Winnipeg Free Press - PRINT EDITION

Anxiety over assisted living

Cost of quality seniors housing a challenge for many

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Depending on the viewpoint, room and board can be a heaven or hell proposition.

Prison would be at the brimstone end of the spectrum while heaven would be akin to an all-inclusive resort (at least for many people).

Margaret Bean's experience at Lindenwood Manor -- an assisted-living apartment in the city's south end -- undoubtedly leans to the divine side.

And it's not because the 55-plus residence is a non-profit facility run by eight Mennonite churches.

"It's a pretty special place, and that's from 10 years of observation," says the 87-year-old retired teacher.

Bean was one of the manor's first tenants. She moved in with her husband, who uses a wheelchair after suffering a stroke and battling cancer.

"We've never once regretted our decision," she says.

That doesn't mean the transition initially involved no anxious moments.

Making the move from their home to assisted living is an anxious time for many seniors.

Your age may be just a number, but aging inevitably takes it toll on the body and mind. And a little help is indeed welcome for many assisted-living residents.

Assisted living is the midpoint on the continuum between fully independent accommodations and 24/7 supervision in a personal-care home, says Theresa Jachnychy, executive director of Winnipeg Mennonite Seniors Care, which runs Lindenwood's assisted-living residences.

"For people who live in assisted-living accommodations, some of them would be able to manage on their own," she says. Others may need a little extra help, while others require home-care visits.

Tenants receive a number of services, including prepared hot meals, housekeeping and recreation, just to name a few.

All cost money, and that can put stress on the pocketbook. It's a fact of finance and life that many baby boomers also are becoming increasingly aware of as they make the transition themselves or help their aging parents move.

Retirement isn't cheap.

A recent report by the Canadian Life and Health Insurance Association (CLHIA) finds the price tag of aging for boomers over the next four decades will cost more than a trillion dollars.

"We estimate pretty conservatively that the bill will come in at $1.2 trillion," says Stephen Frank, vice-president of policy development and health with the CLHIA.

"When you look at the level of government support that exists, and you assume that no new programs are put in place, roughly half of that cost would be covered through existing programs."

That's about a $590-billion shortfall -- or 95 per cent of all RRSP savings in Canada.

Manitoba spends $500 million annually on long-term care and supportive housing.

Funding for personal-care homes -- or nursing homes -- is among the best in the country, says Jachnychy.

"Manitoba really is a good place to grow old," she says, icy sidewalks notwithstanding.

"The province does what it can."

What it has done is standardize services for Manitobans who require care 24 hours a day. The cost of care is capped at about $73 a day or roughly $30,000 a year, says Brian Davis, certified financial planner with Assante Capital Management in Winnipeg.

"In Manitoba, long-term care facilities are income-tested," says Davis, who is licensed to sell health insurance products such as long-term care insurance.

"The higher your income, the more you pay."

Low-income individuals pay as little as about $31 a day, leaving them with about $3,300 in additional money a year. And for partners of individuals in care, the cost of care will not reduce their income below $30,240 a year. (Prices are set Aug. 1 of every year.)

Going forward, Frank says long-term care costs certainly will increase.

"When you look at the shortfall, it's hard to see how governments could cover that, given their fiscal situations," he says.

The big cost driver is simple demographics, Davis says.

"In 1976 there were about 170 seniors over age 85 for every 100,000 Canadians," he says.

"By 2036, that number will be about 1,475 -- almost an increase of 900 per cent."

And the present number of long-term care facilities falls far short of the mark.

"If you think about the current number of long-term beds we have in Canada, we have roughly 300,000," Frank says. "We're going to need about 800,000 by 2047."

To meet demand, 170 new facilities would have to be built every year for the next 40 years.

Yet these figures only include long-term care, such as personal-care homes, and generally not assisted living -- at least in Manitoba. Unlike personal-care homes, costs aren't capped. Assisted-living residences are a mix of for-profit and non-profit, and they have boards deciding who becomes a tenant, Jachnycky says.

The Lindenwood residences are among the middle of the road for cost, she adds.

A 562-square-foot, one-bedroom suite with meals and housekeeping costs more than $1,860 a month. On a per diem basis, that's about $61. The provincial government does provide some financial assistance to low-income seniors, but the cost of quality seniors housing is a challenge even for individuals with savings.

Retired university professor Bob Glendinning, 81, moved into Lindenwood Manor a year ago after selling his home. The proceeds have helped cover the cost of his new home at the manor.

"I was apprehensive and under tremendous strain," he says about selling his home after his wife's death.

Glendinning says he looked at several assisted-living residences. Some were 'ritzy' with lounges and cinemas. But he was concerned about long-term affordability.

"It was a terrifically stressful time," he says.

Today, the co-chairman of the Lindenwood residents board says he feels like family at Lindenwood.

"The staff in the dining room knew me by name from Day 1," Glendinning says. "I don't know how they did it."

Lindenwood -- like many assisted-living residences -- has a waiting list. Word gets around fast about bang for the senior's buck, says the chairman of the residents board, Henry Wiens, 88.

"We didn't really look around because we had friends that lived here and we're not rich, but we weren't worried about the cost."

They also knew about Lindenwood Manor because they belonged to one of the churches.

Not all tenants are Mennonite, but the one thing many do have in common is a sense of gratitude.

"The quality of life here is good," Bean says.

If one gap at the residence exists, it is the lack of a personal-care facility, she says.

"The worst thing that can happen to me is to be separated from the man I've been married to for 68 years."

For the time being, however, their home is indeed heavenly -- though Wiens is quick to point out that doesn't mean it's all smiles all the time.

"I don't want to give the idea that this is utopia. There are people here that complain, too, but I think that's normal," he says. "You will never get a place where everybody is satisfied all the time."

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Growing old in Manitoba, a continuum of care

Theresa Jachnychy, executive director of Winnipeg Mennonite Seniors Care, says the spectrum of 55-plus living options ranges from completely independent life leases on the one end to personal-care homes, requiring 24-hour support and care, at the other.

55-plus life lease: This is a hybrid between renting a unit and ownership. For an upfront payment, tenants get a suite for life and pay rent to cover services and maintenance. If the resident leaves, the lease can be sold and there is the opportunity to receive a return of equity.

Assisted living: These include a variety of seniors' residences that provide a number of services for a fee, including meals, transportation, cleaning, laundry and recreation. These residences can be costly, says Jachnychy. Families with annual incomes of $23,700 or less would generally not be able to afford assisted living. Some low-cost exceptions exist in Winnipeg, including residences provided by the Lions Club, she says. The province also has a RentAid program for low-income seniors, which pays up to $210 per month.

Supportive housing: This type of residence is for individuals requiring 24-hour support and supervision, but who are not ready to go into personal care. Residents pay for rent, meals, laundry and housekeeping. Personal care, such as getting dressed, eating and bathing, is funded through the regional health authorities at no cost to the tenant. Eligibility is assessed by the authorities' home care program.

Intermediate care: Seniors requiring more care and support than assisted living and supportive housing may be eligible for this residence. Thorvaldson Care Center is Manitoba's only intermediate facility.

Personal-care home: Residents typically have complex medical needs. They may suffer from late-stage dementia or disability from a number of health issues, such as congestive heart failure, Jachnychy says.

Home care: The province's Home Care program allows for seniors to continue living in their homes instead of moving to more supportive residences, but quite often seniors living in life-lease and assisted-living residences also receive home-care services. A "direct service provider" will come to the home up to seven hours a day, seven days a week. "Once you top 50 hours a week, you generally go to a personal-care home," Jachnychy says. Home-care workers assist with walking, getting in and out of a wheelchair, and personal care such as bathing, dressing and toileting, states the province's Home Care website.

Housing guide for seniors: For a listing of all housing opportunities for seniors, try the Age & Opportunity Housing Directory, found at www.ageandopportunity.mb.ca

Status quo... not good enough: The study by the Canadian Life and Health Insurance Association concluded governments may not be able to fully fund seniors' long-term care costs going forward, but they can implement policy to encourage Canadians to save. "One would be the creation of a new type of registered savings plan, but geared toward long-term care," says Stephen Frank, with CLHIA. "We think an RESP-type approach makes more sense in this situation." Canadians would sock money away, and the government would provide grants based on annual contributions, and supplementary funding for low-income Canadians. Another possibility is a tax deduction for premiums paid on long-term care insurance.

Cost of long-term care insurance: Long-term care in Canada is relatively new, says Brian Davis, a financial adviser. It isn't cheap, but it's affordable for middle-income earners. It gets more expensive with age, so it's best to consider early. For a 50-year-old in good health, seeking a $500 weekly benefit for life -- about enough to cover a personal-care home in Manitoba -- the premium is about $110 a month. For a 65-year-old, it's about $185 a month.

Republished from the Winnipeg Free Press print edition July 7, 2012 B9

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