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The First Steps
The starting point for everyone on this journey will differ based on their circumstances. If their vulnerable loved one was hospitalized, then they will be fast-tracked, and there is a good chance that they will be guided along the way. If their loved one is at their place of residence and they are now starting to realize that they and their community can no longer care for the loved one, the first place to start is their family doctor. They can write a formal letter requesting at-home care or to have their name put on the list for long-term care facilities. This letter will help get the process started and add a fair degree of weight to your case for the case workers that will be assigned to your loved one.
However, as has happened countless times before, this can present multiple difficulties if your loved one refuses to go to the doctor and refuses to speak about the topic altogether. There is a greater chance of you encountering difficulties if your loved one is starting to exhibit symptoms of dementia. The stigmas around the words nursing or retirement homes can have a crushing impact on the elderly, for they see such places as the welcome mat at death’s door. This hasn’t always been the case in my experience, but it is something that you will have to navigate.
Before we get into the specifics of where to go from here, you need to know the difference between nursing homes and retirement homes. The distinction is not always clear, and the fact that it can vary based on your location does not help. As a reminder, all terms and links presented in this article are for the Canadian province of Ontario.
Retirement homes are for-profit private entities that act as full-service condos for your loved one. The residents at these facilities are usually in relatively good health and typically not in need of memory care. Those in need of memory care services require an entirely different set of services and cautionary measures, and in many medical facilities, entire floors are designated for memory care patients and residents. The downside to retirement homes is the cost. They are a lot more expensive than nursing homes, which will be referred to as long-term care (LTC) facilities from here. They are indeed more luxurious, but every single service is itemized and billed. Every single time that a nurse or personal support worker (PSW) is called to help your loved one can, and in most circumstances, will result in a cost. If your loved one has problems with their memory, this bill can be crushingly high as they keep calling on services that they do not need or that they already had earlier that day. If you are fortunate enough to have the resources to place your loved one in such a home, then it is up to you to do so. Be aware that as their health degrades, you may have to eventually start the process of placing them in a nursing home.
Nursing homes can be for-profit or non-profit and are strictly overseen by the government. These are the facilities where most people end up in the final phase of their elderly lives. Unlike retirement homes, you pay a fixed rate for the room, and most of the services are covered. Extra services such as salon and dental services are extra no matter where you place your loved one. Both homes have nurses and personal support workers on their regular staff. They also have one or more doctors who make their rounds on specific days of the week.
Since the retirement home path is a simple pay-as-you-go service, we will now focus on the nursing home/LTC route.
The Next Steps
The link provided in this article and the steps covered are centred on where I reside and where I have the greatest experience – the province of Ontario in Canada. For those residing elsewhere in Canada or other countries that also have robust healthcare systems, you can use this as a roadmap. For those who are living in countries such as the United States and who do not have the ample health coverage required for proper caregiving services, this article will act as a tool for the services which you must budget for out of your own finances and make you aware of the issues that you will face along the way.
In Ontario, we are truly fortunate that there is a website to go to if you believe that someone in your family requires more help than what you alone can provide. The link is:
www.ontario.ca/page/home-community-care
Here, you will be guided towards your first general assessment and even potentially straight to putting your loved one’s name down for a residency at a long-term care facility. If your loved one is hospitalized, the hospital will guide you toward a proper assessment and make appointments with the professionals needed when it comes time for the patient to be discharged. Furthermore, once discharged and if the patient is still in a medically vulnerable state, there may be a nurse practitioner assigned to your case. The nurse practitioner plays a vital role in the patient’s continual care outside of the hospital, which is pivotal in drawing up a roadmap for their continued care.