FAQ (Frequently Asked Questions)
When comparing rates for home care, it is important to do so on an ‘apples to apples’ basis. Living Assistance Services’ rates are competitive with virtually every other custodial home-care agency which provides accredited Personal Support Workers (PSWs) who are legally entitled to work in Canada, covered under Workers Compensation, fully insured against liability, have a minimum two years experience, meticulous references and who have undergone a police background check.
Kindly contact our office for current rates.
Our Insurance Certificate may be viewed on request or a copy will be provided prior to the service date.
Our Workers Compensation Certificate may also be viewed on request or a copy will be provided prior to the service date.
- When your parent says "I don't need any help" try gently pointing out that they no longer pursue the activities they enjoy like playing bridge, going shopping, choosing library books, etc. Then tell them how much more pleasant life would be with some help so that they could stay in their home and maintain independence.
- When your parent says, "I want things done my way, I'm the only one who knows what I like to eat, do, buy etc." let them know they can choose and supervise the caregiver.
- If your parent is adamant that they don't want a stranger in their house, allay fears by staying with them for one or two days while the caregiver is there as well as dropping in to see how things are at different hours of the day and night.
- When your parent says, "Absolutely not" contact the home-care agency and arrange a Visit with another senior who is happy with their caregiver. Being able to witness a positive situation may help your parent to make a decision.
- Discuss what would happen if they won't let anyone help. Let them experience a couple of days without your assistance so they understand it is best to have someone around regularly.
- Slowly introduce them to outside services. For example, arrange for someone to take them shopping or to the library. A kind and compassionate person coming into the home may earn trust and prepare them to be open to further assistance.
- Consider hiring a geriatric-care manager or Certified Professional Consultant on Aging who has the expertise to help your parent accept assistance.
Retirement residences differ enormously in what they offer. The quality of accommodation and services differs from place to place; cost varies accordingly. Some residences provide access to communal activities that may not be available at home such as swimming pools, exercise rooms, or game nights.
Retirement home representatives will often cite “staff-to-resident ratios”, which are important but not indicative of the potential ongoing costs. Many homes will insist on “extra pay” care at their hourly rate, if additional care is required.
Retirement homes also provide a social environment that can have positive or negative results depending on the individual. More independent seniors tend to dislike not having a meal choice and eating in large groups. Although many retirement residences now offer personal caregiving and nursing assistance, it is often charged as an extra at a rate comparatively higher than it would be for the same help at home. Medication reminders and/or dispensing of medications by nursing staff, is frequently charged to residents “by the minute”.
Should you decide that a retirement residence is the best option, Living Assistance Services can provide the information needed to make the best choice. We offer care to clients in both nursing and retirement homes, we are familiar with and have extensive files for many of the local area residences.
PSWs in Ontario provide a range of health services in a variety of settings: long-term care facilities, adult-day programs, supportive housing, group homes, hospitals, educational facilities, private homes, etc.
Ontario’s PSW training program is a single program that consolidates and replaces the former health-care aide, home-support worker levels I, II, and III, personal-attendant and respite-worker training programs. The Government of Ontario approved the PSW program on April 28, 1997. The development of the PSW curriculum was a joint initiative of the Ontario Government and the Ontario Community Support Association.
PSW training is offered by Ontario community colleges, registered private-career colleges, adult education divisions of some Boards of Education and not-for-profit organizations. All organizations providing this training base their programs on the document “Personal Support Worker Training: Outcomes and Module Outlines” which is published by the Ontario Community Support Association (OCSA). This full-time course runs approximately 20-24 weeks depending on the institution. PSW certificates are issued by the training institution.
Key Elements of the Program (as per the National Association of Career Colleges)
- Grade 12 or equivalent admission requirement in addition to Medical Certificate of fitness to complete the program
- Literacy Test to be completed by all applicants
- Clear police records check (Vulnerable), Standard First Aid and Basic Rescuer CPR
- 285 hours of classroom instruction
- 355 hours of clinical placement – a) supervised on site by the college instructor in both institutional and community sites and b) precepted by the host supervisor in both institutional and community sites.
- Skills Passbook to be completed on placement
- Primary Instructor is a Registered Nurse with 2 years Canadian experience
- Textbook – Mosby’s Canadian Textbook for the Support Worker: 2nd Edition by Sheila Sorrentino, Elsevier Canada 2009 + support materials
- All students write the NACC final theory examination at the end of the placement. Maximum of 3 writings. This is a quality assurance mechanism for the college, the student and NACC.
Because we are a relatively small organization, we have the ability and time to carefully select and screen all potential caregivers. In fact, we hire only one or two of every 100 applicants!
The Director of Living Assistance Services, who also owns the company, interviews each applicant personally. As a minimum, our caregivers are required to be accredited Personal Support Workers (PSW’s) with a minimum two years experience in senior care. Our staff is expected to provide at least three references which are checked thoroughly. These references are typically from families, nursing homes, retirement homes, hospitals and/or volunteer organizations. We also insist each and every caregiver provides us with a Police Clearance Certificate (a background check completed by the Police).
In addition to a strong educational and employment history, we also endeavour to hire only those who possess intangible traits such as caring personalities and a desire to help people. This is what sets our agency apart.
Lastly, we encourage our clients to meet with several caregivers so they can choose the person with whom they are most comfortable. Most agencies cannot do this because of their massive size.
Live-in caregivers, and in some cases, extended live-out care cases can be accommodated outside these areas with special arrangements made for transportation.
Most organizations do their best to project a positive image to potential clients and will claim that they provide quality caregivers who are reliable and sensitive to your needs. The best way to ensure that you find the right match is to ask specific questions about how they operate. Here is a checklist of what to look for and what to look out for.
- We pride ourselves in being one of the few agencies which actively encourages clients to choose their own caregiver. Beware of agencies which only assign you anyone who is available.
- Make sure the agency hires only qualified and experienced caregivers who possess a community college Personal Support Worker certificate or equivalent. Beware of agencies that rely solely on their own training programs.
- Ask how the agency hires its caregivers. If they don’t conduct extensive background checks, talk to references, screen their candidates for personality traits and interview them at least twice, your loved one may be put at risk. Personality traits, such as reliability and a caring disposition, can make or break the relationship between caregiver and care recipient.
- Reputable agencies pay their caregivers fairly and provide them with the statutory fringe benefits, at a minimum. All workers should be fully insured and covered under the Workers’ Compensation Board. Be sure to ask for a copy of a valid Workers Compensation Clearance Certificate.
- Enquire how the agency monitors its caregivers. Careful and continuous monitoring ensures that appropriate action can be taken immediately if needed.
- The requirements of care recipients typically change over time, even day-to-day or week-to-week, depending upon needs and the availability of family members. Therefore, it’s vital that the agency be flexible and able to provide either live-in or live-out service, for whatever periods are needed. Ask if your agency provides service on a 24x7 basis.
- Flexibility may also be required in the locations where care is provided: at home, in a retirement residence or in a hospital. Some agencies do not provide these options.
- Be sure your care provider has liability and dishonesty insurance with a limit of at least two million dollars. This is required to protect the care recipient and their family. The agency should supply proof of insurance by giving you an insurance certificate.
- Finally, time is often of the essence because you need care immediately. Agencies differ considerably in their ability to respond. Some only need a few hours while others need days. Ask to ensure your needs will be addressed on a timely basis.
We encourage families to let us know about their cultural requirements so that we can introduce caregiver candidates who are compatible.
To see if you can claim attendant care expenses, click here.
To see which attendant care expenses you can claim as medical expenses, click here.
The Canada Revenue Agency has policies and information relative to amounts paid for full-time care. There are also provisions for mental or physical infirmity (if the person is likely to be dependent on others for his or her personal needs), and care for the long-term when the need for a full-time attendant has been certified in a letter from a medical practitioner. To read these rules, click here.
In some cases, the 13% Harmonized Sales Tax (HST) may be entirely avoidable. To determine if you qualify, click here.
See their website, http://www.vac-acc.gc.ca/, which provides complete information about veterans benefits.
In the event you are unable to locate the required link, information is available at: www.webmd.com and www.merck.com.
The Ministry of Health and Long-Term Care can adjust the cost of accommodation. However, the existing per diem has been in effect since the Long-Term Care Facilities Act came about in 1994. One should always check that a Long-Term Care Facility has been regularly inspected and request to see documentation to that effect. To apply for accommodation in a Long-Term Care facility, you must contact your local Community Care Access Centre (CCAC).
Not-for-Profit Long-Term Care Facilities are those owned by municipal governments, charities, and private not-for-profits which are not charities. They fall under the same Ministry of Health & Long-Term Care regulations, classification and program standards and use the same funding formula as for-profit. Not-for-profit providers that generate a surplus re-invest these monies to enhance or increase the level of service provided to residents. Although for-profit and not-for-profit come under the same Ontario Provincial Ministry of Housing (MOH) legislation, they each have different Acts that govern them. They are: The Nursing Home Act; The Charitable Home Act; The Municipal Homes for the Aged Act. You don’t need to be 65 years and older to get into them. You must be 18 years of age or older and have health care coverage.
Homes for the Aged are an example of Not-for-Profit Long-Term Care Facilities as are charitable homes for the aged regulated under the Charitable Institutions Act.
Residential Retirement Homes / Communities offer independent living usually in an apartment-type condominium, or house, where community amenities are geared towards retirement living.
Assisted Living is for seniors who require assistance with the activities of daily living, such as bathing, dressing, personal hygiene and medication monitoring.
Care Homes / Residences offer health care services and assistance with the activities of daily living only.
Continuum of Care Facilities recognize the need to provide many levels of care to those with progressive disabilities so residents are not required to move as their condition deteriorates. These facilities provide a “Continuum of Care” with separate wings, floors, rental, supportive and/or life-lease housing catering to specific requirements. Some of these facilities have secure floors for those suffering from dementia or Alzheimer’s.
Palliative Care (or End of Life Care) is provided in hospitals, hospices, and some Long-Term Care Facilities. Palliative care may also be provided at home with private care or publicly funded care delivered through local CCAC.
Complex Continuing Care (formerly known as “Chronic Care”) refers to ongoing, high-level, medical attention in a hospital-like setting. Some Long-Term Care Facilities provide this. Generally this type of care is provided to an individual with a lasting condition that may often be severe.
Here are sample Powers of Attorney for Property and for Personal Care. They are samples only and the forms may vary depending on the care recipient's location. Please do not print or copy them:
Here is a sample "Do not Resuscitate" (DNR) order, which cannot be used for first responders (police, ambulance, fire fighters, paramedics). Sample only and the form may vary depending on the care recipients location.
The updated DNR Form enhances a first responder's ability to honour the wishes of patients and their families. The form has been designed for easier use and should minimize any chance of error and reduce the risk of liability.
This Information Bulletin has been developed to provide an opportunity to review the key points from the updated DNRC. This Form directs the practice of paramedics and firefighters effective February 1, 2008 in situations where a DNR order has been effected. This information bulletin includes detailed information on the DNR Confirmation Form and its use. Each DNRC form has a unique serial number. This form is available to Living Assistance Services clients on request.
Consider visiting several residences and go prepared with a list of questions. Keep notes to gain a strong feel for each place. This will help you determine if a residence is best suited to your loved one’s needs and interests.
Retirement and residential-care homes vary in location, size, price, amenities, extra costs, programs and services. The mix of staff and residents also contributes significantly to the personality of each place. That’s why it’s important to look beyond the physical structure and spend the necessary time to ask questions, talk with the staff on duty and generally sample the product as much as possible.
Here are several ideas that should help you make the right choice for your loved one:
- While touring a care home, talk to the residents about their perceptions of the place.
- Plan to stay or return another day for a complimentary lunch or dinner.
- Don’t limit your tour to suite and common areas. Ask to see the kitchen.
- If you would really like to “kick the tires”, enquire about a trial visit or an overnight stay.
- Ask for references from the families of residents that you can contact.
- Beyond the standard tour, check stairwells and other less travelled areas to see how well they are cleaned and maintained.
- Ask for copies of any paperwork required for admission along with samples of menus, activity calendar and newsletters.
Use the following checklist to identify extra costs and the types of services and amenities which may be included and/or available:
- Service Available:
- Tray service to suites
- Daily housekeeping
- Weekly housekeeping
- Dedicated personal care (if required)
- Dementia unit
- Visiting dental service
- Visiting lab service
- Visiting podiatrist
- Dispensing medication
- Personal laundry
- Recreation program
- Medication supervision
- Vitals monitoring
- Visiting physician
- Physician on call
- Visiting physiotherapist
- Pharmacy services
- Assisted living services
- Respite/convalescent care
- RN/RPN on staff
- Private duty nursing
- Building Amenities:
- Central dining room
- Resident storage
- Air conditioned common areas
- Private dining room/area
- Tuck shop
- Fire and/or smoke alarms
- Horticulture area
- Beauty salon
- Wheelchair accessible
- Sprinkler system
- Swimming pool
- Suite Amenities:
- Private bath
- Heating: individually controlled
- Air conditioning: individually controlled
- Call bell system
- Fire and/or smoke alarms
- Sprinkler in each suite
Ask the following questions:
- What is the staff to patient ratio?
- What are the qualifications of the duty staff?
- Is there an RPN, RN or Doctor on duty at all times?
- How are the patient/family complaints resolved?
- Community Services:
- How close is the nearest hospital, medical clinic, dentist office?
- Are there churches, parks, shops and seniors’ centers nearby?
- How accessible is public transportation?
- Is there an accessible transit service?
- Financial Matters:
- What is the daily/monthly rate?
- Are there charges for additional services you may want or need?
- Is phone or cable service part of your package?
- Is there a resident petty cash account with separate accounting?
- What type of notice period is required should you need, or decide to move?
- How often are rates for accommodation and/or services increased?
- What is the average annual rate of increase over the last few years?
- Admission Policies:
- Are wheelchairs and walkers accepted?
- What about scooters?
- Are any forms of oxygen therapy allowed?
- Is a health assessment required?
- What happens if your health deteriorates?
For more information, click here.
For more information, click here.