Yes, Canada has nursing homes, but they are known by different names
In Canada, the term “nursing home” is widely understood but is generally replaced by the official term “long-term care (LTC) home” or “residential care home”. These facilities provide on-site, 24-hour supervised care for individuals with complex medical or physical needs that cannot be met at home. While the core purpose is consistent across the country—providing a combination of accommodation, personal care, and professional health services—the specific names, eligibility criteria, and funding mechanisms are determined at the provincial and territorial level.
For example, in Quebec, these facilities are often referred to as Centres d’hébergement de soins de longue durée (CHSLDs), while in Ontario, they are called long-term care homes. This provincial variation is a key feature of Canada's healthcare system, where long-term care is not a publicly insured service under the Canada Health Act. As a result, each jurisdiction has developed its own regulations and funding models, although most publicly funded facilities follow similar principles.
Types of long-term care facilities
Not all facilities that house older adults are the same. It is crucial to understand the differences between long-term care homes and other types of senior housing, such as retirement residences or assisted living. The key distinction is the level of medical care provided.
- Long-Term Care (LTC) Homes: These facilities, the equivalent of nursing homes, are for people who require a high degree of medical and personal care on a permanent basis. They have round-the-clock nursing staff and provide support for daily activities like bathing, dressing, and eating. Residents often have complex health conditions or cognitive impairments such as dementia.
- Assisted Living and Retirement Homes: These are generally for seniors who are more independent but may need some assistance with daily living. Services can include meal preparation, housekeeping, and medication reminders. Unlike LTC homes, they do not offer 24/7 skilled nursing care. Assisted living is not typically government-funded.
- Home and Community Care: For those who can stay in their own homes, a range of services can be brought to them, including nursing care, physiotherapy, and personal support workers. This is often a publicly funded option designed to help people “age in place”.
Funding and ownership of long-term care
Funding for long-term care in Canada is a mix of public and private sources, with significant subsidies from provincial governments. While the health care component is largely covered, residents are responsible for paying for their accommodation, or "room and board". Provincial governments typically subsidize these costs for low-income residents.
Ownership of LTC facilities varies as well, and can be categorized into three main types:
- Publicly Owned: These facilities are operated by a government body and are not-for-profit.
- Privately Owned (For-Profit): These are owned and operated by private companies.
- Privately Owned (Not-for-Profit): These facilities are often run by charitable or non-profit organizations.
As of 2021, private ownership (both for-profit and not-for-profit) made up 54% of Canada's LTC homes, while 46% were publicly owned. The distribution varies widely by province. For example, the majority of homes in Ontario are privately owned and for-profit, whereas most in Quebec and the territories are publicly run.
How to access a long-term care home
To be admitted to a publicly funded long-term care home, an assessment is required to determine the level of care needed. This process is managed by each provincial health authority. Eligibility is generally based on having complex needs that cannot be met through home care services or assisted living. The provincial authority also manages waitlists, which can be significant depending on the region and the level of care required.
Comparison of Long-Term Care and Assisted Living in Canada
| Feature | Long-Term Care (LTC) Homes | Assisted Living / Retirement Homes |
|---|---|---|
| Level of Care | 24/7 skilled nursing and medical care | Assistance with daily activities (medication, bathing), but not 24/7 medical supervision |
| Resident Profile | Individuals with complex medical needs, severe cognitive impairments, or high physical dependency | Seniors who are mostly independent but need some support to maintain health and safety |
| Funding | Provincially subsidized for healthcare costs; residents pay for accommodation (subsidies available) | Primarily private pay, with limited government programs available for some services |
| Eligibility | Requires a formal health assessment by a provincial health authority | No formal assessment, based on personal financial means and preference |
| Waitlists | Common for publicly funded beds due to high demand | Not applicable; move-in is based on availability and ability to pay |
Conclusion
For those asking "Does Canada have nursing homes?", the answer is a clear yes, though they are most accurately called long-term care homes. These are a critical part of the Canadian healthcare system, providing essential services for those with significant health needs. However, it is a provincially-managed sector, which means there is no single, uniform system. The details of access, funding, and even terminology vary from one province or territory to another. Individuals and families navigating this system should consult their specific provincial health authority to understand the options and process. The need for these facilities is growing with Canada's aging population, putting continued pressure on the system.
For more detailed information on provincial systems, the Canadian Medical Association provides useful resources on elder care in Canada.
