HOUSING OPTIONS FOR SENIORS

Research Highlights

• The vast majority of Canadian seniors choose to live in their own homes as opposed to long-term care facilities.
• Institutional residency is age-related, increasing from 2% among seniors aged 65 to 74, to 32% among those 85 and over.

Current Situation in Guelph-Wellington

• Shortage of community support services, which causes difficulties for seniors who wish to live in their own homes independently.
• Lengthy waiting list for subsidized housing.
• High cost of retirement homes,which precludes use by a segment of the elderly population.
• Lack of supportive housing units for seniors in Guelph-Wellington (need has been estimated at 1,006 units).

Home Ownership
The vast majority of seniors (93%) live in private dwellings in the community rather than in institutions (7%)¹. According to the 1999 Survey of Financial Security, two-thirds of senior families owned their own home. Of these, 90% owned their home mortgage-free, and had lived there an average of 25 years ².
 
Affordability is an important consideration for senior home owners who must budget for ongoing maintenance costs and rising municipal taxes, as well as for renovation of older structures and adaptations should the introduction of safety, security, and automation features be required.
 
Seniors prefer to live in their own homes/apartments in the community for as long as possible. When they are no longer able to maintain their independence with safety and comfort, seniors require a broad range of options that reflect their personal preferences and meet their physical, mental and social needs.
 
Options can vary with respect to the type of dwelling (e.g. single-unit house versus multi-unit apartment); tenure (e.g. ownership, rental, condominiums, or co-op housing); living arrangements (e.g. living alone, with a spouse, with multiple generations, or with persons who are not relatives); and availability of support services (e.g. homemaking).

Long-Term Care Facilities
Nursing homes and homes for the aged are called long-term care facilities. Long-term care facilities are regulated and inspected by the Ontario Ministry of Health and Long-Term Care (MOHLTC). The main purpose of these facilities is to provide care and services to persons whose needs cannot be met through services in the community. Services include: nursing and personal care; assistance with activities of daily living; treatment and medication administration; special diets; laundry services; room and board; social/recreational programs; and other optional services, e.g. pastoral care. Eligibility to these homes is assessed by Community Care Access Centre (CCAC) case managers. The CCAC also manages the waiting list for admission to long-term care facilities.
 
Institutional residency is age-related, increasing from 2% among seniors aged 65 to 74 to 32% among those 85 and over. Approximately 85% of seniors in institutions are over age 75, and a majority are women. Chronic health problems such as Alzheimer’s disease and other forms of dementia (reportedly affecting one-third of residents), incontinence and the aftermath of a stroke are more common in seniors living in institutions than in seniors living in the community. ³
 
The MOHLTC provides funding for homes. The amount paid by residents for their accommodation is called a "co-payment". The MOHLTC sets accommodation co-payment rates. The following table shows resident co-payment rates effective July 1, 2003 ⁴.

Table 1: Accommodation Rates for Long-Term Care Facilities (July 1, 2003)

*Optional services (e.g. cable TV or hairdressing), can be purchased for an additional fee.
 
At present, there are five facilities in Guelph with a total of 474 beds, and seven facilities in Wellington County with 614 beds ⁷. Wellington County has recently completed a new facility, which contains six neighbourhoods (resident home areas), housing between 28-30 residents in each. The new Wellington Terrace opened its doors on May 8, 2006.

Table 2: Long-Term Care Facilities and Retirement Homes in Guelph and Wellington ⁸

Retirement Homes
Retirement homes are privately owned facilities. They provide a place to stay, meals, the opportunity for social activities, some supervision and support services for those who no longer choose to reside in an independent setting. Typically, they are for-profit based and charge fees for rent, meal packages and various services. Residents have a room (may be shared) with a bathroom, and access to common areas.
 
Retirement homes are not licensed facilities but most comply with the provisions of the Residences’ Rights Act (Bill 120). They are not funded through the provincial government. However, subsidy arrangements through Wellington County Social Services are available at some of the facilities.  
 
There are 22 Retirement Homes in Guelph and Wellington; 52% are located in the County and 48% in the City of Guelph. Ten of these homes have funding arrangements with Wellington County Social Services.

Supportive Housing
Supportive housing provides personal support services and essential homemaking in permanent, community residential settings, for frail/cognitively impaired elderly persons, people with physical disabilities or acquired brain injuries and those living with HIV/AIDS, when their service requirements demand the availability of 24-hour on-site assistance ⁹.
 
Central to supportive housing is the fact that affordability is not a barrier. Most supportive housing involves rent that is geared-to-income or subsidized, so that individuals are not prevented from accessing the services due to inability to pay market value rates.
 
There are no supportive housing units for seniors located in Guelph and Wellington (There are, however, supportive housing for adults with physical disabilities). The former Waterloo Region-Wellington-Dufferin District Health Council (2003) recommended using a benchmark of 4% of the population aged 65 and over to calculate need for supportive housing units ¹⁰. According to 2006 population projections, this equates to a need for 1,006 units in Guelph and Wellington.

Subsidized Housing
Wellington and Guelph Housing Services provides a single source of access to subsidized housing in Guelph and Wellington. Usually the apartment units are “rent-geared-to-income” meaning that the rent is no more than 30% of the person’s income. Subsidized apartments do not have a service component. Any services required by seniors in these units must be arranged and delivered through the CCAC, adult day programs or community support agencies.
 
There are 2,754 units of permanent social housing in Wellington County including 2,306 geared-to-income units and 448 market units ¹¹. 40% of social housing consists of seniors’ housing (1,092 units). Most of the seniors’ housing units are one-bedroom units (870). The majority of these units (62%) are located in the City of Guelph; the remainder are dispersed throughout Wellington County.

 
The average wait for social housing varies, depending on an applicant’s priority rating and desired municipality. From January to April 2006 there were an average of nine seniors per month who applied for social housing, 14% of whom were Special Priority. Of this number, an average of 2.5 were housed every month, 40% being Special Priority and Urgent.

What are the Social Service Issues in Guelph and Wellington?

Lack of Community Support Services
Home support services are essential for seniors who wish to live in the community for as long as possible. When community and caregiver supports are not available to support an elderly person in their own home, they must look for alternate environments. Due to the lack of supportive housing units in Guelph and Wellington, there are few options available for those who cannot afford private retirement home living and who do not require the level of care provided in long-term care facilities.

Lack of Long-Term Care Beds, Particularly in Guelph
Of the seniors residing in Guelph and Wellington, most live in Guelph (56%). Nevertheless, the majority of long-term care beds are situated in the County (56%). This can have a grave impact on senior couples and caregivers who are forced to separate. The lack of transportation services in and to rural Wellington can make visitation difficult.

1. National Advisory Council on Aging. (1999). 1999 and beyond: Challenges of an aging Canadian society. Ottawa, Ontario: Health Canada - Division of Aging and Seniors.
   
2. Statistics Canada (2004). The Daily. Friday, July 23, 2004. Ottawa, Ontario: Statistics Canada – Catalogue No. 11-001-XIE.
   
3. National Advisory Council on Aging. (1999). 1999 and beyond: Challenges of an aging Canadian society. Ottawa, Ontario: Health Canada - Division of Aging and Seniors.
4. Ministry of Health and Long-Term Care (2006). Retrieved from http://www.health.gov.on.ca/english/public/program/ltc/15_facilities.html#3.
5. Long Stay refers to accommodations that are obtained for an indefinite period of time.
6. Short Stay refers to temporary stays at a home. The maximum number of days a person can stay is 90 days per year. There are two types of short stay services: (1) short-stay respite service provides a caregiver with a break from caregiving duties; (2) supportive care service provides the resident support to regain strength and confidence, usually following a stay in a hospital.
   
7. Community Care Access Centre of Wellington-Dufferin (2006). Caregiver’s Resource Guide. Guelph, Ontario: Community Care Access Centre of Wellington-Dufferin.
8. Ibid.
9. Ministry of Health and Long-Term Care (2001). Long-Term Care Supportive Housing Policy and Guidelines (DRAFT). Ottawa, Ontario: Ministry of Health and Long-Term Care, Health Programs Division, Operational Support Branch.
   
10. Waterloo Region-Wellington-Dufferin District Health Council (2003). A Needs Analysis for Supportive Housing for the Elderly in Waterloo Region, Wellington County & Dufferin County. Guelph, Ontario: Waterloo Region-Wellington-Dufferin District Health Council.
11. County of Wellington (2005). Wellington and Guelph Housing Strategy. Guelph, Ontario: County of Wellington.