Hard choices: How to pick a long-term care home

By Fran Yanor, Local Journalism Initiative Reporter,


Ninety-five year-old Patricia Lawson lives in a long-term care facility with physio and recreation therapy, and in-house laundry and meal preparation, which experts say are best practices in care home. //LENA THOMPSON

When Betty Hannis and her two sisters finally had to give their mother’s care over to professionals, they chose Alpine Summit Seniors Lodge in Jasper. Their choice was based not on the quality of care, which Hannis said was good, but because it was the closest long-term care home to Valemount.

Health Minister Adrian Dix, take note: the nearest long-term care facility for Valemount residents is in another province.

Alpine Summit Seniors Lodge no longer accepts British Columbians so Robson Valley residents have to look to facilities in BC for care. For local residents, that typically has meant finding a home in McBride, Prince George,

Clearwater and Kamloops. Although, Hannis says, some people have gone even further north, and south and west to find a bed with 24-hour nursing care for their loved one.

If you’ve already undergone the painful process of having to place someone into care, you probably know the choices in heart-wrenching detail. For everyone else, we did a little research and asked around to gain some pointers on how to pick a facility, what to look for, what to ask, and why.

We’ve just begun our investigation into the state of seniors facilities and services in the Robson Valley, and will continue to report back as we delve into different aspects.

Here’s some of what we learned so far about how to choose a care home.

The Local and Not-So-Local Options
McBride has nine beds designated for long-term care and Clearwater has 21. Both are publicly-funded and run by Northern Health and Interior Health, respectively.

Of the six facilities in Prince George, four are run by Northern Health and two are operated by private corporations. All but 14 of the city’s total 413 beds are taxpayer-funded.

Kamloops has seven residential seniors facilities listed on the Interior Health database, including two run by Interior Health and five for-profit facilities. Together, they serve a mix of residential needs for seniors, including independent and assisted living, complex and specialized services (such as dementia care), and short-term living for people undergoing rehabilitation prior to returning home, and holding beds for those awaiting permanent placement in another long term care facility. Of the estimated 856 beds in Kamloops, 804 are publicly-funded and 33 are private full-pay.

What to Look For
Choosing a care facility for someone you love is never easy. And there never seems to be a good time to do it. But there is a core group of Canadian researchers across the country who have come up with a list of best practices and some questions to ask potential providers to help guide you to the best choice possible.

Statistically, most people don’t plan for, or ease their way into long-term care. Most often, they end up in hospital following an injury or catastrophic health event and suddenly find themselves in need of 24-hour nursing care. According to the Canadian Institute for Health Information (CIHI), a good portion of seniors who end up in long-term care, move there from the acute care ward of a hospital. In fact, as many as 15 per cent of British

Columbians get sent to long-term care instead of returning home because of a lack of home support services in the community. But that’s another story.

Stay tuned for updates on the Valemount Cares supported/assisted living project and RMG’s investigation into issues related to seniors housing, residential care and home support services.

In the meantime, stressful as the occasion will be, the best approach when choosing a long-term care home is to trust your feelings and ask a lot of questions.

How does the place feel?
“Everybody’s a little bit different in what they’re going to value in a particular care home,” says Seniors Advocate Isobel Mackenzie. “And the other reality is… in the north, there isn’t a lot of choice. There’s sometimes only one care home in the community. If you want to be near your mom, that’s the care home that they have to go in.” But assuming there is a choice, Mackenzie suggests asking yourself “How do you feel the minute you walk into the place?”

Are the meals prepared in-house?

In a recent survey by the Office of the Advocate, seniors in long-term care cited meal times, food quality and flexibility around eating as being of paramount importance.

A care home in Nova Scotia employs Red Seal chefs who cook every meal on-site and get feedback from residents so staff know each individual’s likes and dislikes.

Are the dining rooms small and cosy?
Rather than the institutional cafeteria-type settings, smaller tables seating of 2, 3, or 4 people, in areas the size of large kitchens create a homey, comforting environment, say researchers.

Can residents get up in the morning when they want, and go to sleep when they choose?
Having a choice when to get out of bed and when to return is a matter of independence and connected to higher overall quality of life satisfaction.

Is laundry done in-house?
Like meal prep, on-site is one of the best practices among the top long-term care homes.

What physiotherapy and occupational therapy services and equipment are offered, and how often?
Is there a physiotherapist on site, or how often do they visit? Which residents are involved in occupational therapy and how frequently?

What recreational therapy is offered?
Ask to see an activities calendar and the resident participation rates. Ask if the facility offers different programs for different cognitive and mobility capabilities.

Does the facility offer specialized care?
According to CIHI, 98 per cent of seniors in residential care have some cognitive or functional impairment. Some facilities specialize in dementia programming and care. Others might have adaptations for vision impairment and hearing loss. Ask how they will accommodate the needs of your family member.

What are the facility’s UTI stats? Ask to see their fall incident reports.
Facilities must keep a record of both statistics. Both can be indicators of the quality of personal care given to residents.

What are the staffing issues? Are there shortages?
According to Pat Armstrong, a York University professor and powerhouse researcher on seniors care in Canada and globally, low staffing levels, less job security and lower wages have been widely linked to a lower quality of care. With less staff, care is rushed, inadequate, and can be unsafe for residents and workers. Job security is an important factor of continuity of care for residents, essential for building relationships, and creating a sense of community and well-being.

Are maintenance, kitchen and housekeeping staff employees, rather than contracted workers? Are all staff encouraged to interact with residents?
Again, permanent staff create continuity of care, and having the freedom to engage with residents is essential in creating relationships necessary for a sense of community.

Mackenzie suggests the following additional questions:

What are your wages and benefits? What is you recruitment strategy? Do your care aides work directly for you? Or do you subcontract to another company? How many direct care hours are you funded to deliver? And how many did you deliver?
“Those are all legitimate questions to ask,” she says. “Some families are hearing things like, ‘We can’t get staff.’ Okay, well, what are you paying the staff? Or, ‘Our staff are so valuable to us.’ Well, show us how valuable you think they are, what are you paying them?’

The operators answers will reveal how they treat workers, and by extension, residents, and your loved one.

What services are provided beyond meals, laundry and incidentals?
Many long-term home providers offer professionals services for a fee from individuals outside the facility, such as hairdressing, dentistry, pedicures, manicures, massage.

And last, bring out the hammer: could I please see your financials?

Mackenzie says it’s information that operators should freely share. ‘What’s that $446,000 management fee for? And you posted a $1.5 million profit last year but you told me you had to charge my mom for the OT assessment for the wheelchair, I don’t understand, why?”

“They’re absolutely entitled to ask,” says Mackenzie. “It’s their money, because they’re paying privately or they’re a taxpayer. They’re entitled to know how it’s being spent.”

Support local journalism by subscribing below.


Online subscriptions
Paper subscriptions