Choosing a long-term care centre

When it comes time to place your parents (or loved ones) into long-term care, remember that all such facilities are not created equally. Carefully consider the services and level of care offered… will a facility be appropriate for your parent’s current (and future) healthcare needs? If not, know that you may be called upon to repeatedly move your parent which becomes increasingly difficult for both of you. With my own father’s Alzheimer’s disease progression, my family moved him three times before he passed away.

You may well hear a number of terms bantered about describing different facilities. The lines between these terms may be vague. It is vital that you understand and differentiate between these options. Among the most common terms are the following:

Home care: Home care consists of support services that can be provided to seniors who remain living in their own homes. The types of support can vary dramatically, depending on a senior’s needs. Mom could be bathed, dressed and fed in the morning; Dad could have his lunch prepared for him and be taken for a walk.

Independent Living: These types of facilities are ideal for seniors who can still live and function quite well on their own. These facilities typically offer residents their own apartment-style unit (as a bachelor or one-bedroom, for example) with kitchen facilities and a small refrigerator. Residents can typically rent or buy such a unit and home care services can be provided.

Supported Living: Much like independent living, these properties consist of individual apartments but also feature various common areas, shared by the residents. Supportive living facilities offer enhanced security to the resident and resident’s family through around-the-clock emergency response as well as the convenience of prepared meals and housekeeping services.

Assisted Living: Here, a senior can receive more hands-on health care and management. Staff in assisted living facilities can help with medication reminders and delivery and bathing and dressing a resident. Such personal care can become uncomfortable, tricky and risky for family caregivers to provide.

Long-term care: This is, frequently, the final stop for a senior with advanced-health issues. Long-term care centres are staffed full-time by practiced healthcare professionals who competently provide any number of required services to a senior.

Admittedly, looking at long-term care facilities is a daunting task for caregivers. There is the time involved to visit each, as well as any lingering emotional baggage. Looking for secured units for my father made me face the stark reality that he was not getting any better. I was almost envious of Dad who remained completely unaware of forthcoming moves and the amount of work involved. Take the time to visit each facility for a complete tour and ask pointed questions both of yourself and the facility staff. You may want to consider the following questions:

Is the facility conveniently located? A facility on the other side of town will not be either easy or convenient for family caregivers to visit. When Dad was still alive, I did not have a car, so I also had to factor in public transit service to the neighbourhood. You could also judge the facility’s location depending on proximity to shopping, parks and/or Mom/Dad’s doctor’s office. On this same subject, evaluate the location within the location… will Mom or Dad have a sunny window in the room or be close to the nurse’s station? With seniors’ rooms being smaller than a normal residence, ensure as well that there is no wasted space (e.g. pillars or hallways).

Is the property clean and well maintained? Depending on the time of year you visit, you can tell a lot from the facility’s exterior appearance. In the winter, are the sidewalks cleared of ice and snow? In the summer, is the grass neatly trimmed? Are there any potentially dangerous cracks in the sidewalks? Is the interior and exterior of the property well-lit? When touring a long-term care centre, stray a bit off the beaten path… peer into closets and stairwells to see if these areas are regularly swept and mopped.

Can a senior be transferred within the same facility to receive specialized assistance? This, I consider, to be of utmost importance. With such continuing care being available under the same roof, this will reduce the number of additional moves that may become necessary. Limiting those moves reduces your own stress as well as the anxiety from a senior who may not completely understand.

How safe is the facility? Determine the date of the latest building inspection and the most recent elevator servicing. What is the building’s emergency evacuation procedure? Does the facility have emergency lighting in case of a power outage? Is there a lock-up area for both medications and toxic chemicals?

What is offered for meals? Food, undoubtedly, contributes to one’s quality of life. Investigate the menu. How is food prepared and served? Can dietary restrictions be accommodated? Are menu items healthy choices? Can you sample some of the food for yourself?

While there is a great deal to consider when choosing a long-term care facility for Mom/Dad (and imminently placing him/her), step slowly and cautiously. In doing so, you will make a better decision for both you and your parent.

Rick Lauber is the author of Caregiver’s Guide for Canadians available at national Chapter’s bookstores and on More info at

Photo © Silvia Jansen

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