Choosing to live in a seniors’ residence with Louis Sirois, Chief Executive Officer of Visavie
Video by Bien Vieillir à Boucherville
Ginette de la Croix : Hello, my name is Ginette de la Croix from Bien Vieillir à Boucherville. I am pleased to welcome Mr. Louis Sirois, owner of Visavie, a company that offers support services for the search of residences for seniors. As well as home care services. So we’re talking about private home care here. Today, we’re going to discuss together how to wisely choose a private seniors’ residence. So Mr. Sirois, thank you very much for being with us today, before we begin, I’d like to say that if you have any questions, they can be answered at the end by Louis Sirois. So yes, this vignette will be recorded. So if you want to listen to this clip again, you can go to the City of Boucherville’s website to review the clip. If you have any questions after our interview, you can always ask them on the City of Boucherville website. So, once again, thank you Louis for being with us. First of all, with all that we heard during the pandemic, we talked about CHSLDs, conventioned, non conventioned, intermediate resources and RPAs and all that. Can you give us a more precise description of what type of seniors’ residence is?
Louis Sirois: Indeed, it is not easy. First of all, thank you for giving me the floor. So these terms have been mixed up with everything that has happened lately. The government in their announcements, in their press briefings have made the mistake of mixing CHSLD (residential and long-term care center) and RPA (private residence for seniors). This morning we are going to try to clear this up for everyone and make it simpler. The easiest way is to determine what is independent and what is not independent. There are many levels to this. When we fall into the non-autonomous category, where seniors need several hours of care, in theory more than 3 hours of care, we will move to a CHSLD. There are two categories of CHSLDs. There is the public and the private. So, for someone who would like to go to a public CHSLD, he must work with the health milieu, so the social worker will do an evaluation of this person. So after the evaluation, and without becoming very complicated, we call it the SMAF evaluation, the senior will either be admitted or not admitted to the program. So this must be done with the help of the social worker. For someone who needs a lot of care hours and who does not want to go to the public sector, there are private CHSLDs that will admit you after an evaluation. The cost in private is a little more comprehensive. We are talking about several thousand dollars. Probably more than $5000 per person. There are some that are a little less expensive. This is for the CHSLD portion. When you have a little less care, again two choices. When people talk about IR or intermediate resources, we’re talking about between 1.5 and 3 hours of care, the person must also work with a social worker, who, after the evaluation, will suggest going to IR and it’s a company or a public organization. There are some who mix things up. There is no such thing as private IR, it’s public. The elderly person makes the application and will be admitted to IR. If you have the same number of hours of private care, between 1.5 and 3 hours, you can go to a residence that offers care. There are care floors in private residences. Seniors can be admitted and pay this monthly amount. And lastly, we have the famous RPA, residence for elderly people, the majority of the seniors who are autonomous sometimes they need a little help à la carte, it will depend on the choices they will be offered to you. Some residences will have this care or these services. I hope this gives you an idea of the three types of residences. It’s not that complicated but you have to know.
Ginette de la Croix: So you really shouldn’t mix CHSLD and, for example, RPA in the terms. They are two different types of residences for seniors. We also heard a lot in the media about RPAs where activities were limited, or for example, activities even at the meal level. What is it like now? Residential life?
Louis Sirois: There has been, if we talk about evolution and all that, it’s a first. No one has ever experienced such a pandemic. So this pandemic made the residences face a situation that they had never experienced. The government put in place procedures and methods that they too had never experienced. So it was difficult in residence. It was managed differently in all the CIUSSS and CISSS across Quebec. So what was done in a CIUSSS in Quebec City or in Montreal, it could be two completely different things but they gave instructions to the residences and let’s understand that in Quebec, there are 1700 residences and the owners of these residences did not all follow to the letter what was said but mostly at the beginning of the first wave, everything was stopped. No more activities, no more restaurants, no more leaving the apartment, no more visits and that’s when we saw some horrors, some things that were not pleasant to see. Afterwards, evolution made people start to adapt. At the end of the first wave, there was an opening in the residences. They allowed some things to be done inside. Some activities, some visits but very limited. But a little bit of freedom for those seniors who needed it. But then the second wave hit and there was a new closure and it wasn’t pretty either. And today, to follow up on your question, today we are not exactly where we were pre-pandemic but there is a great openness, that is to say, visits on the background in a very open way and people continue to take the safety measures (masks, hygiene etc.) and are able to see their friends. The double vaccinations that are now at more than 98% in the CHSLDs and residences means that people can mix and see their families. We are light years away from what we experienced before and we understand that the impact on what people will have experienced will diminish and they will forget. With good reason. The vaccine does its work.
Ginette de la Croix: So the satisfaction rate of people in residence is satisfactory?
Louis Sirois: Absolutely, we work with seniors every year and we see the difference.
Ginette de la Croix: And tell me Louis, when we consider living in a seniors’ residence, what are the most important elements, in terms of needs? How do you evaluate these needs? It’s very important. We’re talking about choosing a living environment for our old age.
Louis Sirois: We will answer this question with statistical data. In Quebec, 18% of seniors aged 75 and over will go into residences. 18%! And 82% will stay at home. In most cases, there is a trigger to move into a residence and there are all kinds of triggers. I’ll tell you my dad’s story, the trigger can be the loss of a spouse. Loss of physical or cognitive autonomy. I’m tired of taking care of my house, I’m not able to take care of it anymore, I don’t want to cook anymore, I want to be closer to my children outside. It always takes a trigger. My dad had been gone for 6 years since my mom passed away. He was living in his house, very manual and capable. We had been telling him for 6 years without putting any pressure on him, but for him it wasn’t necessary. He was in the 82% who wanted to stay at home. He went to visit his sister in Florida for two weeks. When he returned, he had been robbed. The reaction was immediate, it took him two nights, he called me and said he wanted to go back to a senior residence. So 3 months later, the house was sold, he was moved into a residence, he was very happy! He made lots of friends, lots of activities. It was a difficult change. The perception of many seniors today, especially those over 75-80 years old, is that residences are places where I will end my life. It’s far from ending our lives. The residences are really beautiful, there are some that are impeccable. For those who know the club med, there are many activities, restaurants, bowling, golf, horticulture, bridge clubs and so on! We have all the choices, big, small, medium residence. That’s the question we ask ourselves. After that, the monetary aspect is always an unavoidable element. The activities I want to do, the proximity of the children. I want to have a big building, maybe I want to be outside or closer. Those are major elements. There’s a lot of them too that are asking the question, probably I’m going to have a problem. Is the residence going to be able to provide me with care. They say it always takes care. But we try to see if the residence if it’s an important point for the person, if the residence is going to offer care services. Many residences will offer between 5 and 10% of their housing in care. They will have care floors and there are some that will offer à la carte care, in the apartments. We can call upon certain companies to provide home care services at home. So you have the best of both worlds.
Ginette de la Croix: And tell me Louis, when our idea is made and we really opt for a seniors’ residence, what are the steps of the seniors’ residence process?
Louis Sirois: That’s an excellent question. The steps we always ask the question if there are children or relatives but we try to have family discussions. Because we don’t want to upset anyone and we want to facilitate this transition. We want it to be pleasant. So one of the things that people are doing now that we find excellent, they’re going to go on the web and they’re going to go look for residences. And it’s often the kids who are going to do that research. The web today offers a vast amount of information. How do you go about finding the right residence? Because to arrive and choose, there are sites that will allow you to find and meet your criteria. You can find 10, 15, 20 or 25 residences. How do you determine the right one? It is not always obvious. What we advise and I am not trying to cheat, we are a free service. What we do is that our counsellors come to the house and spend an hour or two with the senior and the family in order to understand and then, we will determine a limited number of residences. We will visit a few residences because otherwise, for a senior to visit 10 or 15 residences, we suggest that it is not good. There are far too many. In Montreal alone, there must be 500. With our help, without pressure, we meet with the seniors and we determine the right choice and after that, we help with the signing of the lease.
Ginette de la Croix: Precisely, we see that the choice to find the good residence for seniors, there is a contractual aspect. So it has to meet our budget. It is indeed, an element that we did not approach Louis, we hear to say that it is rather expensive and I do not speak about the private CHSLD.
Louis Sirois: Indeed, the monetary aspect is an important factor. We are lucky in Quebec because we know the programs in the rest of Canada. We are lucky to have a tax credit for seniors. The government will give you a monthly amount according to the services you will take in the residence. But it is there that we are able to explain that and we determine this credit there for the families. It’s an amount of money that is given to the senior to go to residences. That’s one thing. There are some residences, just with the old age pension and the Canada income supplement, we are able to have a room in a residence for seniors with 3 meals a day. So if someone doesn’t have the money, there are options for you. After that, the options are smaller. It’s a choice and you are guided. For some people money is not a factor, for others it is. We guide because it doesn’t help to give someone the wrong choices. When you fall into the lease aspect. That’s the beauty of Quebec. The lease is governed by the old one which was the housing authority which does not exist any more which is called the administrative tribunal of housing thus the TAL. So there are leases and when you go into a residence, there is what is called an appendix 6. The lease is standard. It will tell you that you are going to rent apartment number 777 in such and such a residence, the rent is $X per month and your lease starts, for example, on July 1st 2021 and ends on June 30th 2022. This is the essence of the lease. With a multitude of legal clauses. No changes possible, it’s all there. After that, we have this appendix 6 which are all the options and services that the senior will see in his residence that are included in the lease. It’s clear, clean and precise. The owner of the residence must offer these services that are listed on Schedule 6. Very important. After that, there are all kinds of clauses, people who ask us if it is legal to put a deposit. These are answers that we have. We guide. We speak with the residence and we intervene for the senior for legal questions. Sometimes, there are people who do not follow the straight line and then we put it straight. We are there when the lease is signed with the senior. We are there to support him.
Ginette de la Croix: We have heard in the media about rent increases.
Louis Sirois: There are two categories of rent increases. For a residence that is new from zero to five years, the owner can increase the rent as he wants. If you pay $1500, if next year he wants to charge $1600, he can do so. You don’t have to agree. You can refuse. All the terms of your lease are still binding. If the residence is older than 5 years, the landlord will send a rent increase and if he increases your rent by 10% for example, you can send a reply to the landlord saying I refuse and we will go before the housing tribunal and we will negotiate together before a manager. That being said, there are rules of economy and competition is strong between the owners of residences and everyone knows how much the other charges. So if there is a significant increase, the landlord doesn’t want to be left with a lot of empty apartments. Rent increases are between 1 and 2% right now. There are always exceptions. But between 1 and 2% and at that moment it is your choice to accept or not. For a rental, we’re talking about $1500 for example, that’s maybe $15 or $30. It’s quite rare for seniors to want to spend time in court for amounts like that. The costs inside the residences are also increasing, the cost of salaries, food, energy, etc. We don’t have a choice.
Ginette de la Croix: Tell us Louis, when we can call on Visavie. You mentioned your services in the search for a residence for seniors. When can we call on an agency like yours to help us in our search? For people who are perfectly autonomous. Are these services well advised?
Louis Sirois: That’s a very good question, Ginette. Since Visavie began 33 years ago, we have helped more than 175,000 families and their seniors. Both autonomous and not autonomous. We do all this, we understand that the autonomous senior, the reaction is that I’ll do it myself. That’s okay. The problem is, when you look on the internet, you’ll see a multitude of residences. That’s okay. We like when seniors are on the lookout and educated. But it’s almost impossible for a senior to know with pictures what’s written to know what’s going on in that senior residence there. Is it a new executive director, is it the same executive director, is the chef still the same chef? Is the person in charge of activities, what’s going on? We know that. We have a team of 160 people who do this every day. We’re able to determine the quality inside the residences. There is one thing that has not been mentioned, to be a residence they must be a certified residence. It is a certification given by the government and we only work with certified residences. To know that the service and the quality that is offered inside the residences, I can tell you, there is a residence last year that was excellent and this year is less good and we go more. We will work with the residences, we will talk to them, we will tell them what is wrong, if they adjust, fine, if not we will not go! Because our clients who are there call us back and give us feedback. It’s a feedback that we have from the seniors and allow us to guide these new seniors there. Whether you are independent or not, talk to us. Again, there’s no cost or obligation. We’ll just guide you. We’re trying to get to the first and right time!
Ginette de la Croix: We know how laborious it is.
Louis Sirois: Exactly. Of seniors 75 and over, 50% have a physical or cognitive problem. 50%. So we are there to support you. It’s not easy for the senior or the children. The children who work, imagine, they are at work, aman, dad, is not able to do these steps. So it is the child who takes care of it. Once again, we help the children a lot in their steps. The children. Don’t try to do it alone, we are able to be there.
Ginette de la Croix: We also talked about home care in your service offer in a seniors’ residence.
Louis Sirois: Sometimes there is none, sometimes they are too busy, sometimes, when a senior needs more hours of care, for example, 3 to 4 hours a week, the residence often has difficulty offering this type of service. It is therefore preferable to call us according to your needs, we will have the person who will meet those needs come to your home, either in the residence or at home. Many times we meet, you know, people often talk about Alzheimer’s, the neurocognitive disorders formerly called dementia are in incredible progression and there is no cure. Sometimes seniors can be in a relationship and their spouse wants to help them. But when they are 8 years old and a person has a disorder like Alzheimer’s, that person wants to support them and is not able to support them. At first she does it but she is busy 24/7. It’s impossible to keep up. We have this help, we are able to do at home to ensure that the spouse does not go into free fall. We will also guide with the care of the CLSC. Because the CLSC offers home care. They are able to provide nursing care and we make up the difference. There are costs for the care but there are never any for the accommodation.
Ginette de la Croix: It is very instructive. If you have any questions after this capsule, you can go back to the site where you registered and ask your questions. Another important point, if you want to receive more documents, you can go to the Visavie site and find the guide that will help you choose your seniors’ residence.