All About Estates

Crisis in Long Term Care


Recently on most days newspaper articles are highlighting some injustice or abuse regarding seniors living in Ontario’s Long Term Care facilities, commonly known as ‘nursing homes’ or ‘old people’s home’. This is a major problem facing society and one that we must get under control.  Last week’s Marketplace Crying Out for Care exposé highlighted abuse amongst residents in many facilities within Ontario. Frankly, it likely caused nightmares for many families as they worry about their family members who reside in some of these facilities.

The yearlong investigation found that in Ontario, “the reported rates of abuse have doubled in 6 years and every day, 9 residents are harmed by another resident and 6 are harmed by staff who are supposed to care for them. The investigation revealed that staff-to-resident abuse increased 148 % from 2011 to 2016.”

I thought I would spend the next few blogs discussing this important issue. This first blog will help set the stage.

I have found that almost all of the seniors I have met would like to remain living in their own homes. I am no different and am sure you feel the same way. The 2011 census data supports this as over 90% of seniors aged 65 plus live in their own private households[1].

In helping families to decide whether ‘to stay or to go’ which means either remain living at home with available care and modifications that might be needed or to explore alternate accommodation, I review the the 3 C’s  which include: Care, Cost and Choice. Included in the discussion is explaining the difference between Long Term Care, which is publicly funded by the Ministry of Health and retirement living, which is privately paid.


However, many seniors don’t have a choice as they cannot afford to either stay at home as their care needs exceed what is possible at home or cannot afford to pay for a private retirement setting. As such, the demand for publicly funded facilities that provide 24/7 nursing care continues to increase.  Stats Can tells us that from our current demographics that older seniors, those 85+ are the 2nd fastest growing demographic  with centenarians (those aged 100 and older) leading the way as the fastest growing age group[2]. The demand on our health care and home care sectors is ballooning and cannot keep up with the current demand for care.

As well, we know now that there are more seniors over age 65 than children under 15,  resulting in less workers contributing tax dollars as well as fewer individuals, whether paid or by size of family, who are interested or able to assume a caretaking role.

The demand on employed carers (35% of working Canadians provide unpaid care to a family member or friend) is high, with the average employee spending 9 hours per week on caregiving. Families are juggling to keep up.

Income for many seniors prohibit them from hiring private care  (averaging in the GTA at approximately $28 +) and without family to assist, they often do with the little that is available from the LHIN’s (Local Health Integration Network, formerly the Community Care Access Centres or CCAC). The services provided by the LHIN will be discussed in a subsequent blog.

The Conference Board of Canada in their report, Future Care for Canadian Seniors, A Status quo Forecast”  shared: “The status quo forecast indicates that by 2026, over 2.4 million Canadians age 65+ will require paid and unpaid continuing care supports—up 71 per cent from 2011. By 2046, this number will reach nearly 3.3 million.”   Older seniors (85+) tend to have greater care needs which greatly impact their ability to live on their own. Functionally they are limited, whether it be from a cognitive or physical impairment. Falls are the number 1 reason that senior have to leave their homes.

In sum, this introductory blog highlights our demographics and sets the stage of the who and the why of those individuals who require Long Term Care. Our Long Term Care options are in a crisis and unless there are some major changes, the future does not look bright.

Subsequent blogs in this series will address eligibility, costs, alternate level of care beds, challenges for younger differently abled adults and the LGBT community, those with dementia and behaviorial challenges and hopefully concluding with some suggestions for improving the system and some options. Stay tuned!




[2] between 2011 and 2016.

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:


  1. Joanne Stewart

    February 5, 2018 - 3:40 pm

    I’m on this journey now with my 93 yr. old father. He had been living with us for over 4 yrs. and needed additional care. Is in a Assisted Living facility but we are on quite the journey. If we didn’t check on him each day I don’t know what would happen. I feel sorry for the people that do not have family close by or do not have family at all. What kind of care are they getting. There are some care workers that do care but the majority just go through the motions.

    • Audrey Miller

      February 5, 2018 - 4:22 pm

      Family is so important. Everyone needs an advocate. So when there is no one family checking in, people do fall through the cracks. Fortunately, there are companies like ours that do provide that type of support and service. As well more EAPs are now offering this type of support as well. Caring for senior and progressing to LTC is especially challenging when the older person has dementia- which my next blog will address. Your dad is lucky to have you in his corner!

  2. Lorie Colledge

    February 5, 2018 - 4:19 pm

    This is so needed! Thank you for taking the time to address the concerns that have impacted many of our families and will have a direct impact on our generation as well. We are living in an era where our children (millennials) are much more “worldly” ….have pursued job opportunities in the U.S. and beyond or are simply very busy with their own families….Therefore it is becoming increasingly difficult for our clients and us personally to know what to do, from both a “cost” (because we are all living longer) and an estate perspective, so as not to negatively impact our children and families (time, money, etc.). These types of discussions need to happen with our clients and at “home”! More importantly, we need to be able to provide access to suitable alternatives to reflect various situations, recognizing that not all are the same!

    • Audrey Miller

      February 5, 2018 - 4:26 pm

      So true Lori, the costs for 24/7 care at home and within many retirement residences can be more than the average person can manage- especially as we are now seeing 2 generations of seniors in the same family!

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