I'm balls deep in this right now. Dad has Alz and is getting late in the game, he was walking and communicating a month ago, now he's unable to walk and communication is getting weaker. There is no option but LTC at this point. He's holding in hospital (OTH in Oakville - gong show - , then moved to JB in Burlington) where he's been comfortable.
LTC is tricky to navigate and the service providers doing the navigating are not terribly well organized or efficient. Here's how it works:
If you are at home, the local health network (LIHN) assesses the condition and makes an application to LTC, you pick up to 5 homes and go on a wait list. The lists have wait times of 5 to 18 months. If you are a 'crisis' placement, you get bumped up and the wait goes 30 days to 180 days. Times are typical -- it depends on turnover). Getting on the CRISIS list is possible when discharged to a transitional facility or to home for waiting a transition. It is hard if you start your LTC application while at home, or if healthy enough for a hospital to discharge you home.
If you are in a hospital when they determine LTC is necessary, things get very complicated as the community LIHN folks flip the file and responsibility to the hospital, hospitals work with an in-house LIHN rep. Arranging for LTC isn't done often direct from the hospital, as they are not very good at navigating the systems themselves.
You have 3 options:
1) Home Care. If you have the resources to care for someone in your house, LIHN may supply a hospital bed, hoyer lift, and 1 or 2 PWS visits per day to help with difficult tasks. There is no cost for this. When you take this option, the patient MIGHT qualify for the crisis list, but it appears this is only if waiting in the hospital. Transition to a preferred home is 30-180 days. If you are at home when the LTC assessment is done, they only place you on the crisis list if your primary caregiver is determined to be incapable of managing your
2) Transitional Care Beds. These are beds in nursing homes that do not generally deliver LTC. They are funded to provide LTC-like care to patients who waiting for permanent LTC. This offloads 1800 hospital beds that are currently providing this service. The problem is these are empty beds that nursing homes cannot fill, mostly in smaller centers 1-2hrs away from the city hospitals that are holding waiting LTC patients. When you take this option, the pairing is usually added to the crisis list so the transition to a preferred home is 30-180 days. The cost is about $100/day. Could be 70Km for urban dwellers, and 300km away for rural. In our case, there were 4 options, each was 70-100km away in rural towns (except Niagara Falls)
3) Private Nursing home care. This is not LTC, it's nursing home care with added services to provide a similar level of care to LTC. Most fix a contract price between $6K and $8K/mo for LTC level care. Supplies, (incontinence, A lot of services are limited, for example, an incontinent elder may get 2 changes a day, and additional changes are billed 'a-la-carte'. i.e $50 for a diaper change, $30 for meds delivery, $20 for a shave. Expect another bill from $500 - $1500/mo. NOTE: Patients go on a regular LTC waiting list if they chose this option.
We're bringing dad home, the fam is setting up a 7-day rotation to help mom care for him. LIHN is providing 2 x 1hr visits with PSWs to help, mostly getting from bed to chair. I have to convert the main floor laundry into a shower room. Not that big of a job, I have 10 days to relocate the laundry into the basement and install an accessible shower stall. An accessible bathroom is already there - I reno'd that 3 years back and had the forethought to put in a 36" door.
So far the hospital has been very cooperative, they promise to care for him until the house is ready. If we refused to play ball, they pick option 2 for you, but won't move your loved one until you consent. They do say their hands are tied on the $400 as of Nov 20 if you don't have a plan in motion.
