As one of our friends commented recently, it can be difficult to
make choices at times when there seems to be a bewildering variety of
options.  Once the decision has been made that a person needs institutional
care, however, the range of choices can be reduced to a manageable level
very quickly.  The Jewish Home & Hospital for the Aged in Vancouver,
for example, is a wonderful place... I would give it full marks in the
"people" department.  But while they probably wouldn't turn
Granny away, if her need for medical and/or personal care matches what they
have to offer, she might feel rather uncomfortable there if she's not
Jewish.  I imagine the same applies to other facilities which are named
after a particular group of hyphenated Canadians, a club or lodge, etc.


          The remainder fall into three general categories:

 1)  Retirement Home/hotel/holiday resort for healthy, active seniors... often
     referred to as "Assisted Living" in recent years.  If you
have to ask how
     much it costs, you probably can't afford it!  Typically these places have
     names which include the word "Manor" & are heavily
marketed as "Lifestyle
     Choices" with the emphasis on features such as yoga & dance
classes, maid
     services, and the preponderance of French in the dining room.  While some
     may claim to provide help with "activities of daily living",
they tend to
     be rather vague as to what particular activities they have in mind... and
     AFAIK there are no government standards requiring them to do it.  I guess
     they don't expect a lot of visitors either.  Parking spaces, if there are
     any, are usually reserved for vehicles belonging to the residents.  These
     homes may serve a legitimate need for some people... e.g. the lady I know
     whose daughter lives in Guam... but they're *not* equivalent to #2 or #3.

 2)  Intermediate Care for those who need help with dressing, bathing etc. but
     who are still more or less ambulatory & physically healthy.  The examples
     I've seen vary widely because they're often housed in the same facilities
     as #1 or #3.  IMHO the old term "Nursing Home", although it
seems to have
     fallen out of favour recently, still conveys the general idea quite well.
     While some personal care duties are delegated to assistants hired for the
     purpose, the majority of the less trendy facilities & those which include
     category #3 have at least one RN on duty at all times.  This level may be
     what's needed for otherwise healthy seniors who have severe dementia too.

 3)  Extended Care (Long Term Care) for those whose need for help with medical
     and/or personal care exceeds the number of hours allotted for #2, and for
     those who are unable to walk.  Typically it looks like a hospital and has
     more or less the same rules as other hospitals.  There's a list of nurses
     & personal care attendants on duty for each day posted at or close to the
     nursing station... which is strategically located where the staff can see
     the doorways of residents' rooms and monitor any activity in the hallway.
     There are private rooms for those who want them, but many residents share
     a single room with one to three other people to whom they're not related.
     As with #2, some fees may or may not be subsidized depending on income...
     and as with #2, people can't just walk in off the street & sign up.  It's
     necessary to work through the local health unit or have a doctor do that.


          This report is based mainly on my own personal experience with
over a dozen facilities in the Vancouver area.  From what I have read the
situation is much the same in other parts of Canada, but if you live
elsewhere YMMV....  :-)




--- timEd/386 1.10.y2k+