How to Choose a Care Home in BC: A Family Guide

Before you start searching, it helps to understand what types of care are available in British Columbia. The right fit depends on your loved one's current needs and how those needs might change over time.

• Independent living (retirement homes): For seniors who are largely self-sufficient but want a community setting with amenities like meals, social activities, and housekeeping. No regulated personal care is provided.
• Assisted living: For seniors who need some daily support — help with bathing, dressing, medication management — but do not require 24-hour nursing care. Residents live in private suites.
• Long-term care (residential care): For seniors with complex health needs requiring 24-hour professional nursing care. This includes people with advanced dementia, significant mobility limitations, or complex medical conditions.
• Dementia care (memory care): Specialized units within assisted living or long-term care facilities designed for people with Alzheimer's and other forms of dementia. These units have secured environments and trained staff.

Many families are unsure which level of care is appropriate. A Home & Community Care assessment through your health authority is the best starting point — a case manager will evaluate your loved one's needs and recommend the right level of care.

In BC, access to subsidized assisted living and long-term care is coordinated through your regional health authority. Here is how the process typically works:

1. Request an assessment: Contact your health authority's Home & Community Care intake line. If your loved one is in hospital, the hospital care team can initiate this process.
2. Clinical assessment: A case manager will assess your loved one's physical, cognitive, and social needs. This usually happens at home or in hospital.
3. Care level determination: Based on the assessment, the case manager determines whether your loved one qualifies for assisted living, long-term care, or other community supports.
4. Facility preferences: You can typically choose up to three preferred facilities in your health authority region. The case manager can advise on availability and waitlists.
5. Waitlist placement: Your loved one is placed on the waitlist for your chosen facilities. Wait times vary — from weeks to many months depending on the region and facility.
6. Offer and admission: When a bed or suite becomes available, you will receive an offer. You generally have 24-48 hours to accept or decline.

The five health authorities in BC are Fraser Health, Vancouver Coastal Health, Island Health, Interior Health, and Northern Health. Each has slightly different intake processes, so contact yours directly for specific instructions.

Visiting a care home in person is essential. Try to visit at least twice — once during a scheduled tour and once unannounced during a meal time or activity period. Here is what to look for:

Physical environment:

• Is the facility clean and free of strong odours?
• Are hallways well-lit, uncluttered, and easy to navigate?
• Do rooms and common areas feel comfortable and homelike?
• Is there secure outdoor space for residents to enjoy?
• Are handrails, grab bars, and emergency call systems visible?

Staff and residents:

• Do staff interact warmly and respectfully with residents?
• Are residents well-groomed and appropriately dressed?
• Do residents seem engaged, or are many left sitting idle?
• What is the staff-to-resident ratio on each shift?
• Is there visible activity programming posted?

Food and dining:

• Can you sample a meal? Does the food look and smell appetizing?
• Are dietary restrictions and cultural food preferences accommodated?
• Is the dining room a pleasant space?
• Are snacks available between meals?

Come prepared with questions. Good facilities will answer openly and without hesitation. Here are the most important ones:

• What is your staff-to-resident ratio on day, evening, and night shifts?
• What staff training and certifications do you require?
• How do you handle medical emergencies?
• What happens if my loved one's care needs increase — can they stay, or will they need to move?
• How do you manage medications?
• What activities and social programs do you offer?
• Can residents personalize their rooms?
• What is your visitor policy?
• How do you communicate with families about changes in condition?
• What are the all-in costs? Are there any additional charges not included in the base rate?
• What is your complaint and feedback process?
• Can I speak with families of current residents?

Take notes during your visit and compare answers across facilities. The way staff respond to your questions tells you as much as the answers themselves.

The BC Office of the Seniors Advocate publishes annual reports and data on long-term care and assisted living facilities across the province. This data is one of the most valuable tools available to BC families. Here is what to look for:

• Resident and family satisfaction surveys: These cover areas like quality of food, responsiveness of staff, and overall satisfaction. Compare scores to the provincial average.
• Direct care hours: The Seniors Advocate reports how many hours of direct care (nursing and care aide time) residents receive per day. More hours generally means more attentive care.
• Complaint data: Look at the number and types of complaints filed against a facility. A pattern of similar complaints is a red flag.
• Inspection reports: Health authorities conduct routine inspections. Review the most recent inspection findings for any facility you are considering.

CareCompare integrates Seniors Advocate data directly into facility profiles, making it easy to compare quality metrics side by side without digging through government reports.

Trust your instincts. If something feels wrong during a visit, it probably is. Watch for these warning signs:

• Evasive answers: Staff who dodge questions about staffing ratios, costs, or complaints
• Strong odours: Persistent urine or chemical smells suggest inadequate cleaning or understaffing
• Residents left unattended: Multiple residents calling out for help or sitting in soiled clothing
• High staff turnover: Ask how long staff have been there. Constant turnover disrupts care continuity.
• Restricted visiting hours: Facilities that limit when families can visit may be hiding problems
• Lack of activities: No posted schedule or residents with nothing to do during the day
• Pressure to sign quickly: Any pressure to commit without giving you time to review the contract and compare options
• Poor Seniors Advocate scores: Consistently below-average satisfaction or direct care hour numbers

No facility is perfect, and one or two minor issues should not rule out an otherwise good home. But a pattern of red flags across multiple areas is a clear signal to keep looking.

Online reviews can provide helpful perspective, but use them wisely:

• Look for patterns: A single negative review may reflect one family's experience. Multiple reviews mentioning the same issue (e.g., understaffing, poor food) are more meaningful.
• Check the dates: Reviews from several years ago may not reflect current management or conditions. Prioritize recent feedback.
• Consider the source: Google reviews, family forums, and Seniors Advocate survey data each capture different perspectives.
• Balance with your own visit: Reviews are a starting point, not the final word. Your in-person experience matters most.

CareCompare aggregates Google reviews alongside Seniors Advocate quality data so you can see both public opinion and official quality metrics in one place. Use these tools to create a shortlist, then visit your top choices in person.

After visiting facilities, reviewing data, and talking to staff and families, you need to make a choice. Here are a few things to keep in mind:

• Involve your loved one: To the extent possible, include them in the decision. Their comfort and preferences matter.
• Location matters: A facility close to family members who visit regularly is often better than a "perfect" facility an hour away.
• Good enough is okay: No care home will be exactly like home. Focus on safety, dignity, and warmth rather than luxury amenities.
• Plan for transitions: The first few weeks are the hardest. Ask the facility about their settling-in process and how they support new residents.
• Stay involved: Your role does not end at admission. Regular visits, open communication with staff, and ongoing advocacy make a real difference in your loved one's quality of life.

Choosing a care home is not a one-time decision. Needs change, and it is okay to reassess. What matters most is that your loved one is safe, treated with dignity, and that you as a family feel confident in the care they are receiving.