Staring at bills and letters scattered across a small coffee table, two women anxiously wonder how they can help their mother afford to live in the modest room they’re sitting in.
Marlene and Janet Kawalez are one of many families with elderly parents living in Fergus Place retirement home who recently learned about changes to service fees.
For the Kawalez sisters, the changes mean an increase of more than $900 every month for their mother Anna’s care. They are already paying nearly $2,500 a month for basic rent, meals and services such as weekly housekeeping and recreation programs.
“How can you do this, how can you put this much stress on seniors and the people like myself who are already stressing taking care of my parents who are both sick?” Marlene Kawalez said.
The family decided to move Anna into Fergus Place two years ago because she was being affected by Alzheimer’s disease and their father Michael was undergoing treatment for colon cancer.
The sisters, who are both in their 50s and live in Milton, travel to Kitchener regularly to check on their parents, get to medical appointments and manage their mother’s care at Fergus Place.
“It is so hard to take care of my parents and my life is on hold and then this comes up, it’s like when will it end? I never thought it would be this hard,” Marlene said.
Fergus Place is one of more than 250 retirement homes across Canada and the U.S. owned by Revera Inc. The retirement home company decided to change their fee structure to charge for “a la carte” services individually, such as night checks and mobility assistance.
The “a la carte” pricing Anna received as part of her increase includes $235 per month for medication administration and $371.28 per month for glucometer checks in suite.
Over 50 services are listed in the “a la carte” pricing that also includes monthly charges of $396 for eye drops twice daily in suite, $168 for stocking application, $84 for stocking removal and $606 for cueing and escorting to and from meals.
Sandra Vlaar Ingram, a spokesperson for Revera, said the new pricing model is intended to meet the diverse needs of residents.
“For individuals who do want additional services, their needs can change from month to month as their health changes … This customized approach makes it easy for residents and families to compare services and costs with other providers or to opt to have these services provided by family or other support personnel they arrange,” she said in a statement.
But according to Marlene, those additional services, like nightly checks, were previously included in their basic monthly cost and was part of the appeal of the home. She said the basic costs are not decreasing with the new fee model, either.
Unlike rent at retirement homes, which are regulated by the Residential Tenancies Act, there are few rules pertaining to service fees.
“There’s much less control over the care services provisions in terms of the costs. The theory is that the market will control that,” said Judith Wahl, executive director of the Advocacy Centre for the Elderly.
The Retirement Homes Act, which comes into effect this month, requires homes to be transparent about any service fees in order to receive and maintain their licence, but does not regulate how much or how often those fees can change.
Some families at Fergus Place are still struggling to understand the fee changes, saying they did not receive enough notice. Finding an alternative place to live is also proving to be a challenge.
Seventy-year-old Georgia Riedel, whose mother lives at the Kitchener home, signed for Revera’s service fee change in May because of a lack of other options at the time. She is continuing to delay her retirement to pay for it.
Riedel and her sister, Wilma Schippanoski, are looking for a more affordable residence for their mother, even if that means settling for poorer quality than they want for her.
“How much of myself do I have to give up to keep my mother here?” Riedel said. “I’m going to be left with nothing.”
Families are often surprised by the costs of retirement care, said Laurie Johnston, chief executive of the Ontario Retirement Communities Association.
“I think people aren’t doing as much planning as they really could,” she said.
Although Johnston said it is a difficult conversation to have, adult children need to talk to their parents about their future and their finances. As people live longer and have more complex illnesses, she said paying for the services they need becomes more challenging.
Publicly funded long-term care facilities are another option for seniors, but the wait list is long and based on individual needs.
There are 791 people waiting to access long-term care locally, said Kevin Mercer, chief executive officer for the Waterloo Wellington Community Care Access Centre. People on the list are monitored and can be prioritized if their health worsens, he said.
Getting to the top of the waiting list to leave Fergus Place isn’t likely to happen any time soon for Angela Peters’ mother, since she is not progressing rapidly with Alzheimer’s disease and has no other major medical conditions.
At 52, all the uncertainty about her mother’s care and finances makes Peters question her future after retirement and that of her siblings.
“What about us when we get to the point of needing it?” she said.
Marlene, caring for her elderly mother, has the same fears.
“I don’t want to go through this and there will be no one fighting my battles. I have no kids.”
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