The ABCs of retirement care
For Jean Doern, it just seemed like the right decision at the right time.
The Winnipeg, Manitoba, resident was 81 years old and had been living by herself for eight years. She was still as active as she’d always been: volunteering at a local school and at her church, and visiting friends whenever she could. She’d always liked her independent lifestyle, but it was starting to get to her. A social person, she felt isolated and lonely when she was home alone; even eating felt like a chore, since it meant cooking and dining all by herself.
By then, she’d already been visiting friends at The Wellington Retirement Residence in Winnipeg for over a decade, knew its facilities well. When her daughter bought a home close to the residence, Doern figured the time was right to make a move. She decided to give retirement community living a try. As it turns out, she took to it right away.
“I kept my house for a month and went back to finish off the little bits and pieces that you need to do . . . but (the residence) was just great, just wonderful,” she remembers. “This was the place I really wanted to be—I never looked back.”
She’s now lived in The Wellington’s independent living facilities for four years, and not only is she enjoying the meals and social engagement, but she’s gotten involved in many of the activities offered at the location as well (“I’m hard to find at home now,” she says). She also feels comfortable knowing that there are people around if something happens to her; her daughter, too, feels better now that her mother’s not alone at home all the time, where anything might happen. “I did not really realize how much she was worrying about me being in the house by myself,” Doern says.
Making the move to a retirement residence can be a tough decision for anyone, whether you’re planning your own retirement or you’re a caregiver looking at options for a parent or family member. Not everyone makes the transition as smoothly as Doern did—the change, at first, isn’t always easy. But it can be made easier if you know all of your options going in and have a better idea of exactly the services you might be looking for. What type of retirement option or residence is right for you?
Receiving assistance at home
For some, the right residence is simply home: the family home they’ve grown to feel comfortable in. “Many people just want to stay in their home environment,” says Gord White, CEO of the Ontario Retirement Communities Association (ORCA). And for those people, White says, the best option is probably home health care or community support services, hands-on support brought into the home to assist someone who might need it for activities that include personal care such as bathing or toileting, and extend to health-oriented duties like managing medications.
Options in home care vary from province to province, he adds, but where government-funded programs don’t meet all of your needs, private services are available to fill in the gaps. Safety is the biggest concern in home health care, though, since staff aren't always on duty 24 hours a day the way they are in a retirement or nursing home.
Home health care works well if all care needs, such as bathing, grooming, dressing and wound changes, can be scheduled, says Irene Martin, the executive director of the Alberta Senior Citizens’ Housing Association. “The biggest problem with home care is the unscheduled care,” she says. “If there isn’t a spouse or family member to help them, there may not be anyone there if help is needed in between scheduled care.” Often dehydration, malnutrition and depression are the first signs of risk for seniors living at home.
An independent lifestyle
When Jean Doern moved to The Wellington, she was independent and active. But there were some things that she found were difficult to keep up with around the house, or that had simply become a drag since she was living there by herself.
That’s often the case for individuals coming into an independent living facility, says Sharon Loewen, marketing manager for The Wellington, operated by Revera Retirement Living. “Someone would make this move because there are one or two barriers to living on their own,” says Loewen. “Things like doing the laundry or making the beds or larger meal preparation.” Those tasks may seem like nothing to someone young, but for an older individual who’s losing mobility, they’re much more difficult, Loewen says. Having a facility take care of them makes life a lot easier, she adds. Residences will vary in exactly the services they offer, but all aim to make their residents’ lives somewhat easier, as far as those daily and weekly tasks go.
Independent living (also called supportive living or retirement living) gives residents things to do and people to do it with. Social outings and activities aren’t just a bonus at retirement facilities, either—they’re part of the appeal. Many retirees—like Doern herself, when she was living alone—can feel isolated and lonely in a home by themselves, without the same mobility they used to have to go out on their own; coming somewhere where there are other people their age and activities to take part in is often life changing. “Usually in January and February, especially, we get a lot of calls because people are feeling isolated—because at that time of the year, they can’t get out because of the weather,” says Sharron Brooks, client relations and quality improvement co-ordinator for Kensington Village Retirement and Nursing Home, a residence in London, Ontario, with an independent living facility as well as long-term care.
“Unfortunately some people wait too long and sometimes need even more complex care that not all retirement communities can accommodate,” says Denise Tidman, vice president of the BC Seniors Living Association. By waiting too long, seniors may no longer be fit enough for a residence that is close to their family physician and that offers their desired independence and activities. Tidman suggests that seniors start looking before they feel a need. This will help ensure they find the right residence for themselves and can be placed on a waiting list. “Doing the due diligence needed to make educated decisions based on your needs is much more proactive,” she says. “Every community is similar but each one offers something different.”
A little more help
Sometimes the services in an independent living facility might not be enough—you may need more assistance than simply weekly housekeeping or having your meals cooked for you. Help with toileting and bathing could be necessary, maybe walking is an issue and you need assistance getting to and from the dining room, or it might be any number of daily activities that are no longer easy to accomplish because of health and mobility concerns.
In these cases, assisted living might be your answer, where half an hour of help a day (or sometimes more) is added on to a resident’s repertoire of care. In some facilities, assisted living and independent living residents live side by side, while in other cases, assisted living will have its own floor or unit.
On applying to enter a home, a doctor’s note and an on-site assessment may be necessary to determine your needs and to see if you require the extra care, says Maryanne Higginson, national director of care for Amica Mature Lifestyles, which runs Amica at Arbutus Manor in Vancouver, British Columbia, and facilities across that province, Alberta and Ontario. “On moving into Amica, you have to have a pre-admission medical form completed, and then the director of care meets with the potential tenant and does a functional assessment based on the medical form and an assessment of the person in front of her,” she says. “Then she works with the potential tenant to determine the level of need that they have.”
Some potential residents enter independent living facilities but see their needs change while they’re there. If health issues become a concern, staff members can often help assess whether more assistance is needed. At Hazelton Place Retirement Residence in Toronto, Ontario, residents can add on some services—like monitoring medication, for example—so that there’s a continuum of care between the independent and assisted living options. Staff get to know residents well and will often be the first to suggest when that extra help might be needed. “We’ll call a conference with the family to indicate this is the stage and this is what’s happening,” says Ron Khan, general manager of Hazelton Place.
What if assisted living isn’t enough? What if you or your loved one needs extensive care? That’s where long-term care facilities or nursing homes come into play. Government regulated, long-term facilities are for those with deteriorated health, says White, seniors who need a lot of hands-on assistance.
“In most cases, it’s not a surprise” for family members to find out that their parent or loved one needs that extra help, says Maurice Rouleau, general manager of Sifton Properties’ Erin Mills Lodge in Mississauga, which has independent and assisted living facilities, as well as a separate residence for long-term care. As is the case across the country, that care is regulated by a provincial body. Individuals or their family members must apply in order to get a spot in a long-term care facility. “They’re accepted based on needs,” says Rouleau.
And what can you expect once you get there? “In a long-term care home, they all follow the same rules. The legislations and regulations are all the same,” says White. “So the way they operate, the services they provide and the way they provide those services are all pretty much the same.”
Faced with a terminal diagnosis and knowing that they don’t have much more time to live, many make the decision not to play out the rest of their days in a hospital, but instead look for a home where they can live comfortably with the medical care they need around them. “It’s a much warmer way of dying than being in a sterile hospital room,” says Sharron Brooks of Kensington Village, which offers palliative care among its services.
Although they have taken in residents especially for that purpose, most of the palliative care residents Brooks sees are those who have already lived at Kensington Village, who want to spend the rest of their time around people they know and care for, as family and friends come in and out in a comfortable, caring environment.
“They already know their life is coming to an end, and they feel comfortable with us,” says Brooks. “This is their home, and in some cases it may have been their home for a long time.”