All About Estates

Until Death Do Us Part- or until we need provincially funded care in a LTC

After 70 years of marriage Norman and Mae are told by our government that in order to get the care they need, they need to live separately. Certainly there is something not right about this statement, yet as hard as it is to believe, that was the story reported in the National Post on Jan 6, 2017.

At age 94 and 91, Norman and Mae have enjoyed what can be considered a long life and an even longer marriage. The article indicates that they have always lived together- no easy feat at any time. I sincerely doubt they ever anticipated having to live separately in order for them both to receive publicly funded care in a Long Term Care facility.

As we age we may not always have the same health care needs as our partners. A couple’s different care needs may be able to be met in the community if finances permit either at home or in a retirement setting. However when care needs exceed what can be met in the community, many look to Long Term Care facilities, our publicly funded ‘nursing’ homes.

Norman and Mae had both applied for Long Term Care. The process for those who may not be familiar requires an assessment and a finding of eligibility by the Community Care Access coordinator. Once deemed eligible, one can choose up to five residences. From here, the choices can be for a ward room rate, semi shared rate or a private room. Regardless of where one lives in the Province, the application process and associated fees are the same.
Accommodation costs are set by the Ministry of Health and Long-term Care and are standard across Ontario. The current rates (maximum) are:

Type of accommodation Daily rate Monthly rate
Long-stay Basic $58.35 $1,774.81
Long-stay Semi-private $70.35 (Basic plus a maximum of $12.00) $2,139.81
Long-stay Private $83.35 (Basic plus a maximum of $25.00) $2,535.23
Short-stay $37.77

The Ontario Long Term Care Association provides the following information based on 2015 data*:
• 627 homes are homes licensed and approved to operate in Ontario
• 57% of homes are privately owned, 24% are non-profit/charitable, 17% are municipal
• More than 40% of long-term care homes are small, with 96 or fewer beds
• Of these small homes, about 43% are located in rural communities that often have limited home care or retirement home option
• 76,982 long-stay beds are allocated to provide care, accommodation and services to frail seniors who require permanent placement
• 708 convalescent care beds are allocated to provide short-term care as a bridge between hospitalization and a patient’s home
• 362 beds are allocated to provide respite to families who need a break from caring 24/7 for their loved one
• Approximately 300 of the provinces long-term care homes are older and need to be redeveloped (more than 30,000 beds)
• The average time to placement in long-term care, as of December 2015, was 103 days
• The wait list for long-stay beds, as of December 2015, was 26,495

So what happened? According to the story, Mae was offered a bed at her preferred setting. By the way, one typically has 24-48 hours to make a decision as to whether to accept the placement or not. If she accepted the bed, Norman would be on his own, which the family felt was not manageable. She passed on the placement bed so she could remain with her husband. Only a few short weeks later, Norman was offered a spot at the same facility where Mae had declined the bed offer. However due to Ministry policy her name had been removed from all of the waiting lists and she now has to wait 3 months before she can even reapply. There was no mention how long the initial waiting period had been. Many of the ‘preferred’ homes have wait lists of several years.
Yes, there is a spousal reunification policy established by the MOHLTC and implemented by the CCAC, however we can only hope that Mae and Norman survive long enough to finish telling their story.

* Sources: Long-Term Care Utilization Report, December 2015, Ontario Ministry of Health and Long-Term Care; Ontario Long Term Care Association, internal database, 2015.

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About Audrey Miller
About: Audrey Miller, Managing Director of Elder Caring Inc. has over 30 years social work and rehabilitation experience working with older individuals and their families. She advises the financial, insurance, legal and business communities regarding elder care issues. Audrey is a recognized expert in her field. Email: amiller@eldercaring.ca