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Home Care Costs & Funding Options in Canada

Explore your home care service options 

For families seeking to enhance the amount of service provided publicly, or who wish to purchase home care privately (when government funding is not available) it is wise to choose reputable agencies. This will guarantee a higher quality of service and fair labour practices. Typically home care organizations will assess costs as part of a pre-service assessment that will also include service requirements and funding options. There is generally no charge for this assessment. A pre-service assessment is a great opportunity to learn about the types of services available, the cost of each, and will help you to prioritize the services you'd like and align that with what you can afford.

Home care organizations will encourage individuals to avail themselves of government funded home care in order to minimize their out of pocket expense. Other funding options such as a private insurance provider or personal payment are also explored.

Regarding the contract

Providers will prepare a service contract that outlines the services to be rendered and the private costs. There is usually no penalty for canceling a contract. There may be a minimum of service hours for each visit. There could also be price adjustments for purchases of large volumes of service.

About costs based on needs

Service rates vary across the country. While local billing rates can vary, the average bill rate in Ontario is between $20.00 to $30.00 per hour for home support, personal care and/or companionship. Professional services including nursing and therapy are significantly more depending on the type of service – typically between $50 and $60.00 per visit. However, these costs should be discussed with the home care provider as different arrangements can be made depending on the type of service, whether it is for overnight support, live-in care or other needs.

How will my costs be assessed?

Typically a home care nurse (often referred to as a case manager) will meet with the client and family to conduct an initial assessment to determine needs. The interview will include a discussion of lifestyle habits, personal care needs, health status and goals. From the responses the nurse will be able to recommend the amount and type of service required.

An assessment for government funded service will be undertaken using provincially approved templates that may also include an income assessment. Assessment scores are used to help guide decision making but are not necessarily comparable between individuals. The professional expertise and other variables influencing the family are important to the determination of services. Once completed, a service agreement and care plan will be developed and care initiated, helping you flesh out this part of a long range care plan for dementia.

Regarding billing of home care fees

An invoice is usually sent to clients and payment is required as agreed by the client and provider. Home care organizations can generally manage all forms of payment types including bank debit, credit card and cheque. Direct payment of staff is not usually required. Clients should be provided with a receipt and/or a statement of payments at the end of the year which may be useful for income tax purposes. 

Why you shouldn't hire casual help

Sometimes families pay neighbours or friends to help their family member and can pay a lower hourly rate. However, there can be significant liability risks to homeowners, concerns about the level of training and lack of supervision and much more work for the family purchasing this service. This includes verifying identity and credentials and conducting background checks, fulfilling tax obligations, acquiring liability insurance and arranging backup coverage in case of illness or sudden termination. A neighbour or friend may not have home insurance coverage for an injury and may seek damages in the event of an incident while at work.

As with all services, it is important to carefully consider costs and weigh the level of service and peace of mind that is provided.