Long Term Care in Prince Edward Island

GOVERNMENT-SUBSIDIZED NURSING HOMES

How Nursing Homes are organized and administered

Nursing homes in Prince Edward Island are residential long term care facilities that provide accommodation, supervisory care, personal care and nursing and medical services on a 24-hour basis. “Nursing homes” refer to both publically supported manors and licensed nursing care beds in private nursing homes.

Assessment and admission for a nursing home within Prince Edward Island is managed by the Department of Health and Wellnes. The Department of Health and Wellness also sets fees for public nursing homes.

Eligibility/Requirements for Admission

To be eligible for admission into nursing homes a client must:

• be a citizen or permanent resident of Canada,
• be ordinarily present for six months or more (in a year) in Prince Edward Island,
• hold a valid Provincial Health Card for Prince Edward Island, and
• have been assessed as needing a nursing home level of care.

Income/Asset Test

Persons going into, or already in, a nursing home who have sufficient income to pay nursing home costs are not required to go through the income assessment process.

Individuals who cannot afford the standard rate can apply to have their accommodation rate reduced by undergoing an income-based financial assessment. At this time, the applicant will be asked to provide his/her most recent income tax information (Notice of Assessment provided by Canada Revenue Agency). Qualified applicants will be eligible for subsidization by the government. The Department of Health and Wellness will pay the shortfall of the resident’s actual income and the accommodation costs, and there is a provision for a personal care allowance in the amount of $123 per month.

Costs

The Department of Health and Wellness funds the basic health care services for all residents in manors and private nursing homes. Basic health care services include nursing and personal care services on a 24/7 basis, including administration of medication and assistance with the activities of daily living. They also include services and supplies for the care of residents such as blood glucose monitoring, management of skin care, management of incontinence, infection control, lab tests, basic supplies for personal hygiene and grooming, equipment for general use of the resident and foot care.

The nursing home resident pays for the accommodation as well as personal items such as clothing, telephone/internet, personal equipment, transportation, recreation and health related services not funded by the government e.g. ambulance services, prescription drugs (if not funded under medication programs), physiotherapy, private nurse or other health care provider.

The cost of accommodation to self-paying residents in publicly supported manors is $114.67/day. Respite care beds cost $114.67/day

PRIVATE NURSING HOMES

A client may choose to live in a private nursing home and pay the full fees charged by the individual nursing home. Each individual private nursing home is in charge of its own admissions procedure, waiting lists and fees. However, for residents of PEI, the government may contribute up to $114.67/day towards private nursing home health care costs, but not accommodation costs.

Costs for Private Nursing Homes

RETIREMENT HOMES / RESIDENCES

How Retirement Homes are Organized and Administered

A retirement home in Prince Edward Island is a multi-residence housing facility that provides accommodation and services such as meals and cleaning for older people. Retirement homes in the province are privately owned and operated and not administered by the provincial government. Each facility usually provides a private or semi-private room or complete living suite and then also provides common living quarters, including a lounge area, a common dining room, recreation rooms, cleaning services, social and/or religious programs and some basic health care services. The unit can be paid for on a monthly fee basis, like an apartment, or can in some instances be bought the same way as a condominium.

Admission, fees and waiting lists for retirement homes are controlled by the homes themselves, not by the government. Admission usually depends on the ability to pay and absence of serious medical conditions that require professional nursing care. Residents are responsible for paying their own fees and government subsidies are not available for accommodation in a retirement residence.

Costs for Retirement Homes

GOVERNMENT-SUBSIDIZED HOME CARE

How Government-subsidized home care is organized and administered

Home support services are designed to help clients remain independent and in their own home as long as possible. Home care services include professional health care services as well as personal care services such as bathing, dressing, grooming and light household tasks that help to maintain a safe and supportive home.

In Prince Edward Island, home care is managed by the Home Care Department of the Department of Health and Wellness. Referrals can be made to Department of Health and Wellness by the individual requiring care, a family or friend. A care co-ordinator will conduct a home care assessment which involves looking at care services that an individual is eligible to receive based on his/her needs as well as the ability of the family to provide care. The hours of care granted by the Department of Health and Wellness depend upon assessment.  The tentative maximum for home care is  28 hours per week.

Eligibility/Requirements for Admission

To be eligible for the Home Care Program an individual must:

• be a citizen or permanent resident of Canada ,
• be a resident of Prince Edward Island,
• have a need that can be feasibly fulfilled with home care.

Income/Asset Test

There is no income or asset test.

Costs

There are no charges for home care. All home care is publicly funded.

PRIVATE HOME CARE

Home care resources through the Department of Health and Wellness are limited and go to the neediest. As a result, many clients get inadequate amounts of home care services and have to rely on private home care services to receive the appropriate amount of care.

Costs of Private Home Care

Scenario 1: Low level of care (early in the crisis management stage of care)

Mrs. Williams is an 85 year old widow living in her own home. She has osteoarthritis and leg edema. She must wear support stockings to relieve her edema and because her fingers and back are arthritic, she needs help getting dressed. To get around her home, she uses a walking support device or rollator. Both of Mrs. Williams' daughters help her out regularly on weekends and evenings while her son-in-law helps maintain the house and takes care of the lawn.

After fracturing her femur in a significant fall 9 months ago, Mrs. Williams' mobility has been severely decreased and she lost 9 kg or almost 20 lbs as a result. She tells her daughters that she forgets to eat and the food in her refrigerator is spoiled. During their visits, her daughters notice she eats very little and sometimes chokes on her food.

To help her eat safely and address her other needs, Mrs. Williams and her daughters agree it's time for some formal care. She needs her meals delivered to her home, someone to supervise her meals and assistance with dressing and bathing. She would also benefit from a home safety assessment.

Care plan to assist family caregivers part-time

• Meal delivery - 2 meals a day on weekdays provided by Meals on Wheels or another meal delivery program
• Meal supervision - 1 hour a day on weekdays (to include a record of food intake and assistance if patient chokes)
• Personal Care (bathing, dressing) - 1 hour a day on weekdays
• Occupational therapist: to provide initial home safety assessment and recommendations

In addition, there will be expenses for two visits of an occupational therapist including a 1 hr. initial assessment and 45 min. follow up after equipment has been installed. The two visits will cost $175.00 altogether.

Scenario 2: Intermediate Level of Care (late in the crisis management stage of care)

Mr. Leung is a 72 year old widower. He lives with his daughter and her husband in a small community outside the city. Mr. Leung has cataracts in both eyes. He also has dementia which has progressed to the point where he requires continual supervision. He forgets to take his medication, does not eat properly and cannot safely prepare meals. He needs cues for dressing and bathing.

Mr. Leung's daughter and her husband assist him mornings, evenings and weekends but aren't available on weekdays. For weekdays, they enrolled him in an adult day program 2 days per week and hired someone to accompany him to and from the program. For the remaining 3 days of the week they've hired someone to supervise him and keep him company. They've also arranged help for laundry and house cleaning.

Care Plan to assist family caregiver full days, during the week

• Companionship/Supervision: 3 times a week, 8 hrs a day
• Adult Day Program: 2 days a week
• Safety Supervision: to and from the Adult Day Program - 2 times a week, 30 minutes each way
• Laundry/House cleaning: 3 hrs a week

Scenario 3: High level of care (in the dependence stage of care)

Mr. and Mrs. Jensen live in a two-bedroom condominium. Mr. Jensen is 93 years old, alert and aware but physically frail. Mrs. Jensen is 88 years old, diabetic and recently had a stroke. Her balance is poor and she's at high risk for falling. She can only walk short distances and needs help to get around. She also has heel ulcers that make walking even more difficult. For longer distances, she uses a wheelchair.

Her family doctor recommends Mrs. Jensen move to a nursing home. But because Mr. and Mrs. Jensen's daughter promised she wouldn't send her parents to a nursing home, she needs to make alternate arrangements. Options include a caregiver to assist Mrs. Jensen with bathing, dressing, toileting, walking, meal preparation, household chores and transportation to and from appointments. A nurse could monitor and chart her medicine use and blood sugar levels, clean her heel ulcers and change her bandages. Mr. and Mrs. Jensen would also benefit from a home safety assessment by an occupational therapist who may recommend safety bars, raised toilet seats, better lighting, removing clutter and securing loose rugs.

Care plan to assist family caregivers full-time, every day

• In-home meal preparation - 7 days a week, 2 hours daily
• Private caregiver - 7 days a week, 8 hours daily to assist with bathing, dressing, toileting and walking and relieve spouse of caregiver duties
• Private Registered Nurse - 4 times a week for 30 minutes to monitor and chart medicine use and blood sugar levels and monitor and change dressing on heel ulcers
• Laundry - 2 hours every other week
• House cleaning - once a week for 90 minutes
• Occupational therapist: to provide initial home safety assessment, recommendations and a 45 minute follow-up after equipment installation