Jean-Marie Cloutier, 83, looks out his room window at his Ottawa-area nursing home. Cloutier suffers from short-term memory loss. (Sean Kilpatrick/Canadian Press)

More than 150,000 Canadian seniors were living in residential care facilities in 2004/2005, according to figures from Statistics Canada. That's about three per cent of the country's population over the age of 65.

That number shoots up to around 20 per cent for people aged 85 or older.

And that's not including those who live in retirement homes, which are for seniors who remain independent, are able to take care of themselves and are willing to pay for whatever services they want.

But there is a caveat: retirement homes are unregulated and are privately-owned. Residents rent apartments where they can cook their own meals, if they choose, or sign up for meal plans. Services offered at retirement homes vary — but long-term medical care is not one of them.

Retirement homes are covered by whatever landlord-tenant legislation is on the books in that particular province. If rents are covered by some form of rent control, then that portion of the person's fee will be controlled. Other services that make up the home's monthly fee are not controlled by any legislation.

Normally, provinces set standard rates for long-term care facilities.

Choosing a long-term care facility for a parent can be a daunting task. Here are some things to consider before deciding on a facility:

The facilities

Location, location, location. Is the facility conveniently located, making it easily accessible for family and friends? What about the neighbourhood? Proximity to parks and stores could be important for seniors who are somewhat mobile.

Check on the condition of the building. Does it appear to be clean and well-maintained?

If your relative will be sharing a room, is there a way to have privacy? Can they keep their personal belongings secure?

You will want to know whether your relative can bring in some furniture. You may also want to find out whether the residence has a private telephone line, cable television and internet access.

Are there facilities that allow families to dine together?

Ask to see a sample menu and ask residents what they think about the food.

Safety

Before moving in:

Ask about assaults. Find out how frequently they happen, and what procedures are followed for intervention and prevention.

Ask about staffing levels. How many of the staff are trained in handling patients with dementia? What is the staff-to-resident ratio?

Visit the home more than once. Don't do just one tour. Drop by unannounced. Visit at different times, including during meals and at night. Does the home smell? Are staff available? Are the residents lining up in the hallway or wandering around? Does there seem to be anything for residents to do?

Visit different floors. Ask to see various areas in a home, including any locked wards. If your request is refused, that could be a sign there may be problems on other floors. Generally the first floor has the residents with the fewest behavioural issues, because that location is closest to the door.

Talk to people. Does the home have a family council? Talk to people on the family council, talk to residents, talk to family members.

After moving in:

If you have questions or concerns about resident-on-resident abuse in a long-term care home, first discuss your concerns directly with the home's administration.

If you witness an incident of abuse, immediately alert staff and make sure the incident is recorded in writing.

If your concerns are not addressed to your satisfaction, contact the ministry responsible for long-term care in your province.

Health services

How often do staff members check on patients? There are minimum times that staff are required to spend with each patient. Those times vary across the country.

If your relative is unable to bathe him/herself you will want to know how often staff bathe residents.

How often are services such as physiotherapy, occupational therapy and foot care available?

Will your relative continue to have access to his/her family doctor? If not, what are the alternatives? Under what circumstances would the home be unable to offer care to someone?

In the end

Once you've had your questions answered and you've narrowed down your choices, be prepared to go on a waiting list — a good reason to make your choices well before the service is needed.