Choosing a long-term care facility

Use a step-by-step process to help ease this challenging experience for both you and your loved one.

Several of my family members have had differing long-term care requirements over the years. My father-in-law, the most recent of my loved ones, required acute hospital care and a month-long stay, after which he needed full-time care giving.

In preparing to select the best-suited facility, we used a step-by-step approach which took several factors into consideration. This eased our challenges in identifying the appropriate long-term care facility for each of our family members.

Step 1: Needs assessment

Determine whether (s)he requires:

  • specialized/skilled daily nursing care (bedridden and/or need daily nursing)
  • assisted living (assistance with a couple of daily activities)
  • expert-type care in areas such as dementia/Alzheimer's

By answering the following questions, your choices of long-term care facilities can be reduced to the ones that provide proper support.

Physical requirements:

  • Is assistance required for daily activities, such as being clothed and/or meal preparation?
  • Is bathing assistance required?
  • Is feeding done orally (if so, is assistance required)? or via tube?
  • Does mobility require the use of an aid such as a cane, walker or wheelchair?
  • Does wheelchair mobility require assistance?
  • Is (s)he bedridden?
  • Is (s)he incontinent?
  • Is there a medical condition? If so, what are the requirements of this condition?
  • Are medications required?
  • Are special treatments required?

Behavioural requirements:

  • Has (s)he been diagnosed with dementia or Alzheimer’s?
  • Are there noticeable aggressive behaviours?
  • Is (s)he coherent?
  • Is (s)he compliant?
  • Does (s)he have the ability to express needs?
  • Is there a mental health issue? If so, what assistance is required, if any?

This is certainly not a comprehensive list, so including the specifics of your circumstance is necessary. The Canada Senior’s Housing Guide is an excellent resource to help you make a well-informed decision.

Step 2: Ability to pay

Long-term care is offered through a mix of public, private, not-for-profit and religious-based providers. The provincial governments typically fund nursing, personal care, programming and food costs. Residents pay for their accommodation, which can cost anywhere from $900 to $5,000 per month, depending on the province, room type and funding available (private home care ranges between $12 and $90/hour). This does not include costs such as cable TV, hairdressing, clothes, toiletries, glasses, hearing aids, pharmaceuticals, dental services, transportation and so on. Developing a budget assessing the affordability of long-term care costs is thus essential.

If your loved one is incurring the cost, the budget may include revenues such as:

  • pension (Provincial Pension Plan, Canadian Pension Plan, Old Age Security, employer-related plan)
  • RRSP income
  • investment income (such as interest and dividends from investments)
  • long-term care insurance
  • gain on sale of home
  • other income streams

It is important to include any payments other than those mentioned, such as income tax installments, in your budget planning.

If you are incurring the cost, our blog post on setting up a budget for a life event can help.

Step 3: Choosing a long-term care facility

Choosing a long-term residential facility is the final, yet challenging, step. The key is ensuring that the quality of care meets your loved one’s needs and your expectations. You can start by researching your province’s resources by visiting the “How do I apply for long term care” section on the Government of Canada’s website.

Using this information, along with an exhaustive checklist, such as this one prepared by the Northwest Community Care Access Centre (see page 3), will give you a solid start on narrowing down your choice to the one best suited for your family member.

Keep the conversation going

Have you thought about a long-term care facility for your family member? If so, what factors impacted your choice?  Post a comment below.


The views and opinions expressed in this article are those of the author and do not necessarily reflect that of CPA Canada.

About the Author

Kathy Lempert, CPA, CGA

Kathy has a strategic and business advisory services consulting practice. Her experience in the aerospace, medical, real estate, pharmaceutical, telecommunications and manufacturing industries includes management of IT software development, treasury back office, development of policies, process and procedures, business process improvement, business plans and budgets. Kathy co-founded a charity in 2014 called Kehilla Montreal Residential Programs, whose mission is to provide a variety of affordable housing solutions that will help break the cycle of poverty. She has also served as a director on various charitable boards, including being treasurer of a large Montreal charity.