After years of living in the same home, the later stages of life may require new arrangements.
Moving can be very unsettling, especially for those with dementia.
But if you plan well in advance and talk everything through, you can make the transition much easier than it might be otherwise.
As Alzheimer’s progresses, there are generally three stages of care that you and your family will consider: first, a retirement residence; next, an assisted living facility; and finally a nursing home or long-term care facility.
While obviously not the only consideration, at each point you’ll need to ask yourself, “does it make more financial sense to keep my loved one at home, and pay for care, or should they move to a facility where their needs are taken care of for a single fee?”
These charts are designed to help you itemize the expenses you’ll face at each stage, so you can develop your own plans.
Which costs more—living at home or moving to a retirement residence?
The best time to think about moving into a retirement residence is before the need becomes too great—so as soon as possible after your loved one has been diagnosed with dementia.
Your charge may have years of relative independence ahead, but if you go through this worksheet together, you’ll both have a clear understanding of the financial cost. When you add it all up, the price difference between staying and going, at this early stage, is often minimal.
You may think, “We don’t need a housekeeper for Dad. We can all pick up the slack for him.” That’s great, but remember that just because you and your siblings can find the time to clean and launder, doesn’t mean that work is free. Your time counts and we’ve given it a dollar value. 
Which costs more—living with family or moving to an assisted-living facility?
There may come a time when your family member simply can’t live on their own in their own home, but they don’t yet need the high level of care and security provided in a nursing home.
The question becomes: can you accommodate them in your home, providing some care yourself and filling in the blanks with nurses, companions and other experts who come to you?
Assuming you work full-time, you will need at least 40 hours a week of help of different degrees of expertise depending on the health of your charge.
Bottom line: when all the costs are factored in, it can be less expensive for your loved one to live in an assisted-living facility than in your home.
Only you and your family know what’s right in your case, and there’s so much more to consider than just finances, but these numbers give an idea of the expenses to anticipate in Toronto, so that you can make this important decision more clearly.
Assumptions
• Caregiver companions: needed 50 weeks per year, 40 hours per week.
• Personal Support workers: needed 50 weeks per year; 4 hours per week.
• Registered nurse: needed 12 months per year; 4 hours per month
Which costs more—living with family vs. nursing home
In Toronto, demand for nursing home beds is far greater than supply, but living in a nursing home is generally far less expensive than living at home and paying for help.
Why? In long-term care facilities in Ontario, the cost for the patient is capped and partially covered by the government, and while you can hire help to come to your home and care for your loved one, those in-home costs aren’t fully covered by the government.
Below is a list of services you’re likely to need when your charge is in the later stages of Alzheimer’s disease.
This illustration assumes you have hired a team to provide round-the-clock care when you are at work; it’s a quality arrangement that might sometimes see more than one person tending to your charge at a time.
The cost reflects that level of consistent care. Bottom line: when it comes to the dollars and cents of it, a nursing home is a sound financial decision.
Assumptions
Respite care — needed 2 weeks a year
Caregiver companion — needed 13 hours a day, 7 days a week, 50 weeks a year
Personal support worker — needed 3 hours a day, 7 days a week, 50 weeks a year
Registered practical nurse — needed 7 hours a day, 7 days a week, 50 weeks a year
Registered nurse — needed 1 hour a day, 7 days a week, 50 weeks a year
About the author
Jasmine Miller