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Whether you're making the decision for yourself or for someone you love, deciding how and where to live the later phases of life isn't easy.
The aging spouse, parent, in-law, aunt or lifelong family friend who's starting to lose the ability to cope independently with everyday life is often the last to admit it. Some of the signs might already be there - forgetfulness, absentmindedness or declining physical health. Perhaps they seem more unwilling - or unable - to dress appropriately, bathe themselves, walk to their favourite grocer or make an appointment to see the hairdresser.
They might seem depressed, irritable, not as happy to see you and more apt to dwell on their increasing loneliness. More and more, they start to repeat themselves or start their sentences with the words "When I'm gone?."
Thankfully, it doesn't have to be like this.
The longevity revolution - it's your choice
The new reality is that there are an ever-increasing variety of lifestyle options for the aging because Canada itself is aging: People over 81 are the fastest growing segment of the population. By 2011, they will number more than 1.3 million, according to Statistics Canada. Seniors aged 65 and older already make up 13 per cent of Canadians, a number that will increase by two percentage points - to 15 per cent - just nine years from now.
Everything is available - from "Freedom 55"-style communities, to supportive housing and support care that lets people stay in their own homes, to retirement homes and nursing homes through long-term residential care facilities. What's important, then, is knowing which option to choose.
A family doctor or geriatrician can spell out any health constraints you should consider; a bank manager or financial adviser can make you aware of the fiscal realities of the situation, but the real stock-taking is up to you.
Seeking out the best care
Families of aging parents, for instance, often are racked by guilt if they don't offer to have the parent move in with them. But be honest: Can you provide 24-hour care? Can you guarantee a safe and secure environment? Will your parent still be able to see the friends and do the familiar things that give pleasure? How will your parent's living with you affect your own lives? Will it curtail your social life and affect the relationships you have with other members of the family, especially your children?
Often, older people themselves opt for a retirement residence. "I don't want to be a burden to you," they might say. What they might mean is they want to be able to bask in the fellowship of people their own age while indulging in bridge, shopping trips, happy hours and prepared meals.
Extensive practicalities to consider when selecting a retirement residence range from laundry facilities through on-site chapels to individually controlled air conditioning; from medication supervision through availability of doctors to the location of the nearest pharmaceutical service; from the availability of assisted-living services through dementia units to extensive nursing care for future aging-in-place consideration.
Long-term care facilities
In deciding on a retirement residence or long-term care facility, you need to be sure the staff will treat your loved one with patience and respect. In the case of long-term nursing homes, ask questions of your local Community Care Access Centre (CCAC); the centres are the gateways to long-term services in Ontario.
Take your time during on-site visits, look around, check the stairwells and the kitchen, talk to residents, take a list of questions and ask them. Find out if you will have a say in making decisions about your relative's care; find out if the relative will. Check the facility's credentials. If it's a private facility, by what standards does it measure its care? Is it a member of the Ontario Residential Care Association or the Ontario Long Term Care Association?
Home health-care services
Sometimes, what's best for a senior with health problems and limited mobility is staying in familiar surroundings - at home. Various community support agencies - both profit and not-for-profit - offer a range of services that fall under the umbrella of home health care. The kind of support can range from home-making services to advanced nursing care.
The choice is up to you, based on the level of care required for the person who will stay at home. But the choice is supported by agencies such as the Ontario Community Support Association and the managed services of the CCACs.
Making the right choice can mean making your own or your relative's golden years comfortable, secure and filled with love and laughter.
They - and you - deserve no less.