Ways to pay for home care beyond writing a cheque

Private home care is paid out of pocket in the first instance, but several programs reduce the net cost. None of them are automatic and most are claimed a year in arrears, so families routinely miss them in the first year, which is the most expensive one.

Tax credits

• Medical Expense Tax Credit. Attendant care and nursing costs can qualify as eligible medical expenses. Keep every invoice, and ask the agency to itemise attendant care separately from housekeeping, because the eligible portion differs.
• Disability Tax Credit. If the person qualifies, it opens access to other programs, but note that claiming the DTC and full attendant care costs together has limits. This is worth an accountant's hour.
• Ontario Seniors Care at Home Tax Credit. This is a refundable Ontario credit for eligible medical expenses for people 70 and over, income-tested. Confirm the current rate and cap with the CRA or your accountant before budgeting around it.

Veterans

Veterans Affairs Canada's Veterans Independence Program contributes to housekeeping, grounds maintenance and personal care for eligible veterans and, in some circumstances, surviving spouses. Eligibility is not limited to those with a service-related disability, and many eligible families never apply. It is worth a call even if you assume the answer is no.

Insurance and accident benefits

• Long-term care insurance policies are uncommon in Canada, but check any older ones, particularly employer-linked ones.
• Extended health benefits from a former employer sometimes cover nursing visits, though rarely personal support.
• Ontario auto insurance accident benefits fund attendant care after a motor vehicle collision, at significant levels for catastrophic injuries. If the decline followed a crash, this is the first thing to check.
• Workplace injury claims through the WSIB can fund personal care where the injury is work-related.

Community and subsidised programs

Municipal and non-profit agencies across the GTA run subsidised adult day programs, meal delivery, friendly visiting and transportation for seniors. They will not replace personal care, but an adult day program two days a week is often the single most cost-effective purchase a family makes: it covers a full day, costs a fraction of one-to-one care, and gives the person somewhere to be.