Chapter 7 of 13
Health, care, and aging at home
Plan for aging at home, retirement homes, long-term care, health costs, and insurance decisions.
7.1 Care settings and stress testing
Care option What it means Planning issue
Family support, paid help, Accessibility, transportation,
Aging at home community services, home caregiver capacity, snow
care, or modifications. removal, and home
suitability. Private-pay housing with Contracts, fee increases,
Retirement home meals, housekeeping, and care levels, and exit terms.
varying assistance.Residential nursing/personal Accommodation charges, Long-term care home care through Ontario wait lists, location, and rate-placement. reduction rules.
Care option What it means Planning issue
Short-term care after illness Fast discharge decisions;
Hospital/rehab transition or injury. keep POAs and contact
plans ready. Unpaid or partly paid care by Burnout, respite, fairness,
Family caregiving family/friends. work impact, and caregiver
tax credits.GIS involuntary-separation election. When spouses or common-law partners must live apart for reasons beyond their control — most commonly when one enters a long-term-care home or hospital — the couple can ask Service Canada to be treated as two single individuals for GIS and Allowance purposes. Because the single-rate maximums and income tests are more generous than the couple rates, this election often increases combined benefits by thousands of dollars per year, precisely when care costs rise. Ontario GAINS follows the federal determination. This is not automatic: notify Service Canada of the separation and ask about the involuntary-separation provision. Also coordinate with the LTC rate reduction application for the basic room (§13.2.12), which is based on income. Official source: https://www.canada.ca/en/services/benefits/publicpensions/old-age-security/guaranteed-income-supplement.html
7.2 Choosing a retirement home
Ontario retirement homes are private-pay rental housing with optional care services. They differ from long-term-care homes, where admission is coordinated through Ontario Health atHome and government funding covers nursing and personal care.
Before signing:
- Confirm the home is licensed and review its RHRA inspection record.
- Obtain the written agreement showing rent, meals, care charges, optional services, and increase rules.
- Ask about staffing, emergency response, medication support, and increasing care needs.
- Review termination, transfer, and discharge provisions.
- Confirm resident rights and the complaint process.
- Estimate the total cost if care needs increase, not only the introductory rent.
Official source: Government of Ontario - Find a retirement home
7.3 Aging-at-home tax credits and Ontario supports
Program Planning use
Federal non-refundable credit for qualifying Home Accessibility Tax Credit (HATC) renovations that improve access or reduce risk for an eligible person.
Federal refundable credit for qualifying creation of a self-contained secondary unit Multigenerational Home Renovation Tax for an eligible senior or adult eligible for the Credit (MHRTC) disability tax credit. See §7.6 — creating a secondary unit can affect the Principal Residence Exemption.
Federal non-refundable credit for eligible support of a spouse, partner, or dependant Canada Caregiver Credit (CCC) with an impairment; amounts and eligibility depend on relationship, income, and circumstances.
Helps pay for eligible devices such as Ontario Assistive Devices Program (ADP) mobility, hearing, respiratory, visual, and other equipment; coverage and client share vary by device and program rules.
Track receipts, travel, attendant care,
Medical expense tax credit / disability devices, renovations, and certificates;
supports determine who in the family should claim
eligible expenses.7.4 Travel and out-of-country medical insurance
Travel policies can be invalidated by changes in symptoms, tests, treatment, or medication during the policy's stability period. Read the policy definition of stable, disclose accurately, retain medical records, understand exclusions, and call the insurer before travelling after any health change.
7.5 Insurance decisions in retirement
Insurance should solve a defined risk. Compare the cost of premiums with the financial harm if the event occurs, the availability of public coverage, and the household's ability to self-insure. Reassess life, health/dental, travel, critical-illness, and long-term-care coverage after retirement, mortgage payoff, widowhood, and major asset changes.
7.6 Principal Residence Exemption and change-in-use
- CRA may treat you as having a deemed disposition of the affected portion at fair market value, potentially crystallizing a capital gain, and
- the income-producing portion may no longer qualify for the PRE going forward, so a partial capital gain can arise on the eventual sale of the home.
- A change in use may be avoided where the income use is ancillary/secondary to the main residential use, the home is not structurally altered for the income use, and no capital cost allowance (depreciation) is claimed — but these conditions are specific and fact-dependent.
- In some cases a subsection 45(2)/45(3) election can defer the deemed disposition; eligibility and timing rules apply.
- Keep records of the home's value before and after the renovation and of the area/percentage used for income.
- Coordinate any secondary-suite plan (for a caregiver, adult child, or rental) with a tax professional before starting, so the household weighs the MHRTC benefit against a possible future PRE loss.
7.7 Navigating the Ontario health and home-care system
Knowing which door to knock on matters as much as knowing a program exists. These access points apply province-wide, though local service capacity and wait times vary by region.
Need Where to start (province- Planning notes wide)
Ontario Health atHome (the
provincial home-and- An assessment determines
Publicly funded home care community-care service; eligibility and hours; public
(nursing, personal support, formerly the LHIN/CCAC hours may not fully meet
therapy) home-care function). Ask needs, so budget for private
your hospital, doctor, or call top-up (see §7.1).
the provincial service to
request an assessment. You choose preferred
Apply through Ontario homes; wait lists vary sharply
Long-term care (LTC) home Health atHome, which by home and region.
placement coordinates LTC Accommodation charges
applications, eligibility apply, with a rate-reduction
assessment, and the wait list. option for the basic room
based on income. Local community support Availability and cost differ by
Community supports (meals, service agencies; many are municipality; respite can
transportation, adult day found through the provincial relieve caregiver burnout
programs, respite) service or 211 Ontario (dial (§7.1).
2-1-1). Hospital care- Discharge decisions can
Hospital discharge to home coordination/discharge move quickly; keep POAs
or LTC planning team. (§8.1) and a contact plan
ready in advance.Need Where to start (province- Planning notes wide)
Health card / OHIP coverage ServiceOntario for renewals; Extended absences can
while away confirm out-of-province/out- affect coverage — relevant to
of-country residency rules. snowbirds (§9.5).- Start the assessment process early — before a crisis — because wait lists and paperwork take time.
- Public home care rarely covers 24-hour needs; combine it with private care, family caregiving, and community supports.
- Keep a written care plan and contact list with your POA-for-Personal-Care attorney (§8.1, §8.8).
- Use 211 Ontario as a free, province-wide referral line for local seniors' and community services in any municipality.
Educational guide only. Rules and benefit amounts change. Confirm important decisions with official sources and qualified professionals.