Long-Term Care

Moving a loved one into long-term care may be the toughest decision you face, whether you make that decision alone, with your care recipient, or with other family members and loved ones. When It’s Time to Consider a Move includes a list of changes you may observe that are good indicators that long-term care should be considered.   

There are two types of government-funded Long Term Care facilities in Nova Scotia.  

  1. Residential Care Facilities are for those who need personal care, supervision, and accommodation in a safe and supportive environment and who are able to exit on their own in an emergency.   They are described in further detail under Residential Care Facilities.
  2. Nursing Homes are an option for people who have difficulty performing everyday tasks, such as dressing or bathing, and are appropriate for those who are medically stable yet have nursing needs beyond home care.

Initiating the discussion about moving to Long Term Care (LTC) can be stressful. Although the doctor may say that LTC is needed, it is the Continuing Care Coordinator who will assess your loved one’s needs and recommend them for government-funded LTC.  A Continuing Care Committee meets on a regular basis to make these determinations. 

If your loved one has been approved for a move to LTC you may be asked for your top two or three choices of facility.  You and your loved one may want to tour a few facilities to determine which ones are most suitable.  Other than cleanliness and quality of food, it is sometimes hard to know what other questions to ask.  There is a short checklist of 28 questions to consider when touring LTC facilities; there is also a longer, more detailed checklist of 150 questions called Transition To LTC Checklist, to guide you through a more in-depth tour.  There is no expectation that you ask the Administrator all 150 questions. Rather, they are offered as a means of raising your awareness of what aspects of LTC living might be important to you or your loved one.

Fact sheets from Continuing Care on Long-Term Care and Paying for LTC as well as a complete Directory of LTC Facilities may be helpful in preparing for this change.

Caregiver Tips

All facilities are different.  It is likely that everyone is working hard at a difficult job and possibly in an understaffed environment.  If you see something that concerns you, talk to someone about it.  Contact the Director of Care or the Administrator with your concerns or suggestions as this demonstrates that you want your loved one to enjoy the best quality of life available to them.  

If a situation presents itself of a more serious nature you need to know how to proceed and what to expect. The policies and procedures outlined in Long-Term Care Program Requirements: Nursing Homes and Residential Care Facilities will supply you with guidance in handling more serious matters. As well, the Protection for Persons in Care Act provides information for family members of LTC residents, including details and contact information if abuse is suspected. Both of these Acts outline the roles, responsibilities and rights of all parties involved in the long-term care system and are in place to ensure the health and safety of persons in care.

It may be helpful to find someone who is familiar with the facility and ask about their experience, providing a positive testimonial. Perhaps a member of the facility’s Family or Resident Council will be able to help you in this respect. Examples of Family Councils include The R.K. Macdonald in Antigonish, St. Vincent's Nursing Home in Halifax (see minutes), and Mountain Lea Lodge in Bridgetown. Not all nursing homes have Family Councils,  although the Department of Health and Wellness states that any nursing home found to be without a family council is required to put one in place as a condition of their licence.  If you want to stay more involved with your person’s care, you may want to become a member of the Family Council. Or, you may want to become a member of the facility's Residents Council.

It is quite natural to second-guess the decision to move.  As time passes, you will hopefully see that it was not only a necessary decision but a good one.  For now, perhaps you can take comfort in knowing that others experience the same feelings of guilt when someone else is giving care, and relief that your loved one is safe and you are able to reclaim parts of your life.  This article, Into the Hands of Strangers: Placing a Loved One Into a Nursing Home, is a moving, first-hand account of a woman faced with the difficult reality of placing her husband, who had dementia, into LTC.  Transition to Long-Term Care may help you manage your expectations in the first days and weeks of placement and Coping with Guilt and Grief after a Nursing Home Placement may help alleviate some of your deeper feelings.

Many caregivers ask us which LTC facility is the best.  Although at CNS we are not able to recommend one facility over another, it has been our experience that a LTC facility, like a book, can’t be judged by its cover. Older facilities, similar to more modern ones, have caring and professional staff who are dedicated to making the quality of life of every resident a priority. At the end of the day, the facility that is best for you will depend on your personal taste, needs, and whether there is space available.

To help set an optimistic tone, Social Fitness shares a caregiver’s story about her positive experience and the benefits that came from her mother’s move to long-term care.