by Joy Birch, President, Highview Residences
A practical guide to help families understand their options, ask the right questions, and make thoughtful decisions for someone they love.
Choosing a dementia care home for someone you love is one of the most important decisions a family can make. It can also feel overwhelming.
Where do you begin? What type of care is needed? How much will it cost? And how will you know when it's time?
At Highview, we've spent more than 25 years supporting people who are living with dementia and helping families navigate these questions.
We've brought that experience together in seven practical steps to help you understand your options, plan ahead, and make decisions with greater confidence.
Here are the 7 steps to choosing a dementia care home
Stage 1 – Begin with Discovery
Start with the person, not the diagnosis.
Before comparing homes, costs, or care services, take time to understand what matters most to the person you love.
What still brings them joy? Which daily routines are important? What are they still able to do independently? And what has become more difficult?
Perhaps Mom still enjoys reading the newspaper each morning. Dad loves sitting in the garden. Or your wife lights up whenever the grandchildren visit.
Dementia changes many things. It does not erase the person.
Think about what a good day looks like today, what support is needed, and what you hope daily life might look like six months from now.
The more clearly you understand the person, the easier it becomes to recognize a home that feels like the right fit.
If you’re looking in a specific area, start with our guides for London, Kitchener-Waterloo and Lucan.
Stage 2 – Understand the Different Types of Care
Not every home provides the same level of support. In Ontario, it's helpful to understand the difference between private care options and government-funded long-term care.
Private care options generally offer shorter waiting times and do not require an application through Ontario Health atHome.
Retirement Living (RH): For older adults who remain largely independent, with meals, activities, housekeeping, and some additional support services.
Assisted Living (AL): Provides more help with personal care, medications, mobility, and everyday activities, often within a retirement home.
Dedicated Dementia Care (DC): Designed specifically for people who have dementia, with familiar routines, thoughtful design, secure living areas, and support for independence.
Long-Term Care (LTC) follows a different process. Applications and placement are coordinated through Ontario Health atHome. Waiting times are often two years or longer, depending on the community and homes selected.
Families receive a room offer when a suitable space becomes available. The government subsidizes nursing and personal care, while individuals contribute toward accommodation costs.
The important question isn't simply which type of home is available today. It's which home can support the person you love as their needs change, while continuing to offer as much independence, purpose, and connection as possible.
Stage 3 – Understand the Financial Picture
One of the first questions families ask is, "How much will it cost?"
It's an important question, but the monthly fee doesn't always tell the whole story.
In Ontario, retirement living and private dementia care are privately funded. Long-term care operates differently, with government funding supporting much of the care provided.
When comparing homes, ask what is included in the monthly fee and which services cost extra.
Consider meals, housekeeping, personal care, medication support, activities, and transportation.
Families are sometimes surprised to learn that they can apply for long-term care while choosing private dementia care in the meantime. We call this a gap strategy.
For some, private care is an interim solution while waiting for long-term care. For others, it becomes a longer-term choice.
Understanding your options early, including conversations with a trusted financial advisor, can make planning much easier.
Stage 4 – Visit the Homes
A website or brochure can tell you about services and amenities. A visit tells you something different.
It lets you see daily life.
Start with a shortlist of two or three homes. Bring your questions, take notes, and pay attention to how each home feels.
Look beyond the suite.
Are people comfortable in the shared spaces? Do team members know people by name? Can someone easily find their way around? Is there secure access to outdoor spaces?
Ask what an ordinary Tuesday looks like, not just what appears on the activity calendar.
Look at mealtimes, everyday routines, and opportunities to participate in familiar activities.
And ask one particularly important question:
"How will you get to know my mom?"
Buildings matter. But people create the home.
Exploring homes near you? Our local guides show what everyday life looks like and how to choose a dementia care home in your community:
Step 5 – Understand Waiting Lists
Sometimes you find a home that feels right, but there isn't a room available.
Ask how the waiting list works, how you'll be contacted, and what happens when a room becomes available.
Find out how quickly you may need to make a decision and whether you can decline an offer without losing your place.
It can be helpful to explore your options before a move becomes urgent.
Being on a waiting list doesn't necessarily mean you've decided to move. It can simply mean you're preparing for what may come next.
Step 6 – Know When It's Time
"How will we know when it's time?"
It's one of the hardest questions families ask.
Sometimes a fall, hospitalization, or safety concern makes the need for change clear. More often, changes happen gradually.
Meals are missed. Medications need more reminders. Personal care becomes difficult. Someone who once enjoyed getting out spends more time alone.
And the person providing most of the care may be becoming exhausted.
Rather than looking for one defining moment, consider the whole picture.
Is daily life still working well? Is the person safe? Are they experiencing connection and enjoyment? Can the current level of support continue?
Moving earlier isn't automatically better. Neither is waiting longer.
The goal is to make a thoughtful decision that gives the person the greatest opportunity to settle, build relationships, and continue enjoying everyday life.
Step 7 – Saying Yes and Making the Move
Even when you've found the right home, saying yes can be emotional.
You may feel relief, sadness, uncertainty, and guilt—all at once.
Begin by helping the new team get to know the person beyond their care needs. Share their routines, interests, preferences, and what brings them comfort.
Make the new room familiar with favourite photographs, furniture, bedding, and meaningful belongings.
Think carefully about how and when to talk about the move. For some people who have dementia, knowing too far in advance can create unnecessary anxiety. Work with the home's team to plan an approach that respects the person and their needs.
Whenever possible, arrange for the room to be completely ready before the person arrives.
And allow time for everyone to adjust.
A move doesn't end your role as a spouse, daughter, son, sibling, or friend.
It may create more opportunities simply to enjoy being together again.
A Little Gentle Encouragement
You don't have to figure everything out today.
Choosing a dementia care home is a process, and every family's journey is different.
Start by understanding the person you love. Ask questions. Visit homes. Explore the financial picture. And give yourself time to make thoughtful decisions.
Even if the person you love never moves into a Highview Home, we hope this guide helps make a difficult process a little easier.
Your Free Guide: 7 Steps to Choosing a Dementia Care Home
Our complete guide takes you through all seven steps in greater detail, with practical questions, planning tools, and space for your own notes.
Read, save, or print the full guide; free, with no sign-up required.
Free PDF Guide
Your Free Guide: 7 Steps to Choosing a Dementia Care Home
Practical questions and tools to help your family understand your options. Save it, print it, and take your time.
Joy Birch is the President of Highview. She draws on personal experience, research, and—most importantly—the many conversations she has with families navigating this journey.
Highview offers thoughtfully designed homes where people living with dementia are cared for in ways that feel familiar, calm, and truly like home.
The goal is to create a place where people are supported to live with independence, connection, and purpose in daily life.
Each Moment | By Design | With Love