providing counseling, psychosocial support, education and advocacy for elders and their families
Seniors seeking access to government-funded support programs are assigned a social worker to assess their needs. These needs are usually based on the activities of daily living (ADLs).
Activities of Daily Living
ADLs are defined as "the things we normally do" such as feeding ourselves, bathing, dressing, grooming, working, homemaking, and leisure activities. ADLs is a term used in healthcare to refer to these kinds of daily self-care activities performed within an individual's place of residence, in outdoor environments, or both.
Health professionals routinely refer to the ability or inability to perform ADLs as a measurement of the functional status of a person, particularly with regard to seniors and people with disabilities.
Basic ADLs consist of self-care tasks, including:
- Personal hygiene and grooming
- Dressing and undressing
- Feeding oneself
- Functional transfers, e.g. Getting out of bed
- Voluntarily controlling urinary and fecal discharge
- Elimination / toileting
- Ambulation (walking or using a wheelchair)
Instrumental ADLs let an individual live independently in a community
- Housework
- Meal Preparation
- Taking medications
- Managing money
- Shopping for groceries or clothing
- Telephone use
- Using technology, such as a microwave, cell phone or answering machine
- Care of others (including selecting and supervising caregivers)
- Care of pets
- Community mobility
- Financial management
- Health management and maintenance
- Meal preparation and cleanup
- Safety procedures and emergency responses
- Shopping
Evaluating a senior's ADL abilities
When assessing a senior for home care and support services, the social worker will evaluate the person's ADL abilities and recommend services to address any deficiencies, while still allowing them to maximize the abilities that are in place.
For example, a low-vision client may need special equipment, but still be able to read documents and pay bills; a client using a wheelchair may need assistance with a shower but still be capable of shopping and making meals. Developed by Comfort Life with help from ElderCareCanada
Government-funded home
care & support
How do I apply?
Referrals for government-funded home care and support services may be made by a family doctor, the senior themselves or family and friends, with the senior's knowledge and consent. The initial contact will result in the assignment of a case manager or "care coordinator".
What does the case manager / care coordinator do?
- Talks about needs and answers questions about what what's available in your community
- Conducts a health care assessment
- Develops a customized care plan that meets your specific needs
- Checks in regularly with you and adjusts your plan if your needs change
- Is the access point for all government-funded home care & support services
Care and support services:
Care resources are scarce and expensive, so each person's requirements are carefully assessed and the hours of care and support assigned are based on that assessment of needs.
Care and support services are delivered by health provider agencies under contract on behalf of the provincial ministry of health.
Care Services:
- Nursing
- Personal support (help with bathing, dressing, etc.)
- Physiotherapy
- Occupational therapy
- Speech-language therapy
- Social work
- Nutritional counseling
- Medical supplies and equipment
Support Services:
- Meal delivery and dining programs
- Caregiver relief
- Transportation services
- Community dining
- Friendly visiting
- Supportive housing
- Adult Day Programs
Who will deliver these services to me?
Care and support services are delivered by health provider agencies under contract on behalf of the provincial ministry of health. Care will be delivered by Personal Support Workers (PSWs) who are trained in care techniques, and by Homemakers, who are trained to deliver meal preparation, housekeeping and companion services. Developed by Comfort Life with help from ElderCareCanada
Long-term care, or nursing homes
Long-term care, or nursing homes, are designed for persons requiring 24-hour care. Long-term care homes provide a wide range of services for people who can no longer live independently, and may be coming from their homes with community and government support, from a retirement residence that does not offer heavy care, or from hospital.
Cost subsidies:
The provincial ministry of health subsidizes the costs of long-term care; residents must pay the accommodation portion of the cost. Additional subsidies are available if income is insufficient. Provincial ministries of health also administer and regulate these homes, which may be private, non-profit or municipally owned.
Services include:
- Nursing and personal care
- Regular and emergency medical care by the on-call physician
- Treatment and medication administration
- Assistance with activities of daily living
- 24-hour supervision
- Room and board, including laundry services (special diets are also accommodated)
- Pastoral services
- Social and recreational programs
Short-Stay
Long-term care homes have short-stay programs for up to 60 days at a time, to a maximum of 90 days during the calendar year to provide respite for a senior recovering from an illness or surgery, or for caregiver relief.
Eligibility and Admission
The community social worker / case manager is usually the point of entry to the long-term care system. In most provinces, applications are not made directly, but after the case manager has:
- Met with you to provide information about long-term care homes
- Provided information about financial options, if required
- Carried out an assessment at your home or in the hospital and determined your eligibility
- Helped with the application forms and coordinated the application process to facilitate access to long-term care
- Empowered seniors and their decision-makers with the information to make an informed decision on a long-term care home that suits needs and interests
- Placed the applicant on the waiting lists of the selected long-term care homes
- Offered a bed in a chosen long-term care home when one becomes available
Applicants must be over the age of 18, have a valid provincial health card and have health needs that cannot reasonably or affordably be met in the community, and can be met in a long-term care home.
Typical Rates – reviewed annually:
| Type of Accommodation | Daily Rate | Monthly Rate |
| Long-Stay Basic | $53.23 | $1,619.08 |
| Long-Stay Semi-Private | $61.23 | $1,862.41 |
| Long-Stay Private | $71.23 | $2,166.58 |
| Short-Stay | $34.63 | $1,053.33 |
If there is insufficient annual income to pay for the basic room, a subsidy is available for a 'basic' level room. Based on Canada's principles of universal health care, if a potential resident is deemed to be eligible for placement in a long-term care home, admission cannot be refused because of an inability to pay.
Choosing A Home
It is strongly recommended that you or someone you trust make appointments to visit the long-term care homes you are considering before you make a final decision.
Here is a checklist of things to consider:
- Is the staff friendly, warm and concerned?
- Do residents look content and well cared for?
- Is there a tone of dignity and respect for the residents?
- Is the home convenient for family and friends to visit?
- Are there areas in the home where you can visit privately?
- Is public or volunteer transportation available?
- Is there flexibility around visiting hours?
- Do the activities at the home sound interesting and appealing?
- Are family members involved in planning for the resident's care?
- Does the home support a Family Council?
- Is the home able/willing to meet your religious, cultural, language and dietary needs?
- Are there choices at mealtimes (e.g., menu, location, times)?
- Can you arrange to sample a meal or participate in an activity at the home?
- What are the policies around smoking, non-smoking and alcoholic beverages?
- Is your family doctor able to continue providing care?
- What special needs can the home accommodate (e.g., oxygen, scooters, electric wheelchairs)?
- Can you bring your own furnishings?
- Is there an option to keep your personal belongings secure (e.g., lockable drawers)?
- What are the extra charges, if any, for personal needs and services?
- Is the home accredited? Have you checked its record with the provincial ministry of health?
Developed by Comfort Life with help from ElderCareCanada
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