People are living longer, so we need to consider that they may not be able to live at home alone because of poor mobility or diminished capacity. So, planning where one wants to live should be at the core of one’s lifestyle plan. Families often suggest retirement home living when a person needs increasing assistance making meals, housekeeping, and looking after their day-to-day needs. It is crucial to choose suitable accommodation to avoid making a mistake—financially or for one’s lifestyle.

In a previous blog post, I discussed housing options for seniors in Canada, from independent living at home to retirement living to long-term care facilities. There are myriad options for post-retirement living; however, with targeted marketing by retirement home companies, people often choose retirement homes as their first option.

Consider an example where a couple in their mid-eighties seek assistance to plan their next decade of life. The wife has been diagnosed with early dementia and an aggressive type of Parkinson’s disease, which is affecting her mobility and other body systems. They want to consider two options: stay in their 4-bedroom, two-storey home and make significant modifications or move together to a retirement home at the appropriate time. They have no children, and no extended family is nearby to act as caregivers. What do they need to consider?

Retirement Homes are Distinct from Long-term Care Homes

As an elder management consultant, I’m often asked questions about long-term care planning vs long-term care homes. The terminology used by some industry and academic people can confuse the public. Long-term care planning usually occurs when an older person’s care needs increase. Planning options for an older person can range from independent living to 24-hour nursing care in a long-term care home or “nursing home.” A long-term care home is an option that can be considered during long-term care planning.

Long-Term Care Homes

Long-term care homes are publicly funded. In Ontario, applications for admission to a long-term care home must be made through a government agency that used to be called Home and Community Care Support Services (HCCSS) and has been renamed Ontario Health at Home.[1] The regional organizations continue to exist but have recently been consolidated under one governance model. There are 620 licensed long-term care homes in Ontario and just over 76,000 beds, all of which are at total capacity. [2] The waiting list is years long, with over 40,000 people awaiting admission.

Retirement Homes

Retirement homes are private businesses, and residents sign a tenancy agreement to pay for meals and accommodation, a list of care services required, and the identified costs. The private retirement home company uses a hotelling business model; their goal is to have full occupancy and to sell care services to their residents. There are 776 licensed retirement homes in Ontario. The Retirement Homes Regulatory Authority (RHRA) administers the Retirement Homes Act, 2010 (RHA) and is responsible for licensing and regulating retirement homes. The Residential Tenancies Act, 2006 (RTA) also governs retirement homes concerning written tenancy agreements.

The first steps to take if a client is looking at a “retirement home.”

Is the “retirement home” regulated?

If a client is looking at a “retirement home,” the first step is determining whether it is regulated under the RHRA. Only licensed homes are regulated by the RHRA, and it should be noted that “retirement home” is not a protected title. There is an excellent Key Facts to Know About Retirement Homes document published by the RHRA with valuable information about licensing, the care services that retirement homes can offer residents, resident tenancy agreements, returning to a retirement home from a hospital, and more.[3]

What are the person’s care needs now and likely to be in the future?

The following critical step to consider is what the individual’s care needs are today and their needs before deciding on the location or type of retirement home. Marketing campaigns can give the impression that a range of services is provided for people with care needs. However, the reality is that many retirement homes do not offer care services for people who require more complex care, such as dementia care programs, feeding assistance programs, or mechanical lifts. If more care services are needed after a person moves in, not only do the monthly costs escalate, but it is possible that the resident will be asked to leave if the retirement home cannot meet their care needs, and a solution cannot be found.

Too often, families move a parent or loved one into a retirement home and are influenced by the furnishings or other amenities rather than meeting the escalating care needs. The result? It is a short-term stay and another disruptive move for an older person. It’s better to avoid these costly errors by planning well in advance and choosing options carefully.

[1] https://ontariohealthathome.ca/?v=2024.1

[2] https://www.oltca.com/about-long-term-care/the-data/

[3] https://www.rhra.ca/wp-content/uploads/2018/05/Fact-Sheet-re-Retirement-Homes-May-2018-final.pdf