By: Kristin Kent
Published on Fri Jun 28 2013
Renya Onasick knows the challenges of caregiving.
As a parent, an involved daughter and long-distance caregiver of her mother, Onasick is engaged in all family matters.
This involvement comes with a price: the costs for elder care, a critical component of future planning, can be significant. The cost, however, is not just financial.
Onasick’s mother had a stroke in July 2003 and “basically lost her short-term memory and some peripheral vision in her right eye,” says the Boston-based woman whose mother lives in Toronto.
“It was tragic and difficult. The impact of having your own family affected by something like that is major,” she says.
“You’re 24/7 when you’re dealing with a parent. You can be called in at any time — night or day. It’s very challenging and emotionally draining.
“And there’s no single right answer. It’s always a balancing and juggling act,” she says.
Caregiving is increasingly falling on the shoulders of family members. The Ontario Ministry for Health and Long-Term Care recognizes this as a growing issue.
Ontarians are living longer, with less chronic illness and fewer disabilities than previous generations. Still, according to the United Way, 47 per cent of seniors in Ontario today live with a form of disease.
The Ontario Seniors’ Secretariat says the number of seniors aged 90 to 100 has increased 27 per cent since 2006. There are 1.9 million seniors aged 65 and over in the province. That number is expected to hit 4.1 million by 2036.
Each of these people will have different needs as they age.
Mario Sergio, the Minister Responsible for Seniors in Ontario, says the most important thing seniors can do for themselves is understand their future needs and make a plan of action “while they are in control of their mental capabilities.
“People are living longer. They need to understand their options and make a decision with respect to their own life and what kind of life they would like to see for themselves,” he says.
Part of that planning boils down to affordability. Eldercare can be expensive. To offset costs, eligible seniors are encouraged to apply for a range of benefits including: Ontario Drug Benefit Program (OBD), Old Age Security Program (OAS), Spouse Allowance, Ontario Energy and Property Tax Credit, Canada Pension Plan (CPP), Guaranteed Income Supplement, Senior Homeowner’s Property Tax Grant and Provincial Land Tax Deferral Program for Low-Income Seniors.
Keep in mind, potential income is not automatic; a senior must apply for each option.
Should an individual wish to stay at home, but requires care, the family may want to hire a personal support worker (PSW). Both private and public agencies offer part-time and live-in care at varying costs.
The average rate for a PSW in Toronto is $23 an hour, plus HST. If the recipient requires 24-hour care, that adds up to $4,366 a week.
Audrey Miller, managing director of Elder Caring Inc., an organization that helps families with geriatric care and planning, says family members should consider pooling their resources.
“It’s important to get everyone on the same page and make a plan of care because it’s costly all the way around,” she says.
“A conversation also needs to be had about time,” says Miller. “How much time can you, the daughter, give to the parent in your very busy work week without burning out?”
For many families, seeking care outside of the home is the last resort.
“People don’t want to move,” says Miller. “Where you start is with safety. If you’re dealing with a lone senior who has dementia, what are the risks involved when the doorbell rings?”
The Ontario government encourages seniors and family members who live with them to apply for the Healthy Homes Renovation Tax Credit. This may help seniors stay at home longer and offset the costs of home upgrades.
If it’s apparent staying at home is no longer ideal, seniors have options in both private and public sectors.
In terms of private retirement residences, housing options run the gamut from shared rooms to hotel-style luxury.
According to the Canadian Mortgage and Housing Corporation, the average cost of a senior’s residence in Ontario was $3,066 a month in 2012.
“There is not one fit for everybody,” says Miller. “The concept today in retirement living is aging-in-place; being able to have your care needs met where you are.”
Seniors may move into a retirement residence with full independence. As they age, they may require more care. This is commonly referred to as “assisted living.” It’s a good idea to ask a prospective residence if this type of care will be available if needed and at what cost.
The public sector provides another kind of long-term residential setting: long-term care facilities. They are directed through the Community Care Access Centre (CCAC) and rates are uniform across the province.
A private room, for example, is $2,200 per month.
The costs in both the private and public sectors may include three meals per day, utilities, on-site medical services and access to a registered nurse.
Jason Abbott of WEALTHdesigns.ca, a fee-only consulting company in Toronto, hopes more people will consider eldercare in their overall financial plans.
“Most people’s focus is maximizing retirement income,” says the retirement and estate planner.
“But I tell you, if you strap on a $40,000-a-year, long-term care facility expense, retirement lifestyle goes out the window. It has to be part of the overall retirement planning discussion,” he says.
Miller agrees. It may be a difficult conversation but necessary if decisions are to be made in accordance with personal values and desires.
“We can’t predict what’s down the road, but we can start to prepare ourselves,” she says.
“If you’re an adult child, and you’re thinking, ‘Gee, Mom wasn’t so good at Father’s Day, I noticed her conversation was a little off.’ Ask her: ‘Mom, can I join you at the doctor’s appointment? I’ll give you a lift and take you to lunch.'”
Conversations don’t have to be aggressive and overpowering. Miller suggests starting with key questions:
What kind of care would you like? Who will take care of your financial affairs? Are your papers in order? Who is your power of attorney?
“That should go for ourselves as well,” says Miller. “We need to have our own power of attorney in place so when we can’t speak for ourselves, someone knows what our wishes are.”
Make a workable plan for your future
Create a road map
Your financial plan should address an array of issues and help you achieve your goals. To start, take a good look at where you stand.
> What are your current living expenses? Future living expenses?
> What are your current sources of income?
> Are you eligible to receive government and other benefits?
> What assets do you hold? What is their current and future value?
> Do you have investments?
> What are your current and future insurance needs?
Save key papers
The Canada Revenue Agency wants you to keep your income tax returns for six years. It’s a good idea to keep bank and investment statements, bills and other tax forms too.
Get expert advice
You may choose to build your own plan or you may decide to consult a certified financial planner. Note these professionals are paid in a variety of ways. Some charge an hourly rate and some are fee-based, while others earn commissions by selling financial products (investments, insurance).
Designate a power of attorney
Make sure everyone knows you have a plan in place. Designate a power of attorney to manage all your affairs, financial and otherwise, in case you are no longer able to yourself. The word “attorney” here does not refer to a lawyer. Put simply, it is a word to describe your chosen decision-maker. The power-of-attorney document is a legal document that gives someone else the right to act on your behalf.
Know your rights
There are different kinds of power-of-attorney documents, and the Ministry of the Attorney General suggests you be aware of the risks and benefits of all of them. You can name someone to manage your finances through a continuing power of attorney for property. For health-related decisions, including where you receive care or what type of meals you will receive, you must name a power of attorney for personal care.
If there is no power of attorney in place, the government will appoint someone you may or may not know to make decisions for you. It’s always best to have someone you fully trust to make decisions on your behalf and in accordance with your values.
Correction – July 4, 2013: This article was edited from a previous version that mistakenly said that the cost per week for 24-hour care is $4,366 a month. In fact, that is the weekly cost.