Seniors Care Options

An older adult worries about what will happen to them if they become ill or disabled and need care.   There are many seniors care programs and options to consider.  Some are subsidized.

Public Care – subsidized

Home and Community Care Services

  • Are accessed through the health authority;
  • Are accessed by the individual/representative who
    • meets general provincial eligibility criteria
    • agrees to participate in a formal assessment that is conducted by their health  authority, and,
    • are assessed as having needs that can be met by the services;
  • Are subsidized by the Ministry of Health and administered and delivered by the health authorities and other contracted providers; and

NOTE – While individual preference for service is considered, the individual’s need as determined by a formal assessment is the primary consideration in determining which service is provided.

Community Nursing

Community nursing services are provided by a licensed nursing professional to clients in the community who require acute, chronic, palliative or rehabilitative support. Services include assessment and nursing interventions such as education, wound care, medication management, chronic disease management, care management, post-surgical care and palliative care.  Generally, community nursing services will be provided on a short-term basis and community nurses assist clients and their families to be confident in taking over care at home.

Community nursing services may be provided in a variety of settings such as clinics, the client’s home, assisted living residences, family care homes, group homes, or other community settings

Home Support

Home support services are designed to help older adults remain independent and in their own home as long as possible. Home support services are provided by community health workers to clients who require personal assistance with activities of daily living, such as mobilization, nutrition, lifts and transfers, bathing, grooming and toileting.  They may include safety maintenance activities as a supplement to personal assistance when appropriate, as well as specific nursing and rehabilitation tasks delegated by health care professionals.

Adult Day Services

Adult day services include an organized program of personal care, health care and therapeutic social and recreational activities in a group setting that meet client health care needs and/or caregiver needs for respite.

In some cases transportation is provided, while in others clients are responsible for their own transportation to and from the program. Many adult day service programs are connected with residential care facilities, while others operate independently.

Community Rehabilitation

Community rehabilitation services are provided by a licensed physical therapist or occupational therapist to clients who require acute, chronic, palliative or rehabilitative support. The main goals of rehabilitation therapy are to help improve or maintain physical and functional abilities and to provide assessment and treatment to ensure a client’s home is suitably arranged for their needs and safety. Generally, community rehabilitation services will be provided on a short term basis and community rehabilitation therapists assist clients and their families to be confident in taking over care at home.

Community rehabilitation services may be provided in a variety of settings such as clinics, the client’s home, assisted living residences, family care homes, group homes, or other community settings.

Choice in Supports for Independent Living (CSIL)

Choice in Supports for Independent Living (CSIL) provides eligible home support clients (clients living with physical disabilities and who have high-intensity care needs) more flexibility in managing their home support services.

CSIL clients, or a designated Representative or a client support group, receive funds directly for the purchase of home support services and assume full responsibility for arranging services, including recruiting, hiring, training, scheduling, supervising, and paying home support worker(s).

Caregiver Respite/Relief

Many people receiving home and community care services are assisted by informal caregivers, often a friend or family member. Respite care can give the caregiver temporary relief from the emotional and physical demands of caring for a friend or family member. Respite may take the form of a service that is provided in an individual’s home or a residential care facility, hospice or other community care setting such as an adult day centre.

End-of-Life Care Services

End-of-life care is supportive and compassionate care that improves the quality of life for people and their families who are facing the end stages of a terminal or chronic illness, or preparing for death.

End-of-life care addresses physical, psychological, and spiritual concerns and focuses on comfort, respect for decisions, and support for the family.  It is provided wherever the client is living, whether in their home, in hospice, an assisted living residence or a residential care facility.

Private Care Services

  • Are accessed by the individual directly from the service provider;
  • Each individual can shop and compare for services that best meet their needs and preferences;
  • All aspects of service provision are agreed to by the individual and the service provider; and
  • Government does not provide any financial assistance to individuals or service providers for the service.

Moving Out of the Home

It may be that an older adult needs to move out of their home in order to receive adequate care.   The following are types of residences available.

Assisted Living

Assisted living services provide housing, hospitality services and personal care services for adults who can live independently and make decisions on their own behalf but require a supportive environment due to physical and functional health challenges.

Short-Term Residential Care

Short-term residential care services are provided on a short-term basis (usually less than three months) and include convalescent care, residential hospice palliative care and respite care.

  • Respite care provides a client’s main caregiver a period of relief, it can also provide a client with a period of supported care to increase their independence.
  • Convalescent care is provided to clients with defined and stable care needs who require a supervised environment for reactivation or recuperation prior to discharge home, most commonly following an acute episode of care.
  • Residential hospice palliative care is provided to clients who require support with comfort, dignity and quality of life in the final days or weeks of their lives, and is distinct from end-of-life care provided to residential care clients who become palliative.

Long-Term Residential Care

Residential care services are provided in facilities that provide 24-hour professional care and supervision in a protective, supportive environment for people who have complex care needs and can no longer be cared for in their own homes or in an assisted living residence.

Staying At Home

Many older adults want to stay in their own home if at all possible (“aging in place”), even after truly independent living becomes difficult, unsafe or uncomfortable.    This is usually an issue for those 85 and older – most younger seniors are able to live independently or with some home care.   Their care needs may be such that  publicly subsidized care may no longer be appropriate.   The Health Authority or their care plan may say they should be moving into assisted living, or even long term residential care.   They will likely not have the money to afford round-the-clock private care, which the government does not help with.  What can they do?

Many older adults may be ‘house rich and cash poor.’  They may own a house with substantial equity, especially in the lower mainland.  Are they ways to tap into some of that equity to pay for care?


Financing Care – Some Issues

Reverse Mortgages

One way to tap into the equity (mortgage free portion) in a home is using what is known as a ‘reverse mortgage.’   This allows you to obtain money without selling your house.   Unlike a regular mortgage, you don’t have to make any regular or lump sum payments on a reverse mortgage.  Instead the interest owed on the mortgage accumulates.   The principal and the accumulated interest will be charged against the equity of the house when you either sell the house, it is no longer your principal residence, or after you die.  While tapping into your equity is attractive, there are some significant drawbacks.  For more information, see our page on reverse mortgages here.

 

Private Care Agreements

Another way that the equity in your house can be used to help you, is to promise it to someone else in the future, in exchange for their promise to look after you now.   This is known as a ‘private care agreement.’  While these sorts of agreements can be attractive, there are also significant dangers.  Please see our page on private care agreements here.