Options for Senior Living

This is the first post in a three-part series on the costs of senior care. The series discusses options available for seniors’ living and care, the costs involved, and how those costs can be covered.  In this first post, we look at the various options available to seniors: retirement homes, assisted living, long term care homes (LTC), and in-home caregiving. In the second post, we will take a more in-depth look at how much these different options cost. In the third post, we will discuss how families can meet the costs of senior care.

Options for senior living: First, the statistics about living longer

Statistics Canada publishes figures on both life expectancy and ‘Health-Adjusted Life Expectancy’ (HALE). Life expectancy is the number of years a person would be expected to live, depending on the year they were born. HALE is an indicator of the average number of years that a person is expected to live in a healthy state, a summary measure that combines both quantity of life and quality of life.

  In 2007 (the last published figures), life expectancy was 83 years for a Canadian woman, and 78 years for a man. HALE calculations show that women in Canada can expect to live in a healthy state to the age of 71 (i.e. without a disability or chronic disease), and men can expect to live in a healthy state to the age of 69.

This means that Canadians with average life expectancy will likely spend the last years of their lives (12 years for women, 9 years for men) coping with a chronic disease or disability. These include conditions such as chronic pain, limited mobility, dementia, and diabetes, all of which interfere with independent living.

With the aging of the baby boomer generation, governments and private markets have realized that there is a major demand for a range of high quality lifestyle choices for these ‘disability years’. People retiring today want the best life possible, even if they will be coping with diminished health.

Options for senior living: Retirement Communities

Many of the retirement communities available now are for seniors who are generally in good health and do not need help with personal care or ‘Activities of Daily Living’ (ADLs), such as feeding, bathing, dressing, grooming, and homemaking. Retirement community residents live in single units and are genuinely independent, being responsible for their own schedule and care.

An example of a fabulous retirement community within the Greater Toronto Area (GTA) is the Tapestry at Village Gate West in the heart of Etobicoke. The average age of a Tapestry resident is 82 years. With their room fees, residents get access to the gym, the pool, transportation to doctors’ appointments and church, suite cleaning, and, if they don’t feel like cooking, credit toward eating with other residents in the dining room restaurant or pub.Fees for a studio apartment begin at approximately $3200 per month, one-bedroom at $4,100per month; and a two-bedroom apartment starts at $5,700.

Options for senior living: Retirement Homes and Assisted Living

Assisted living is a term used for a residence or apartment building catering to seniors who need help with ADLs such as cooking meals, bathing or dressing themselves, doing laundry, and taking medications. Assisted living is generally suited to people who need light care or a low level of supervised care, but are otherwise free of serious problems with their mobility and mental and physical health. In addition to residences devoted exclusively to assisted living, retirement homes that advertise rooms for independent living (from basic to luxury) usually also have one or two floors of the building reserved for residents who need assisted living.

  On assisted-living floors, staff are employed to help seniors with light personal care like bathing and dressing. Room costs increase when more personal care is needed.  Private caregivers can also be hired, either from the residence or from outside companies, to administer a higher level of personal care, such as help with feeding, transfers into and out of bed, and incontinence briefs.

Retirement homes and assisted living residences can be for-profit or not-for-profit.  In Toronto,
St Hilda’s Towers, a not-for-profit residence, charges $2700 per month for a one-bedroom independent living suit, with a full meal plan included in the fee.

A moderate assisted-living package in a one-bedroom suite at St Hilda’s costs roughly $4000 per month.At a for-profit retirement home on the more luxurious end of the scale, such as the beautiful
Bradgate Arms, the minimum monthly spend will be about $3500. Larger suites, better views, and the addition of assisted living help will incur a higher charge.

Options for senior living: Nursing Homes or Long Term Care (LTC) Facilities

Nursing homes for seniors are typically for the disabled elderly with serious chronic conditions who require high levels of personal care assistance, as well as medical care.The average age of residents is 85 years, and the average stay is 2 years.

Government-subsidized LTC is roughly $1,800 to $2,300 per month, with the range in cost mostly dependent upon the difference between a semi-private and a private room.  Ratios of staff to residents can be one worker for every 14 or 20 residents in the night time, so many residents will also hire a private caregiver to supplement the care.

Central Toronto has many long term care homes. Two deservedly popular ones are Baycrest Apotex Centre and Kensington Gardens in the Annex.

Options for senior living: Staying at Home with Home care

For many people, however, the most attractive option will simply be to stay at home, surrounded by familiar sights and the memories they bring. Home care also has the benefit of having one-on-one care with a dedicated caregiver that you will grow to love and trust. In-home care is tailored to fit your needs, and is the best care for people with dementia. Good PSWs (personal support workers) can quickly become almost like one of the family.

After one of our clients passed away, the family seated their caregiver at the head table during a family wedding, in token of their esteem for him and their gratitude to him for his service to their late father. Home care can range from three hours per week of companionship or meal preparation, all the way to full-time personal care and round-the-clock end-of-life palliative care.

Never before have seniors had the benefit of so many lifestyle choices in their later years, all designed to allow maximal independence and quality of life.

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