Aging and caregiver bring up a range of concerns that most people have never encountered. Emotional and physical changes in an older person, impacts of caregiving on the caregiver and family dynamics, interacting with public health and long term care systems, looking for resources and housing — all of these often create confusion, anxiety, and stress. SeniorZen eldercare advisor is available to help you understand and deal with the range of concerns that arise as you look for Senior’s Housing and confront other issues in the journey of aging and caregiving.
Peter Silin, MSW, RSW, CCC (Registered Social Worker and Certified Clinical Counselor) is the author of Nursing Homes and Assisted Living: the Family's Guide to Making Decisions and Getting Good Care. Diamond Geriatrics, his Vancouver based Care Management company, has been providing case management services, assessments, advocacy and guidance and support to family members and Seniors since 1996. Peter provides seminars and workshops and is a consultant to business and government. He has over thirty years of professional experience in the public health system, geriatric medicine, geriatric and general psychiatry and family and individual counseling.
Frequenlty Asked Questions
Questions on Eldercare
Due to changes in income for our parents - and no longer using these services, it would only be fair and reasonable to renegotiate the fees for services never uesed. What is one's legal position in this? Yes, a contract was signed - but with
I don't know what province you are in, so it is hard to say. and I am not sure which optional amenities you are talking about. My guess is that when your parents moved in, they signed some sort of contract outlining fees and their application to each unit and resident. You could talk to the provincial ombudsperson or you could see if the residence is a member of any professional organization and contact the organization. It sounds like you have talked to the administrator of the building. If it is owned by a larger company, you could talk to a regional or national person from the company. Last of course, you can consult a lawyer, which I am not. In some provinces a residence may fall under strata laws or even landlord tenant.
Would you or someone with your organization be available to speak to the Canadian Bar Association, Calgary Section on Elder Law, for about 40 minutes inclusive of questions, about Seniors housing in Alberta and particularly about legal issues, legislation etc.
I would look at the following website:
In that, at the bottom there is one link which may be what you want:
I would also call your local Health Authority and ask to speak to a licensing department, and see what they can tell you.
From your question, it sounds like you may have some concerns about care. If you have some complaints, you might also want to contact the Ombudsperson in Alberta:
I am Amin from Nepal.I got Permanent Residence along with my wife Rachana Adhikari Khadka and i would to let you know that we are very soon moving for Vancouver, Canada.My wife is Registered Staff Nurse in my home country Nepal and she has worked here for 4 years in hospital and tutor for caregiver course for 1 year.She has a volunteer experienced in different health related NGO as well.As soon as we arrived vancouver she wants to work as a caregiver.She is young age of 24 yrs, energetic and able to work at any time.I have found your service facility through google website.So, could you please provide to get the good way to find job facility as a caregiver as soon as we contact you after we arrived at vancouver?
If you want her CV then i can send it you.
Hope for your valuable response and suggestion.
With Best Regards,
Please refer to this section on our website for job inquiries: http://www.seniorszen.com/senior-care-jobs
Well, let me start off by saying that I am a Geriatric Care Manager, so would be considered a transition consultant.
It depends what the consultants say they will do, and whether you can or want to do the work yourself. Often you can get most of the information that you want, or at least begin to, from the health authority in the area where the person needing help lives. If they are knowledgeable, they can save you time, and explain how the whole system works. They can help you ask the questions you might need to ask.
Look at someone's qualifications and background to see if they would really have an understanding of what the issues involved in transitions are. Are they professionally qualified and experienced in eldercare? what kind of experience, for how long, what is their education and training. Transitions are far more than just helping someone choose a senior's housing. Will the consultant help you understand all of those issues--help you broaden your knowledge, help you find resources.
Also, how are they paid, are they getting a fee from the places to which they refer? I am often offered a fee, and turn it down, or if it is seniors housing, ask them to apply it to a client's rent, so the benefit does not come to me, it comes directly from the client. My feeling is that if someone is getting paid by the housing, then it is hard to be objective.
I charge a direct fee by the hour. As a Registered Social Worker, my fee is in line with what others with a masters degree charge (actually a bit less). Sometimes people can write it off through their extended health or even use my services via their Employee Assistance Programme at work if they have one. Look at my website, www.diamondgeriatrics.com for information on transitions and housing and resources.
Peter Silin, MSW, RSW, CCC
I am having doubts on the destined living quarters they have determined, she has vastly improved in 3 weeks after collapsing and having memory loss and confusion. Still shows some confusion with numbers but i believe she can function with a live-in or daily care giver. How do i confirm this or make sure i am making the right decision before taking her from her home?
ANSWER: No one can make your mother move to assisted living unless they have the legal authority to do so. She can make that decision, or her next of kin can make it if she is unable. You may have to go through the provincial legal channels to get the authority, which might include going to court. You could consult an elder law attorney for more information on this.
I would wonder how they made this decision and diagnosis and what they think after her current improvement. It is possible that she has Alzheimer's as well as another condition which caused the recent decline and that has resolved so she is doing better.
You can have an occupational therapist and physiotherapist do an assessment of her ADL--Activities of Daily Living, and of her mobility and risks for falls and other problems. Discuss with them what help your mother would need to live at home. Most people with the right amount of help are able to do so, but it live in help can be expensive. Look at some of the resources on my website, at www.diamondgeriatrics.com for information on caregiving and resources. You can also contact your local Alzheimer's Society and ask them about caregiving issues and meeting the challenges of caregiving. My recent newsletters, including the one to come out tomorrow talk about "The Dementia Road" and what caregivers need to be aware of.
I am available for phone consultations also. My fee is $110.00 per hour.
The current programme serves the needs of the person who needs care very well, however it does not serve the caregivers. It separates them from their families for long periods of time. If the person to whom they are providing care dies or goes into care, they can be left without the ability to work legally, as they are on contract for that person only. The caregivers provide long hours usually above and beyond what they are contracted to do. I think that there needs to be some kind of government agency that they can turn to and who monitors their working conditions and how the contract is going. To know their rights is one thing--to be able to ask that they be honoured is different, and more difficult.
Peter Silin, MSW, RSW, CCC
In a word, no, or at least no, if you are in BC. As a matter of fact, if it is a private facility, they may not pay any of the costs. However, some private facilities have publicly funded beds, to which someone can transfer when one becomes available. You could ask the facility if they have them. Check to see what kind of tax breaks you will have when it comes tax time, as care homes are deductible expenses if you have filled out the necessary papers. If you father is a Veteran, there may be some funding available through the Veterans Department.
Different health authorities and provinces have different structures for complaining. I would start with the people on the ward such as the Nursing Leader or the Social Worker. See if there is a specially designated person/office to handle patient care complaints. Every hospital will be licensed and you can call the licensing people who are responsible for the hospital. Most provinces also have an Ombudsman who can step in and do an investigation, although it can take a while, depending on their backlog and urgency. You can find them by googling "ombudsman" and your province. Be clear and as detailed as you can about the problems, citing examples. Also be clear about what you expect in terms of care. Understand that there are limits on the care provided these days--much less physiotherapy, counselling, and other associated health disciplines than there used to be. If there are specific areas of care you want, perhaps you can hire someone to supplement what it provided. In my area, one of the things I do as act as and advocate, depending on where you are, there may be people in private practice who can provide the same function.
Peter Silin, MSW, RSW, CCC
Yes, Peter is an expert on senior care/senior housing in Canada, so feel free to ask a specific question.
The term senior care, similar to seniors housing, covers a broad range. The short answer is that in the publicly funded system, there are subsidies, but they are generally based on your income. If you are looking for assisted living, or nursing home care, the cost will always be below your income, because the costs are determined by income. If you are looking for home support (someone to come to your home to help out) this is also based on income. However, if your income is at a certain level, there is often no difference between what you would pay through the publicly funded programmes and by buying service privately. The advantage of the latter is that there is more flexibility in the tasks the home support worker can do and you are the direct determiner of times and tasks. Call your local health authority to find have an assessment. There is also subsidized supportive housing and low rent independent housing through the public system, however it is limited. To find out more about this, go to B.C. Housing, www.bchousing.org. There is a specific page on supportive housing for seniors: at http://www.bchousing.org/Options/Supportive_Housing/SSH
Peter Silin, MSW, RSW, CCC
Questions on Senior Housing
My father presently lives at first place seniors residence but the care here is not quite enough for him, so this is our first step enquiring into a seniors residence where he has nurses, caregivers and assistance with your day to day living. he's currently on pension and has an income I am enquiring about financial assistance how he would qualify or go about receiving financial assistance to get him into a senior residence.
If there is any information that you can provide to me as to how I begin the process I would greatly appreciate it.
Really you are looking at your father going into a nursing home. The best people to contact would be the local seniors care care providers or the community care access centre nearest to your father. Alternatively, often people at the Alzheimers Society have some information on that.. You might want to call the Ontario Seniors Secretariat at http://www.seniors.gov.on.ca/en/index.php. You don't say what his income is beyond his pension so I cannot tell you if he would be able to afford private care or not. Most private nursing homes cost between 4,000 and 6,000.00 per month minimum.
Peter S. Silin, MSW, RSW, CCC Diamond Geriatrics
I am not sure exactly what you mean by retirement, in terms of services you need or other parameters such as costs but here is quick list of what I found in the area:
EARL HAIG SOCIETY
1800 Austin Ave.
Coquitlam, BC V3J 1S4, Ph: 604-937-3790 Area: COQUITLAM
Provider: Royal Canadian Legion Branch #178
Cost: No cost
1010 Alderson Ave.
Coquitlam, BC V3K 1W1, Ph: 604-937-5578 Area: COQUITLAM
Provider: Societe du Foyer Maillard
Maple Ridge, BC V2X 6E4, Ph: 604-463-1078 Area: MAPLE RIDGE
Provider: No Provider provided
SUNWOOD MATURE LIVING COMMUNITY
12241 - 224th Street
Maple Ridge, BC V2X 6B9, Ph: 604-463-5527 Area: MAPLE RIDGE
Provider: No Provider provided
12275 224th St.
Maple Ridge, BC V2X 6H5, Ph: 604-466-8602 Area: MAPLE RIDGE
Provider: Chartwell REIT
Peter S. Silin, MSW, RSW, CCC
Ito calculate affordability, I have to look forward to increases in rents etc after moving to a retirement home as part of our budget for my wife and myself.
It depends on what you mean by retirement home. If you are talking about a building for seniors or restricted by age simply, then they are usually covered by the provincial landlord tenant regulations. This would be for rent only. If you are talking about private assisted living and nursing homes, they may or may not be covered by provincial regulations. Publicly funded nursing homes and assisted living do have restrictions on what they can charge and their increases, but it is not via the landlord tenant legislation usually, but by the provincial body charged with regulating the facilities in general. For services in private homes my guess is you are pretty much out of luck in terms of having any restrictions on increases in fees for services.
The best thing to do is to call landlord tenant agency in your province. You could also call your provincial ombudsperson. Finally, you could call the health authority in your area and ask them if the particular residence is covered.
Peter S. Silin, MSW, RSW, CCC
i live in brampton, i took in a homeless man 82, called peel to help him was told there is a waiting list for assistance, that i would be better off putting him back on the street for him to get help, icannot do this. but i can only help for a couple more months. he get old age and cpp. but out of this he said he has to pay his ex wife 500. i really dont know were to get him help.
A few ways to approach this, and my thoughts:. One, if he is only getting OAS ( Old Age Security) and CPP, he should not be paying his wife $500 per month. Something does not sound right there. Second, you can bring him to a shelter or at least call the shelters and ask them if they can help. Third, you can call the local Peel health unit which is responsible for seniors and housing, and get their help. Fourth, if none of those produces results, call the newspaper. Fifth, if he was on the street for a while, he knows how to survive. You can simply tell him he has one month to find himself something, after which he will have to leave.
What was there that made you take him in? If there is a health issue, you can also bring him down to the local hospital emergency ward, and then he becomes their problem. Most likely he would be known to them.
You can find more information about Designated Assisted Living (DAL) facilities in Alberta here: http://www.albertahealthservices.ca/627.asp . At this point we don't work with any assisted living facilities in Calgary area, but this might change in the future.
2ndly, if we change provinces will we still be entitled to health care? We live in Calgary but are thinking of going to bc.
You may have to go through a waiting period before you are eligible for medical services when you change provinces. Generally, there is a reciprocal agreeement so that coverage is continuous. The best thing, for the details is to contact your Health Authority in Calgary.
Peter S. Silin, MSW, RSW, CCC
We work with several communities in this area: http://www.seniorszen.com/care/independent-living/ontario/st-catharines
Would you be interested in hearing back from any of them? If yes, please call us at: 1-888-484-5282.
RETIREMENT HOMES FOR THE ELDERLY – CHOOSE WISELY! (From an article I wrote for local newspapers)
Before moving into a retirement home, it is very important to determine what the annual increase in rent will be. For instance, the Mulberry Independent Living Estates in Moose Jaw, owned and operated by Holiday Retirement, an American company, increases the rent annually to as much as 6.1%. This results in an increase of $195 per month for a one bedroom suite at an average rent of $3,000. The residents are extraordinary people who worked hard for many years to make a living, raise a family, contribute to their communities, pay taxes, save, invest wisely and prepare for old age. With the annual exorbitant increases in rent, how long can they remain independent? The Mulberry has been holding various events this year to entice new renters but still have a number of vacancies. It is obvious that its reputation of annual high rental increases has deterred many from moving there.
The elderly people living in the Mulberry Estates are not taking a “holiday”; it is their home. It is a first class establishment with a caring workforce and many amenities. However, corporations should not be allowed to gouge those who live in retirement homes such as the Mulberry. It is more and more difficult to earn investment dollars, and those on a fixed income cannot afford the ever increasing rent. The residents at the Mulberry feel trapped and have no other recourse but to pay or leave. Where will they go? The provincial and federal governments are facing a great dilemma in the costs of support for the elderly now and in the future. Since the elderly are no longer employable, the rental rates should not be compared to market rental prices. The logical solution would be to charge a fair and equitable rent to the present and future residents for the duration of their stay.
First thing to do is check whatever contract you may have signed to see what they say. This would include looking at what they have in costs for services. Second thing is to contact your provincial government residential tenancy/landlord tenancy branch to see if the residence is covered under the provincial legislation. They may be and that may trump whatever is in your contract from the residence. If there is a provincial Ombudsperson, their office may be able to help negotiate something. If the residence is publicly funded, there is most likely nothing you can do. Find out how they estimate charges and make sure that your individual charges fall within the guidelines that have been set.
In the end, some seniors residences are not included under any protective legislation and they are free to do as they wish. Unfortunately,
She may qualify for some benefits in terms of tax relief which, while not a direct subsidy could leave her with additional disposable income at the end of the year.
As for subsidies, it depends on what province she is in. For British Columbia there is SAFER--Shelter Aid for ElderResidents http://www.bchousing.org/Initiatives/Providing/SAFER. You could contact the local health authority for some additional information or even often the Alzheimer's Society has provincial information on this.
Be aware that in Assisted Living costs can increase with care needed, so you should be aware of how those costs will increase if your mother's condition deteriorates. Care charges are often calculated on a per task or number of minutes needed and can go up by levels.
Peter Silin, MSW, RSW, CCC
Complaints that food is usually covered with some sickly sweet & sour sauce, meat is tough, very fatty, or freezer burnt. Very often the residents in mom's dining room throw out half of their meals due to poor quality. This is on- going. Once the cook was even in tears because quality of food was so bad & she had no choice but to cook & serve it. Samples of food has been taken to the part- time manager who has said she would not eat it either. I worry that these folks are not getting enough usable protein & other important nutrients. Please help. Wendy
Depending on the province there is differing overseeing of assisted living facilities. If it is not a true assisted living, and more of independent living, there might be less you can do. Try to find out who is responsible in the province or health authority.
Currently we don't have any partners in Kitchener. The closest location would be Paris, Ontario.
You can click here to contact our partner that can help you with your request in Missisauga area.
Hi, all residences that we work with are listed on our website.
We also dislike the idea of being in a Senior Ghetto.
Honestly, it is hard to know what to think when I know so little about you.
Depending on where you live, assisted living may be covered or partially covered by your province through your local health area. However, if you are both healthy enough to drive to Mexico every year, I would question whether you need Assisted Living. There are other types of seniors housing providing different kinds of services. Independent or Supportive housing provides meals and housekeeping once a week, recreation, and a call system. Assisted living provides help with personal care. So my question for you is, and for you to ask your children: what is it that they think you need? Also discuss with them why they think you need this. What is it that they see or are concerned about for you? Why is this coming up now? It may be that they are just worried that something will happen, and they want to make sure you are in a situation where you are safe. Maybe they are just worried. And maybe they see something that you do not.
This may be a good time for you to sit down with your children and discuss the future, and talk about the "what happens if" questions, such as what happens if one of you needs some kind of care or support, or both of you do and how will you go about finding it. An income of 3,000.00 may cover some kind of seniors housing and there are often provincial subsidies in the various provinces. Do a little bit of research by calling the provincial health unit near where you live, and find out what you can about the various types and costs of seniors housing that are available. Also, learn about other supports that might be available if you need them in future.
Independent living (housing) is also sometimes called supportive living or housing. It generally means that there are meals available in the facility, as well as recreation, light housekeeping once a week and an emergency call system. The meal plan may be one meal a day up to all three or some variation. There is no personal care available at this level of housing.
Assisted living provides the same services as independent/supportive living, but there is also personal care available. These services will include personal laundry, help with bathing, help with dressing, medication reminders. There may be a nurse supervising the care provided, but there is no nursing care available. Assisted living is often regulated by the province in which it is found and they must adhere to the standards of those regulations. If you are looking at Assisted Living, ask about how it is regulated in your province, and who the regulator or regulating office is.
In the private system, you may find housing that has both options available. You could go in not needing help, but if your abilities decline, then you can buy extra services as you need them. The charges may be determined on a pay by the service plan, or by the amount of help you need in terms of time. When looking at seniors housing, always ask if they have these options, and what additional costs may be. Also be sure to ask at what point they would determine that your needs are great enough so that they can no longer meet them, and would ask you to move. This is a real and frequent occurrence in Seniors Housing.
Peter Silin, MSW, RSW, CCC
There is a huge variation in the wait times for seniors housing. It depends on whether they are publicly or privately funded, which province they are in, an where in the province, and the type of housing your are looking at.
For instance, if you are looking for publicly funded, subsidized homes there is generally a wait list. Depending on the urgency and the availability of all housing, you could be admitted within a few weeks or it could take up to a couple years or more. Privately funded housing depending on where you live can be available within a month or two. If you are in a rural area and there is only one type of facility that fits your needs, it could take a lot longer.
The first thing to do is contact your local health provider in your province. The second thing is to determine what type of housing you are looking for--independent (or supportive) housing, assisted living, or a nursing home? Some provinces have smaller group homes and other options available.
Peter Silin, MSW, RSW, CCC