Decision coach

As you get older you may find you can’t manage to get around the same way you used to. But you want to stay in your home and stay independent for as long as you can. There are ways to do this and people who can help you. And there are some choices that you need to think about. Choices about keeping healthy, staying active and still getting the care you need, but in a way that suits you. First, it’s important that you know what your options are for staying independent, and the pros and cons of each option, before deciding which option you prefer. It’s good to be thinking ahead so that you have time to think about all this.

The best option for you might not be the best option for someone else. So it’s important that you think carefully about the pros and cons, and discuss your preferences with people who are important to you and who are involved in your health care.  They can give you information for your specific situation, for example what kind of homecare services you are eligible for, and how we can adapt the options to suit your needs and preferences.

The experts in these videos can each in their own way help you stay independent at home.

The options they suggest are meant to help you think about what is important for you. Although they are experts, you don’t have to follow their suggestions. You must weigh up for yourself what you think are the pros and cons of each option.

For example if your health professional suggests that you hire someone to help you with your bath twice a week, you might think, yes, that would be safer and easier — yet you’re not comfortable having somebody help you. On the one hand you’d like to have a visitor to chat with and ask questions, but on the other hand it might cost more than you’re able to pay. You need to think about when they could come, for how long, and how it will affect your other activities. Can you make this option work for you (such as choosing the carer, the timing, etc), or is there a different option available?

We encourage you to find solutions that work for you, your caregiver and your health care team.

After watching these videos you may have a clearer idea about what’s most important to you in these choices. If you haven’t already done so, a first step in decision-making would be to contact your family physician or your health and social service centre to tell them about your changing situation. They can then refer you to other specialists if necessary. You could also think about who among your friends, relatives and neighbours might help you with these decisions.


I am a widow, I’m 74, I have 2 daughters and one lives here close by.

I manage okay around the home; I am able to look after myself.  I still do the dishes and some cooking but I must admit that I don’t always feel like cooking, especially if it’s just for me. My appetite is not what it used to be.

I feel fine when I am in my home surrounded by my things, my memories. I wouldn’t want to move. But I sometimes feel lonely. I can’t easily visit my friends any more as I don’t drive, and it’s too far for me to walk. But taking a short walk is easy now, ever since I got my new walker. At first, I didn’t want to use it, you know, I didn’t think of myself as that old. But now I find I’m actually more independent WITH my walker than without. I can walk faster and further, and whenever I’m tired I sit down and rest a bit on the seat. I couldn’t live without it now.

My daughter does a lot for me, I am really lucky. She comes every Saturday to do groceries with me, and gets other things I need. And I can always call her. But then I often think, “well, I shouldn’t ask too much of her; she has her own family and a busy life”, so I’m sometimes reluctant to pick up the phone. I see her once or twice a week, but I’m still alone the rest of the time. The other thing that worries me is that I’m having trouble with my bladder. Buying the diapers is expensive, and they are so bulky and hard to carry. Putting them on and taking them off is hard too. Sometimes I nearly fall. This is something I don’t like to talk about it with anyone, not even my daughter. But I had to, because she helps me do my shopping.

Recently, my daughter asked me whether I was still able to manage, staying at home. It was kind of her, to worry, but I was a bit offended. Of course I can manage! But then a nurse at the clinic asked me some questions about difficulties I’m starting to have at home. I think everybody should have this discussion with someone in the healthcare system early on. You have to decide how you’re going to manage at home right now, but you also have to think about what you may need 5-10 years down the road. It may be a big investment of time and money which is only worth it if it’s going to be useful in the long term.

For me, the best ways to stay independent were easy to find. I already had my walker, and a nice man put up some safety bars in my home so I could move around more easily. My daughter offered to help me with even more chores so I could stay on here.

And, I decided to get involved in some activities at the nursing home in the village. I met some very nice people there and I enjoy myself; I do an art class and also an exercise class. I eat my lunch there too. Twice a week their van picks me up, and takes me home afterwards. Because of them, I don`t feel so lonely anymore.

Informal caregiver (grandson)

I am the main caregiver for my grandfather, who is 94 years old and still living at home.

He used to be a captain so he is very much used to doing things on his own. He likes to be in charge and doesn’t want anyone else deciding for him. Moving to a nursing home is out of the question for him. But he is not as strong as he used to be and he needs help remembering things, like going for appointments, or even cooking. His personal hygiene is not what it used to be. He really needs someone looking after him.

When my grandma was still alive, she did all the cooking and cleaning, and my grandpa and her always agreed about everything. But me and my grandpa… we often disagree.
I live too far away to help him out on a regular basis, so I don’t know what to do anymore. I respect his wish to stay at home as long as possible, but I would like to know what our options are.

Informal caregiver (daughter)

I am the primary caregiver for my mom, who is 88 years old and is still living on her own in the split-level house in the countryside where my parents raised us. A few months ago I noticed that she’d lost some weight and was not getting out as much as she used to. I felt she wasn’t managing as well as she used to and I started to worry about her living alone.

It’s hard for me to find time for her – I have three small kids at home and I work full time. I worry that she’ll need more and more of my help – but also that she doesn’t always ask for it when she needs it. She’s proud, and she’s really determined to stay in her home. “I’m leaving this place feet first” she says. But that might get hard to cope with at some point too.

For now I want to help her live in her house as long as possible, so we started to ask about options for keeping her in her home. As I never dealt with this before, I had no idea where to begin, so I asked around, and saw that it is often a team effort. All the people involved in my mom’s healthcare have given valuable feedback on my mom.

I first asked the family doctor. My mum has several chronic illnesses so she sees her regularly. She referred me to a health and social service center, and they started a formal evaluation of the possibilities for keeping my mom independent at home. They told me I could have come directly to them as well.

One thing that I have learned from this experience is that it’s best to speak up and ask all the questions you can think of. There is usually somebody who can help you, or refer you to someone else who can help you.

Social Worker

As a social worker I assess how you are managing in the community and I help you get access to available grants and support programs. I know about the legal issues related to decision making, housing options, and finances and can help you with these things. I work in a team and we each think about the different needs of the senior, so we can really get a sense of your whole situation. We are like the central point between all the people involved in your health care.

Because there are both private and public programs to help you stay at home, you need to know what you can afford to pay, or decide what you are willing to pay. For example, can you afford to pay someone to help you take an extra bath a week, or to pay for housekeeping once in a while? If you have some private insurance this might pay for some services that aren’t paid for by the public healthcare system.

Who’s in control of your finances, and who might be able to discuss this with you? For example, if you pay online, you can pay for all kinds of services without having to go outside (like groceries, medication, clothes). However, some people find it difficult to use the internet for this. If you do not have someone to help you out with this, you could ask your bank to explain paying for things online.

For people who can’t afford any extras, there are some public programs at the city, provincial and federal level. These programs are not always easy to find, and have strict eligibility criteria. Also, for most of these services, you can only get a tax credit or reimbursement after you’ve paid. The funding and reimbursement systems are often complicated, and I can help you fill out the forms. My job is to help you find the support you need.


Architects and interior designers can suggest ways to adapt your home so you can stay there as long as possible. They can suggest changes that are ergonomic and safe, but in ways that respects your personal taste. For some changes you can get reimbursements.

These are a few things you can ask yourself:

Is your house safe to walk around? You can always take up carpets and rearrange furniture to clear your way.

Can you reach everything you need in your kitchen, with your mobility devices? Are the cupboards the right height?

How do you get to the bathroom, especially at night? Is there anything in the way that may cause a fall, like a throw rug? Can you reach the light from your bed? Is the bed at the right height so you can get out of it easily, with maybe a grab bar? The same goes for the toilet seat.

In the bathroom, if there’s a small step between the floor and the shower or the toilet, or slippery surfaces and no bars to hold on to, it’s easy to fall.

What are your stairs like, in your home? The deeper the tread, the more likely you are to fall. Also, do the stairs have a safe bannister, good lighting, and nothing on the steps for you to trip over? You can get stair lifts or platforms. You can also rethink how you live in your home so you don’t have to use the stairs on a daily basis, such as moving your bedroom downstairs.

How easy is it to get into your home? If you can’t bring your mobility device inside your home, do you have a place to park it? Like a garage, or a veranda?

We also have to think about being active outside; which is where urban designers and municipalities have a role.

Are the sidewalks in good condition? Sometimes the sidewalk surface is uneven or suddenly slopes, or the curbs are too high. If they are in public areas, you can report sidewalks and paths that are in bad shape or blocked to your city hall or local councillor.

Also, if possible choose stores and a health centre that are easy to get to. Does the route have benches or other places where you can sit and recover your strength on the way? Do the traffic signals give you enough time to cross? Are there public toilets you know you can use?

Are there stairs or a ramp into the buildings? Are the doors big enough for your mobility device? Is there a place to park it? If you drive, do you know where the handicapped parking is so you don’t have to walk too far? So architects and interior designers, can help you stay mobile for as long as possible.


As pharmacist I check your medication, renew your prescriptions, and give you vaccinations. I might see, for example, that one medication has the side-effect of causing fatigue or dizziness and might increase your risk of a fall. We can also discuss starting new medications. Whenever you have doubts or questions about medication, you can ask me for advice.

If you have trouble coming over to your local pharmacy, you can call us with your questions, and we may be able to deliver your medication to your house.

Caregiver representative

I volunteer with an organization for caregivers. Even though there are specialists for all kinds of tasks, ultimately a lot of the burden of caring for someone falls on family caregivers. It can be really difficult to combine caring for your loved one with taking care of your own family, and your job. Sometimes it’s also hard to get the information you need, or get in touch with the right people, and you can get caught up in bureaucracy. Being a caregiver can be physically and emotionally exhausting.

Our purpose as a caregiver association is to support caregivers. We offer respite care, as well as educational get-togethers and support groups. Of course we do understand that caregivers do not have much free time for this kind of things, so we offer a lot of online support as well.


As a nutritionist, I often become involved in someone’s care when they are in hospital or going to a nursing home. However, eating well should be emphasized earlier! It’s important that you eat food that is nutritious and tasty, but also that you eat enough. Eating well helps you stay fit, have good strong bones and muscle strength, and gives you enough energy to be active. If you lose your muscle strength it gets hard to do those basic activities around the house, and it can cause dizziness and falls. Please remember also that it’s important to drink lots during the day; you should keep your body hydrated at all times.

When people eat less, have less appetite, move less, or lose weight unintentionally, these are signs for me to check a person’s eating habits so that they can stay healthy.

Sometimes you don’t feel like cooking every day, which is completely normal after many years of daily cooking. Or you may have lost a loved one who did all the cooking for you. Some agencies, such as Meals on Wheels, can deliver prepared meals to your house one or more days a week. It is not free, but the meals are often enough to last for 2 days.

Perhaps you can go for meals in a nearby senior’s residence, join a cooking group, or go to church suppers. This way you can have a good and affordable meal and some company at the same time.

Another option is to have your groceries delivered to your home. Many supermarkets deliver for a small extra fee. You can ask for this at your regular supermarket. You can even order groceries on the internet. Or, ask family or friends to pick up groceries for you when they do their own.

Sometimes there is just one vitamin that is missing, a dietitian can tell you what to eat to fill that gap, or tell you about vitamin supplements or meal replacements (like fortified drinks or bars).

Also, this may sound strange, but in order to eat, you have to be comfortable with your teeth. Ask your dentist to advise you about taking care of your teeth or fit you with new dentures, so you can keep enjoying your food.


As a physiotherapist, my job is to help you function as best as you can in your home and community. I prescribe exercises to help you stay physically active and flexible, and to keep your balance and your muscle strength. We can also see what you need in terms of help walking around in your home or neighbourhood, or going up stairs.

We look at your home and come up with exercises that fit your situation. We don’t take everything out of your hands, but teach you other ways of doing things for yourself. We prefer to focus on what you can do, instead of what you can not.

If you are less physically active, you are more likely to fall. My focus is to keep people as active as possible but keep them moving safely. This might be with exercises in an outpatient physiotherapy department in a hospital or a private practice.  Especially exercises which focus on balance and leg strength can help you prevent falls. Ask a physiotherapist in your region what exercises or programs might be helpful for you. It is also important to keep active in and around the house, such as doing the dishes or some cleaning, and if possible, going out for walks. We also need to think about how you can move around in your home safely. Without realizing it, people often use walls or counters for balance or support when walking around. But this is not always the safest way. We can help you find other solutions. Sometimes small changes can make your place accessible for a walker or a wheelchair, or make it safer for you to walk around.

Occupational therapist

Occupational therapists assess what kind of support you need both at home and outside, and suggest where you can get it. We also suggest equipment that you can use to help with your daily tasks.

When we evaluate your situation we look at your safety and happiness too.

We can help you with using a walker or cane.

Do you have solid shoes with a good tread, and crampons for the winter? If not, perhaps a family member could take you out shopping for these things.

Also, dogs are great company, but put a bright collar on your dog so you don’t trip over them.

We look at your judgment and ability to understand risks. If this is a problem, your family doctor could refer you to a specialist in geriatric medicine.

How do you ask for help in emergencies? If you fell, could you always reach a phone, or would an emergency bracelet or necklace be useful? They automatically phone for help if you press the button.

Do you feel safe where you are? Do you have people who can help you out when you need it?

Your happiness is also important. For some people, it is important to be with other people to feel happy. So we make sure that people who want to go out and do things with other people know where to go, and what to do. Sometimes people think they don’t want to mix with other people, but often they change their minds once they’ve tried it.

A recreational therapist encourages people to socialize. This can include exercise activities, games such as bingo, and cultural activities such as painting or drawing. Recreational therapists usually work with senior programs or in long-term care facilities.

There are also day centres where you can meet others in the same situation as you. Some programs are specifically designed for people who have Alzheimer's disease. You may be able to get physiotherapy and occupational therapy as well.

Another activity that is good for mental and physical health is gardening. You can do it together or alone, and whenever you like. If you don’t have a garden, you can grow plants on your balcony or help in somebody else’s garden. But perhaps leave the heavy lifting to others.

If you still drive your own car, have you had any bumps or accidents recently? You can take a test to make sure you’re still safe, and get equipment such as extra mirrors. If you don’t drive, there are other options:

The bus has a cheaper rate for seniors. If the bus stop isn’t too far, ask someone to print out the schedule for you. Try to use it outside rush hour so you can get a seat near the door. It can be difficult to keep your balance in a moving bus. Some buses can accommodate wheelchairs.

Taking a taxi around town is much cheaper than owning a car! There are some taxi services that can take you to appointments, wait for you, and then bring you home again. This is called an accompaniment service. There are also taxis adapted for wheelchairs. Ask your taxi company.

There may be adapted public transport especially for elderly or less mobile people. You will need to be checked to see if you are eligible.

Some seniors’ residences have a van that can come pick you up to participate in their day centre activities, and bring you home afterwards. Ask about this when you inquire about their activities.

Nurse in home care

My job is to provide direct medical care at home, such as wound care, blood tests and medication. As nurses we also assess all aspects of your health- physical, emotional, mental and also what you need to keep on with your daily routines. Based on this we will ask various different professionals to help you stay at home as safely as possible.

One thing that is important if you are going to stay in your home is whether you are able to do basic things like getting out of bed, getting dressed, washing and making your own meals. It is important to keep doing things yourself for as long as you can. We often say “use it, or lose it”. But once you can't do these things anymore, you can still get help to do them.

Home support workers can provide services in your home. These are people who are trained to help you with meals, bathing, dressing, grooming and going to the toilet. They work for private agencies as well as in the public healthcare system. Sometimes volunteers, or friends or family can help too.

There are also organizations that offer housekeeping services to help you clean the house. You can also hire someone to keep your yard maintained and the snow cleared in the winter.

For other chores around the house and household repairs such as installing grab bars in bathroom and toilet, you can hire a handyman by the hour or have him/her come once a week to do whatever needs doing. To find a handyman, you could ask for a recommendation from friends, family, neighbours or a nearby seniors’ residence.

Besides these services, there are other things that can help. For example,

If remembering is difficult: Pillboxes help you take your pills at the right time, and calendars help you remember your appointments. If you sometimes forget to turn off the oven, replace it with a microwave, which is a lot safer.

Are you hard of hearing? Perhaps you need a hearing aid.

How about your eyesight? Glasses help, but having enough light in the place is also important.

Is bladder control a problem? Incontinence is a problem for most people as they get older. There is no need to be ashamed of it, we will all have to deal with it someday. Drugstores and online stores carry incontinence items, such as panty liners and disposable or washable adult diapers, as well as waterproof pads and mattress protectors. These all cost money, though. Disposable diapers are quite expensive, but washable diapers make lots of laundry. Make sure you have clothes that you can change easily.

Home support worker

As a home support worker, I can come to your home in the morning to help you get out of bed, have a bath or shower, get dressed, make your breakfast, and other daily activities you’re finding difficult. We can also come in the evening to help you get ready for bed. Some of us can help you with your medication as well. Once your needs have been evaluated, the local health centre can send me to your home. Sometimes we are affiliated with a nearby senior’s residence or nursing home. Or else you can hire our services from one of many private agencies. We try to come at a time that’s convenient for our clients. For many people we become almost like a friend. However, we have to try to focus on your physical needs, and we have lots of other clients, so we can’t stay and chat all day!

Family Doctor

As a family doctor I’m involved in acute care, prevention and chronic conditions. I’m the one who refers you to specialists. Also, I have to sign all the forms that assess your health or abilities, and you need my signature to get on a waiting list for a public nursing home. If you have a family doctor, it’s a good idea to ask him or her about ways of staying independent in your home. I can make contact with a home care team, and make sure a case manager assesses your needs. I can help both seniors and caregivers make decisions about what to do next. If you don’t have a family doctor, you can ask for an evaluation at your health and social service center, and they can refer you to other professionals.

If your caregiver looks exhausted, I might suggest you go and stay in a respite home for a while. Caregivers often really want to look after you the best they can but they need a break too. This helps them recover their strength to go on looking after you once you get back home. I can organize this.

There may come a time when it’s no longer possible to stay in your home. It’s a good idea to start looking around at residences early on. Think about your need for social activities versus your need for privacy and time alone. Also think about how close the residence is to where your loved ones live, and the kind of services they offer. Find out the staff/resident ratio, for example. For more information about this you can ask your home care team.

Informal caregiver

My husband and I live in a one-level city apartment. We moved here five years ago when my husband had had a stroke and lost the use of the right side of his body. He recovered fairly well, but our home was too difficult for him. So we moved to a place designed for seniors; with an elevator, grab bars in the toilet, and an alarm bell. We like it a lot here.

You know, I have always looked after my husband very well. I prepared meals, did the grocery shopping, cleaning, did all his laundry and ironing. But now it is getting a bit much for me. So we recently hired a cleaning lady, and our daughter sometimes helps with laundry and groceries. But he’s having trouble taking a shower, and dressing, and some other medical things. I always thought if we couldn’t manage on our own, we’d have to go into a nursing home, but it seems it’s possible to stay at home, and have extra help. I’d really like to look into this before giving up our apartment. We can always change our minds later on.

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