Life lease or rental assisted living/retirement home?

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NOVICE99
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Life lease or rental assisted living/retirement home?

Post by NOVICE99 »

Moderator, please move if you think this belongs better in the Retirement section.

Here's my dilemma. My parents moved in with me when dad become disabled. He's now 89, almost blind, uses a walker. Mom is younger, still helps with light housework. I do all the cooking, laundry, etc etc, have a maid coming in once a week and emergency 24-hour alert installed.

So, aside from me having no life of my own, and my parents not being able to afford to rent or buy, I would like some suggestions/advice on what to do as together as a couple, they're not ready to go to LTC and there's a long waitlist for the nicer homes.

Is it better to rent a unit at a seniors home (meals, laundry and housekeeping included) withn 24 hr RNs on site, or buy a life lease apartment for them (have to buy services like meals etc) so that I can have the equity when I sell or maybe move in one day myself? I guess my questions are more for emotional and comfortable safe living for my parents, and "selfishly" what would be better financially for me as a single person.

Another option is for us to continue to stay in our current home, and to hire a caregiver on an incremental basis as their needs increase (don't know how demanding are the caregivers that come to Canada and require a 3-year sponsorship)? I've also seen an option called supportive housing but can't tell if that's assisted living for low-income groups (a rowdier lifestyle perhaps) or if the "supportive" refers to support services being amenable.

As I'm sure many baby boomers have had to make these tough decisions, I'm hoping someone will share their experiences good and bad and any regrets in selecting any of the options which I may or may not have thought of!

Thanks ... :? :? :?
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Re: Life lease or rental assisted living/retirement home?

Post by Bylo Selhi »

NOVICE99 wrote:Moderator, please move if you think this belongs better in the Retirement section.
See this ole thread: Life lease, eh?

Perhaps a Mod can reopen it for posting and merge this thread into it.
Is it better to rent a unit at a seniors home (meals, laundry and housekeeping included) withn 24 hr RNs on site, or buy a life lease apartment for them (have to buy services like meals etc) so that I can have the equity when I sell or maybe move in one day myself? I guess my questions are more for emotional and comfortable safe living for my parents, and "selfishly" what would be better financially for me as a single person.
My advice in terms of priorities:
1. Find a facility that best meets your parents' needs.
2. Find a facility that you all can afford.
3. Whatever the arrangement, make sure that you can live with it. You're of no use to your parents if you burn out helping them or if you lose your job as a result.

Secondary issues include:
• Rental vs. life lease vs. condo.
• Equity and money-making opportunities. (The terms and conditions in the LL property discussed in the linked thread almost guarantee that.)

Also give some thought as to your options as your parents' health declines and their need for additional help increases. The "frictional" costs of buying a LL for a short period, say under 5 years, almost guarantee that you'll lose money. Beyond that moving is disruptive for all concerned. Some retirement communities provide a continuum of care, e.g. starting with independent living, then assisted living, then long term care (nursing home.) If one or both parent's health is declining such communities may make more sense.

In ON contact CCAC for help in evaluating options. Other provinces presumably have similar agencies. Your municipality will also have resources for seniors, e.g. meals on wheels.

See also related threads, e.g.
Long term care
Are children required to pay for parents' LTC home costs?
Good Luck If You Go To Live In A Nursing Home
Aging Parents
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Re: Life lease or rental assisted living/retirement home?

Post by caricole »

and my parents not being able to afford to rent or buy
Is it better to rent a unit at a seniors home (meals, laundry and housekeeping included) withn 24 hr RNs on site
At a first glance

Your parents «could» earn up to 32K including OAS suplement

With your father condition, the credits available they should not pay any income taxes with this income

Is it pssible to rent a unit in a séniors home as described above for 2.500$ a month ???

This would then be the first choise solution, for the time being

my opinion
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Re: Life lease or rental assisted living/retirement home?

Post by NOVICE99 »

Thanks for pointing me to these links - I had my own senior's moment and forgot they were in another category. In fact I even found a few of my old threads :oops: Re-reading them and the posts after I last checked, gave me a lot of information but not a lot of encouragement.

I'll continue posting here until Moderator merges the threads. My parents are currently on the CCAC list for a basic unit for LTC. With their OAS and some GIS included, I can afford to pay the delta for a semi-private or private rooms for them. So my question is: are the waiting lists shorter for the non-government subsidised rooms, and how do I find out - do I call the CCAC or the LTC home itself (some don't seem to be too transparent with giving information)?

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Re: Life lease or rental assisted living/retirement home?

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(some don't seem to be too transparent with giving information)?
In BC we found the harder you push the more action you get. In BC these lists were not at all transparent, we wondered if they really do exist. They try/tried to place people on a basis of "need". (not a bad thing) So if your parents are doing alright where they are now that would maybe move them down the list.
Some retirement communities provide a continuum of care, e.g. starting with independent living, then assisted living, then long term care (nursing home.)
Watch out for this. We were promised mom would stay in the same location just move to a higher level of care as she needed it. Never happened. Each level of care had it's own long phantom waiting list.

Our assisted living location was very good, extended care not so much, understaffed, contracted out food etc.. Our mom had better care at the assisted living location but was not allowed to stay do to "Government regulations, 1.7 hours of care per day only".
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Re: Life lease or rental assisted living/retirement home?

Post by Bylo Selhi »

BRIAN5000 wrote:Watch out for this. We were promised mom would stay in the same location just move to a higher level of care as she needed it. Never happened. Each level of care had it's own long phantom waiting list.
My experience has been quite different. At the LL facility where my mom is staying, existing residents get priority placement in assisted living. They even get a discount on AL based on the length of time they spent in LL.
Our assisted living location was very good, extended care not so much, understaffed, contracted out food etc.. Our mom had better care at the assisted living location but was not allowed to stay do to "Government regulations, 1.7 hours of care per day only".
This is provincially regulated so BC may be quite different from ON. In any case there's a lot of variability among facilities. As I said in the previous threads, the for-profit ones tend to be inferior to the non-profit ones, especially those affiliated with religious groups. (<OT> This is yet another example where right wing political tenets break down.</OT>)
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Re: Life lease or rental assisted living/retirement home?

Post by Pickles »

If your Dad is 89, a life lease is not the way to go. Rental or LTC is the best. CCAC in Ontario controls regulated long term care and nursing home admissions. If you go to the "bootleg" nursing homes (unregulated accommodation with some level of care services offered) you can get your parents in pretty quickly but these are costly facilities. A regular rental apartment works for some, depending on the level of care required and available. Eg. easy to get meals on wheels and there are catering places geared to supplying evening meal but competent nursing and personal care services are harder to find, though CCAC may help.
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Re: Life lease or rental assisted living/retirement home?

Post by freedom_2008 »

There is an article in the April issue of MoneySense by David Aston, talking about all the possible options of old age care and benefits/assistance from the governments. I didn't read it thoroughly, but there could be some useful info for OP.
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Re: Life lease or rental assisted living/retirement home?

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Pickles wrote:If your Dad is 89, a life lease is not the way to go. Rental or LTC is the best. CCAC in Ontario controls regulated long term care and nursing home admissions. If you go to the "bootleg" nursing homes (unregulated accommodation with some level of care services offered) you can get your parents in pretty quickly but these are costly facilities. A regular rental apartment works for some, depending on the level of care required and available. Eg. easy to get meals on wheels and there are catering places geared to supplying evening meal but competent nursing and personal care services are harder to find, though CCAC may help.
Based on my own experience with a family member, I find these comments fairly mystifying. We visited many many places before moving my grandmother-in-law, approaching 95 (next month), to a "bootleg" retirement home nearly 6 years ago. I find the use of the phrase "bootleg" troubling - she is in a facility that meets her needs and provides the level of care required, which includes meals, regular medical care, in-home visits from a doctor and pharmacy, medical transportation on an emergency and routine basis, "panic buttons" in every room and checks if the resident does not appear for a meal, laundry, hairdressing, bathing assistance, etc. etc. She uses a walker and has several persistent ailments and requires routine medical monitoring to assess and control prescriptions and blood pressure, but she is independent and this is a place that works for her.

Although we are paying more than we would if she were in a regulated LTC facility, she would be in a (in my opinion) vastly inferior "ward" arrangement if we went that route, losing one of her most precious assets - her privacy. Because she has the disability tax credit, her (nursing home) expenses are pretty tax-efficient and only surpass by a fairly insignificant amount (a few hundred dollars per month) her total CPP + OAS income (and she has a very small DB pension).

This whole experience is very different from that of my own grandmother, who wanted to stay in her own home and we patched together a (very unworkable) set of in-home arrangements with VON, Meals on Wheels, government-supplied homecare, etc. It was extremely stressful and she ultimately died in after 12 weeks in an ICU after being admitted once one of her chronic conditions (multiple myeloma) made her unable to return home (because she required too much aftercare after transfusions) and then contracted MRSA in the ICU such that no public facility would take her. It is VERY difficult to schedule CCAC/VON care on any kind of emergency basis and on-call in-home nursing support is EXTREMELY expensive.

When people are writing here about these issues, do they have personal experience? I have been very involved in both situations and (with my husband) am the primary person responsible for the well-being of my grandmother-in-law. Are the anecodes and warnings supplied here based on personal experience, or cautions based on...what, exactly?
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Re: Life lease or rental assisted living/retirement home?

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My experience has been quite different. At the LL facility where my mom is staying, existing residents get priority placement in assisted living.
Yes mom got priority too, if there is no room there is no room and they will not actually show you a list so you can gauge on your own how long it would take for a spot to open up.
Two to three year waiting lists are a common response at many AL, LTC. The government can get you in quicker or immediately if there are severe care issues. My comments are based on what has happened with my mom and what is now happening with wife's parents.
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Re: Life lease or rental assisted living/retirement home?

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IME with my grandmother a very significant percentage of the population on the waiting lists does not take a spot when it is offered. I think this is a part of the rationale for taking the existing residents when a space opens - I was lead to believe at one of the high-end homes we had been investigating for my grandmother that fully 70% of the spaces *do not* go to the next person on the waiting list - for a variety of reasons including: the list is stale and the person no longer wants/needs care (they can no longer be accomodated in that house, they are no longer alive, they've made other plans in the meantime), or the person is on multiple lists and they are waiting for their "preferred" place and this was just a backup.

Also, I understand that different facilities manage their lists with varying degrees of attention. Some places will call once a year to inquire whether you want to retain your spot - but most do nothing and just visit the list if/when there is a space. In general I believe the idea that there are "long waiting lists" is something of a misperception, especially for non-regulated facilities.
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Re: Life lease or rental assisted living/retirement home?

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Flights of Fancy wrote:IME with my grandmother a very significant percentage of the population on the waiting lists does not take a spot when it is offered. I think this is a part of the rationale for taking the existing residents when a space opens - I was lead to believe at one of the high-end homes we had been investigating for my grandmother that fully 70% of the spaces *do not* go to the next person on the waiting list - for a variety of reasons including: the list is stale and the person no longer wants/needs care (they can no longer be accomodated in that house, they are no longer alive, they've made other plans in the meantime), or the person is on multiple lists and they are waiting for their "preferred" place and this was just a backup.
That's been my experience as well. My mom got a suite at the AL part of her LL facility within a month of putting in her request, in part because she has an immediate need. To further underscore your explanation the AL part of the facility also makes suites available on a short term basis for people who are recovering and/or need rehabilitation-related services like OT, after hospitalization.

Also CCAC encourages frail seniors who live independently or in AL to get on the LTC list well in advance of need. Being on the list gives them priority over those who aren't. It's a given then that a substantial number of those who percolate to the top of the list aren't yet ready to move to LTC.
Also, I understand that different facilities manage their lists with varying degrees of attention. Some places will call once a year to inquire whether you want to retain your spot - but most do nothing and just visit the list if/when there is a space. In general I believe the idea that there are "long waiting lists" is something of a misperception, especially for non-regulated facilities.
It's also a good marketing tool. The longer the list, even if most on it aren't prepared to move, creates a sense of urgency for those who need to move. I certainly sensed that in my mom's case. I've heard the same from friends who went through this for their parents. This is no different than the real estate agent who tells a buyer to make an unconditional offer at or above asking price because there are competing conditional offers (even/especially if the conditions are unlikely to ever be met.)
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Re: Life lease or rental assisted living/retirement home?

Post by Pickles »

FoF, the term "bootleg" is jargon used by some to describe unregulated care accommodation that offers the same range of care services as nursing homes and Long Term Care Facilities. The average Ontario citizen has no idea that they are not subject to the legislation that regulates private as well as public nursing homes and LTC facilities.

Some of them are well run (at a cost -- they charge more than the regulated price) and others are just terrible. The only provincial law they are subject to is rent regulation. There are no regulated standards regarding number or qualifications of staff, services provided, etc. What you see and specify in your contract is what you get. I'm glad your mother-in-law is in a good one. My experience is with extremely marginal care home facilities where vulnerable socially isolated adults were ripped off financially and subject to abuse.

Your own grandmother's experience is all too common. Many seniors want to stay in their own home and CCAC encourages this (because there aren't enough spaces in nursing homes) but the patchwork of supports usually place the greatest burden on relatives, not professional, coordinated care workers. When the senior who has not agreed to be put on a waiting list finally goes into crisis, they may well end up in a nursing home that has spaces, not one they or their family would, in hindsight, have chosen.

This is the situation facing my 95 year old neighbour right now. She flatly refused to go on a waiting list while still semi-mobile and competent. Now, after a medical mishap, she is ready to be discharged but her daughter who has cared for her for the past 20 years can no longer do so because of her mother's worsened condition. The daughter has been sent on a fool's errand to visit nursing homes and compile a list of 5. None of them have vacancies and the hospital will soon force her mother into one that does, quite possibly the Leisure World one in our neighbourhood that was subject to investigation after two residents were killed (and this is aregulated facility :roll: ).
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Re: Life lease or rental assisted living/retirement home?

Post by NOVICE99 »

Thank you all for sharing your experiences - I appreciate the openness here and am trying to compare it to my own situation. Dad and mom are already on the list for LTC; however because dad's condition is more serious than mom's (he sleeps a lot of the time on the couch and mom still helps with housework), he needs assisted living and mom doesn't but of course they don't want to be separated in an LTC facility (he would cope, mom would go crazy). So assisted living seems like the way to go, and except for retirement type places which would provide some level of care expensively, there's only LL as an option it seems.

I also heard from a friend that once one is in a LL, that admission to LTC under same management is easier - notwithstanding the strict rules the CCAC persistently reinforces to me. The reason why we chose the basic option is that there may be a slight chance of them getting to share a 2-person room in LTC instead of being sent to 2 different homes and die of loneliness in a private room as I'd be commuting back and forth to visit. Also I was told that even if a bed becomes available in the same room as dad, mom may not get it! For better and for worse, till death does us part - is now for better and when worse, LTC does us part ... :cry:

Now, are there any places Retirement, AL, LL or LTC where one should NOT go due to quality of services? Am slowly creating a shortlist to visit.
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