Getting the Bottom Line on Retirement Home Costs

Q. I’ve heard the ads, seen the glossy brochure and checked the website – but I still have questions. Even when I call, no one would tell me prices or costs or what to expect.

How will I find out everything I need to know? What costs are normal, what are excessive, and are there ‘hidden’ costs that I won’t know about until I’ve moved in?

Why is it so hard to obtain the answers I need? What have they got to hide?What questions should I ask to get the information I need?

A. Find out what to ask for by doing your homework. What do you need, what are looking for, and what’s out there to meet your needs?

Imagine buying a car. You’d check ads, articles, the Internet, and talk to friends. You’d think carefully about the size of car, the features that are must-have’s, its intended use and, above all, your budget. You’d visit a few dealers, ask a lot of questions, do a test-drive and strike a deal you felt comfortable with.

Approaching a move to a retirement home isn’t much different!

Task one of the homework is to assess your needs, and determine your budget. If you’re ‘active and independent’, you’ll be looking for ‘independent living’; if you have increasing health challenges, it will likely be ‘assisted living’; if there are chronic or heavy care needs, you would be seeking a nursing home, also known as ‘long-term care’.

Your next step is to evaluate your budget, which entails capturing your existing living costs, versus the costs and services offered by a retirement residence. Check a site like for a downloadable spreadsheet. The resulting amount tells you what fund you are able to devote to monthly rental and care costs for the upcoming years.

To understand what questions to ask, consider how a typical retirement residence is structured: the basic services of accommodation and care, the extras and the optional costs.

Accommodation- services and options:

Independent Living is for seniors requiring minimal assistance with their daily activities.

Assisted Living is for seniors requiring help with activities of daily living such as personal care, meal preparation, medication management, transportation or getting around; it may extend to extensive help with daily activities such as bathing, dressing, getting to meals, being fed and assisted at bedtime.

Dementia Care is designed for dementia clients who may be wandering or disoriented; these units may be secure with keypad entry

Costs typically include three meals per day, as well as morning and afternoon snacks; diets can be developed for diabetic, low-salt or cultural requirements.

Questions to ask about accommodation include:

– What is included in accommodation charges? Is it just ‘rent’, or are utilities, cable TV, Internet, personal alarm, sheets and towels and personal laundry included?

– Is there a flexible meal plan, if I want to prepare a meal, such as breakfast, in my own suite? Am I charged for meals that I miss or have elsewhere?

– Are pets allowed, provided care can be arranged for them?

– What are the admission requirements (typically a TB test and chest x-ray); do they entail a cost or lead time?

– Do I need tenant’s insurance; if so, does the residence have a group plan?

– What move-in incentives are available, such as a free month’s rent if move in within a month or free parking?

– What rental increases can I expect? (3%-4% per year is typical)

Care- services and options:

personal care entails hands-on assistance with bathing, toileting or dressing

nursing care entails delivering medication, injections, assessment of vital signs; many residences have an RN onsite 24/7

medication management assumes responsibility for holding and administering medications, which are usually ordered and delivered by a single pharmacy, so that residents need not go to the drugstore themselves

medical doctors are available, usually being onsite one day per week; residents are put on a list for the doctor to see

Questions to ask about care services include:

– How is care provided and costed? Is it provided by a ‘sister’ company which is a care agency? Is it charged by the hour, and in what time increments? Is there a minimum or maximum amount of care?

– If I am in independent living, what happens if I need care? Does the residence supply care, and at what cost? What is my ongoing commitment? May I bring in my own caregiver? Is publicly-funded care still available even though I am in a residence which can provide care?

– What happens if I am taken ill when the doctor is not onsite? Is the policy that 911 is called? Must I go to hospital? Will I be accompanied by a staff member?

– Is there a maximum amount of care that is allowed in a retirement home, versus needing to go to a nursing home? Who makes that decision?

– Are the costs for care tax-deductible? (Yes they are, and should appear separately on your monthly bill; an annual care cost recap is also provided at tax time)

Third-party services and options

Residents are often unpleasantly surprised by receiving bills from other service providers, such as the. Examples may include the pharmacy that delivers all medication to the residence, physiotherapy services which are no longer covered by provincial plans, visiting services such as footcare and the onsite hair salon or spa.

Questions to ask about third-party services include:

– Are medications and other supplies ordered at a central pharmacy? Is using this pharmacy mandatory? Is their service truly cost-effective, or is there another reason for the arrangement (such as being owned by the residence’s parent company).

– Assess whether visiting health services such as physiotherapy, eye, dental or hearing clinics, and medical lab visits are cost-effective for you

– For off-site activities such as trips to theatre or restaurants, what does the cost cover? Is it just transportation on the residence mini-bus, or does it include the event ticket or meal bill?

As with every important purchase, knowledge is power. The more you know your own needs, preferences and budget, the more information you can gather, and the better your decision will be.

Footnote – “Who do I talk to?”

Here are some of the industry titles for the people you’ll meet at a typical retirement residence, and what they’re responsible for:

‘The marketing lady’ – community relations manager, family consultant, lifestyle consultant

‘The nurse’ – registered nurse (RN), registered practical nurse (RPN), registered licensed nurse (LRN)

‘The nurse’s aid’ – personal support worker (PSW)

‘The head nurse’ – director of care,director of wellness, care services director

‘Activity lady’– activation specialist, life enrichment manager, lifestyle program coordinator

‘Front desk’ – concierge, customer service specialist, client service consultant


Pat Irwin

Pat M. Irwin

Pat M. Irwin is a certified professional consultant on aging (CPCA) and is the President of ElderCareCanada. She founded the company in 1999 to meet the need for effectively managing the family dynamic between seniors, their adult children and adult siblings including options for support, housing and care, relocation issues, elder care mediation and more.