Retirement Living Options are Many and Varied

Peter Krivel, Staff Reporter [The Toronto Star / Reprinted with permission]

What’s the difference between a retirement home and a nursing home? If you don’t know the answer, join the club.

Nursing homes are government licensed and charge set fees, says Esther Goldstein, a former social worker at Sunnybrook and Women’s College Health Sciences Centre, who has written A Comprehensive Guide to Retirement Living in the Greater Toronto and Surrounding Area, published by Retirement Residential Placement Services Inc.

Her definition of a retirement home is that "anyone can hang out a shingle and call it one."

Because of this, there are huge misconceptions about the two, says Goldstein, who gives lectures on how to choose a retirement home to groups ranging in age from university students to seniors.

"Sometimes I never finish my presentation because there are so many questions," she says. "And the questions always centre around the tremendous confusion around the two, especially now that retirement homes are providing more and more care."

Nursing homes, which are also called long-term care residences, are open to anyone older than 18 who has a health card, Goldstein says.

They provide 24-hour-a-day assistance with personal care. They prepare meals and feed people if need be. They can bathe residents, do laundry and administer medication. Doctors and nurses are available.

The homes also have standardized rates across the province, ranging from [$1445 per month] for a public ward to [$1993 per month] for a private room.

And if you can’t afford the ward rate, you can get a government subsidy.

A retirement home is governed by various provincial acts and building codes, Goldstein says, even though it might just be a large house with a few rooms rented out.

One difference in the retirement homes is the levels of care they provide. Some will take you in when you’re fully independent and then charge you more as your needs increase.

"You walk into some of these places and they actually look like nursing homes because the people they’re looking after require so much care," Goldstein says.

Some smaller retirement homes might not accept people who need a lot of care, but this is slowly changing because of increasing demand for such places.

"The beauty of a retirement home is that you can have privacy and independence, but there’s also a safety feature of knowing there’s always someone around who can provide you with assistance when you need it," Goldstein says.

"That’s peace of mind for many families to know that a parent isn’t alone at night. That there’s a call bell and when you press it, somebody comes. It takes away some of the anxiety about the person living alone."

A resident has their own room in a retirement home, but they can also share if cost is a factor. A resident brings their own things, and meals are provided.

Some retirement homes will also have a kitchenette for snacks and breakfast. They’ll do your housekeeping and laundry, or provide washers and dryers. They have social activities and they administer medication and help with a bath if required.

"But if you’re independent and able, you do it all on your own," Goldstein says.

"It’s the idea that you’re not well enough to be on your own but that you are not yet at the stage when you need a nursing home."

Costs for these homes can range from less than $1,000 to more than $7,000 a month. Each home determines what service it will provide.

"This is your big difference," Goldstein says. "I can’t say that someone on basic pension can go to most retirement homes. You can’t. You can’t afford it. If you’re just getting your basic pension there’s no way you can go to one of these homes. The average retirement home is in the range of $2,000 to $3,000 a month."

One question Goldstein is always asked is why she doesn’t rate individual homes in her retirement guide.

"First, I don’t have the right to rate anything," she says. "But also everyone is so individual in his or her needs. What I may like, you may not like."

You may absolutely hate the places I like. There’s so much diversity and so many homes out there that’s it’s difficult."

She says it’s important to start talking early about relocating to a retirement home. If you are looking for a parent, they should be involved in the choices.

"You want to be able to make an informed decision and have time to do so. I’ve seen so many situations where people have been forced to make a decision because of the circumstances. They can’t stay in the hospital and they can’t go home, so decisions have to be made quickly."

If a parent is involved, the time to talk begins when the parent becomes frail, has problems preparing meals or has memory problems.

If your parent is adamant that a retirement home isn’t an option, Goldstein suggests you sit down and say you’re worried something bad might happen.

If the refusal persists, ask them what they would want in a home and make a list.

"Get a sense of what their needs are. It may be completely different to what you think."

Goldstein then suggests you search for places that meet these criteria.

"For example, price is a major limiting factor. Another factor is the area. You want to be able to reach her quickly if she needs you."

A lot of people fear if they’re institutionalized their relatives will dump them and never see them again, so Goldstein stresses you explain this won’t be the case.

"Tell them that you’ll still be the caregiver and will still have responsibilities," she says.

"Moving to a retirement home just means that when you visit, you aren’t busy cleaning their house, worrying about shopping, checking their fridge to see what things have expired. You’re sitting there and visiting with them."

Sometimes it’s important just to show them life can be better if they’re being looked after and you’re not worrying about them all the time, she says.

When you find a few places that meet their criteria, make an appointment to visit them.

"Most of these places will take you for lunch. That’s a big thing. It may be a beautiful place but if your relative hates the food, then it’s miserable. Then go for a tour. You can even book a vacation there.

"Your parent can stay for a week with no commitments and keep the apartment. It’s not something you can force somebody into overnight. It’s introducing the idea," says Goldstein.

Her guide is in its sixth edition. It covers homes in the 416 and 905 areas but next year will cover all of Ontario.

It has an extensive listing of retirement homes, but also goes into greater detail about what a retirement home is and other options, from help in the home to homes for couples with different needs.

It’s available at Chapters or Indigo Books or by going to Senioropolis.com or calling (416) 457-6554.

The Toronto Star,
Saturday June 14, 2003
Time of Your Life Section, R4

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