Retirement Residences in Ontario

Retirement residences and communities (also called retirement homes) are ideal for older persons in relatively good health who may have minimal or moderate care needs and cannot (or do not want to) be in their own homes. They provide a safe, supervised environment that allows for the opportunity to enjoy organized activities, socialize with people their own age, have their meals prepared and housekeeping is done by someone else, and obtain some care if needed. Residents can maintain privacy, dignity, and independence while having the freedom to choose how much to do for themselves, how much to have done for them and how and with whom to spend their time.

Residents can usually bring some of their own furniture. A few homes even allow small pets (if the pet owner can look after them). Several people living in retirement residences still drive their own cars. Most are free to leave during the daytime without supervision. Retirement living residences vary greatly in location, size, accommodation, cost factors, services, amenities, and staffing. In general, costs are market-driven and dependent on location, ownership, care needs, amenities, and other factors. Residences in rural areas may be less expensive than comparable ones in large urban centres. They are all privately owned and operated. There are over 750 licensed homes[1] in Ontario and many new ones currently under construction.

In June 2010, the provincial government passed the Retirement Homes Act which now governs residences across Ontario. The legislation details mandatory standards for resident care and safety. As well, all homes must continue to abide by the regulations set out in the Residential Tenancies Act, 2006[2], the Health Protection and Promotion Act (which sets standards that impact a variety of businesses, including retirement residences, related to water quality, sanitation, and safe food preparation) and the Ontario Building and Fire Codes.

Retirement residences in Ontario may be for-profit or not-for-profit. Rates across the province are not standardized; fees are based on various factors determined by each residence (e.g. location, amenities included, suite size, ownership, size, care level, etc.). Some not-for-profit residences may have available subsidies and are usually owned by a religious, charitable, or community organization with management responsible to a central board of directors. There are no government subsidies available for retirement home residents; however, some costs related to care might be tax-deductible. The Canada Customs and Revenue Agency (CCRA) allows retirement home & long-term care home residents to make a claim on their annual tax return for the care services they receive as a medical expense provided the required documentation is submitted for qualifying services (for more information visit the link for Attendant care or care in a facility at www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/deductions-credits-expenses/lines-330-331-eligible-medical-expenses-you-claim-on-your-tax-return/attendant-care-care-a-facility.html).

Unlike long-term care homes, there are no standard application forms for all residences and no central processing agency. Application to enter a retirement residence is made directly to the residence itself. Prospective residents may be required to undergo a physical assessment (or have a medical form completed) by their physician or medical personnel attached to the residence, prior to moving in, to ensure that the residence can meet their physical and medical needs. Some residences may have waiting lists.

Residents mostly enter a retirement residence while they are still healthy, active, cognitively alert, and fairly independent[3]. They can look after some or most of their personal care and can usually get to the dining room unassisted. Most retirement residences have health care aides and/or nursing staff available in the event of a medical emergency. Many can provide supervision with medication administration and bathing if required, although some may charge an extra fee for these services. Meals (usually in a central dining room), housekeeping (and sometimes some laundry services), and in-house recreational programs are generally included in the monthly cost. Accommodation differs from one residence to another and ranges from ward to semi-private to variations of private rooms, suites, and/or apartments. Some have suites with some form of a kitchenette to allow for light meal preparation; however, there are often restrictions around using several types of electrical appliances in your suite. Depending on the residence, available personal care services may range from minimal assistance to a comprehensive continuum of care. A home that offers varying levels of care may enable residents to continue to be managed in their chosen residence if their health deteriorates and their need for care increases (some residences term this Aging in Place[4]).

Home and Community Care Support Services (HCCSS) may coordinate some personal support and/or professional services (e.g. physiotherapy, nursing, etc.) for residents of retirement residences. Provision of service is based on individual assessment of needs by a HCCSS Care Coordinator and the services available in the residence. Professional services are usually time-limited and for assessment and training.

While some homes refer to themselves as ‘assisted living’ and include some basic care, others will offer assisted living (AL) programs or units (sometimes called special care, enhanced care, supportive care, independent supportive living, or personal care) where more nursing and/or personal care is available for residents who require it currently or in the future. Depending on the home and how they set up their packages and rates, assisted living may include variations of housekeeping, laundry services, meals, personal care, and medication management.  In most homes that offer this as an option, there is an extra cost for receiving this kind of care or residing in this type of unit, and sometimes a waiting list for a separate unit, if there is one. 

In many retirement settings, extra personal care can be purchased on an hourly, daily, or monthly basis, either through the residence or from an external agency. In some homes, residents may hire private companions or ‘shared care’ (two residents hire one person who attends to both of them, enabling them to share services, reducing the cost of extra care) if the amount of care included in a resident’s monthly fee (or the amount of care the residence can provide) is not enough.

Some residences have secure units or floors for residents with dementia/memory issues who are at risk for wandering. There are also a few residences that specialize in dementia care and are only accessible to those with significant cognitive impairment. Depending on the circumstances and symptoms, someone with dementia may be better suited to a long-term care home. Factors such as safety, behavioral issues, cost, and care needs should be considered carefully when making a placement decision for someone with Alzheimer’s Disease or dementia.

Many retirement residences provide short-term respite care for people who are recovering from an illness or to provide relief for a caregiver, vacation care while caregivers are on holiday and trial stays for a few days or weeks, to allow people to try out the residence before making a final decision.