Living in a Long-Term Care Centre (CHSLD) or a Senior Home 

Long-term care centres and senior homes are for seniors who are losing their autonomy or who need continuous medical care. In French, these facilities are called Centres d’hébergement et de soins de longue durée (CHSLDs) and Maisons des aînés. They are designed for people who can’t live at home alone or in an intermediate resource. Some CHSLDs are part of the public health care system, while others are private but follow rules set by the government.

What’s the difference between a CHSLD and a senior home?

Senior homes (Maisons des aînés) offer an environment that’s more private and comfortable, similar to your own home. They’re for people who are capable of living in a group setting and who have lost a significant amount of autonomy. 

Long-term care centres (CHSLDs) are for people who have more complicated medical needs or who require continuous care. This can include people who can’t get around by themselves, eat without help, or who have major cognitive problems. CHSLDs can also be for someone who needs temporary care and rehabilitation after being in the hospital, or someone who needs end-of-life and palliative care. 

How to get a spot 

To be eligible for a spot in a CHSLD or a senior home, you need to be: 

• registered for Quebec’s public health insurance plan, 

• assessed at a Santé Québec (Quebec health) facility, like a hospital, local community services centre (CLSC) or integrated university health and social services centre (CIUSSS). 

You can ask for a spot in one of these ways: 

• You can contact your CLSC to request a spot for yourself or a loved one.  

• During or after a hospital stay, you can talk to your doctor or the hospital staff about requesting a spot.  

• If you’re living in a private seniors’ residence or an intermediate resource, you can talk to a resource person in your building about requesting a spot. 

You will be offered a spot in a CHSLD or a senior home (Maison des aînés) if it’s too difficult or dangerous for you to stay at home, in a private senior’s residence (RPA in French), or in an intermediate resource. The decision will be made together with you and your loved ones based on your situation.

To decide if it’s the right place for you, the medical staff will assess: 

• your health and level of autonomy, 

• how urgent your situation is, 

• how many spots are available in nearby long-term care centres and senior homes. 

If the medical staff decide you are eligible, the government will give you a spot when it becomes available. Eligibility criteria and wait times can limit your options, so make sure to get informed and plan ahead. 

Services and care provided 

CHSLDs and senior homes offer many services, including: 

• nursing and medical care,  
• help with taking medication, 
• meal preparation, 
• help with bathing, getting dressed, and doing laundry, 
• help with moving around, getting up, and going to bed, 
• recreational activities, like board games, movies, and access to a library. 

The facility staff decide which services to give you based on your needs. 

Here’s an example. In a CHSLD, someone could get help with taking a shower and getting dressed, and then participate in a group recreational activity. If necessary, the staff would help the person adjust their wheelchair and get around safely. At the same time, the staff would also take care of any medical care, like managing medications and checking blood sugar levels. 

How much it costs to live in a CHSLD or senior home 

The cost of living in one of these facilities depends on the type of facility.

Public facilities

For public CHSLDs and senior homes, the government decides how much you pay based on your financial situation. This amount can’t be more than the maximum amount set by law. You will receive a monthly invoice from the Régie de l’assurance maladie du Québec (RAMQ or health insurance board). 

Health care and social services are free. Your monthly payment covers things like:   

• your room or apartment,  
• your meals,  
• some services, like cleaning the common areas.  

The amount you pay is reassessed each year, on January 1^st. The RAMQ website has a calculation tool you can use to estimate the cost. If you’re struggling financially, you can apply for the fees to be reduced. If you disagree with the RAMQ’s decision, you can request a review.  

Private facilities

For private CHSLDs and senior homes, the owners decide how much to charge you. The amount may be higher than the cost of a public facility. 

Safety and quality standards 

CHSLDs and senior homes, whether public or private, must be approved by the government. 

These facilities must also meet quality and safety standards set by the government. Santé Québec (Quebec health) staff visit each CHSLD from time to time to inspect them. Reports of these visits are put online by the Ministère de la Santé et des Services sociaux (MSSS or department of health) (French only).

Surveillance cameras in rooms 

In some cases, a camera can be installed in your room for your safety. Ask your facility about their rules.

Code of ethics 

CHSLDs and senior homes must follow a code of ethics to protect the dignity and rights of their residents. You can usually ask to see a copy of this document. 

What to do if there’s a problem 

If you have a problem while living in a long-term care centre (CHSLD) or a senior home, here are some steps you can take:  

• Speak with the person in charge of your facility.  
• Talk to your facility’s users’ committee or residents’ committee. These committees represent your interests and can accompany you in taking next steps. Ask facility staff for the contact information for your committees.  
• If taking these steps doesn’t solve a problem you’re having with the quality of the services you’re receiving, you can file a formal complaint with the local service quality and complaints commissioner. The commissioner can investigate the situation and propose solutions.  
• For more information on filing a complaint or for help with doing this, you can communicate with a Centre d’assistance et d’accompagnement aux plaintes (CAAP or complaints assistance and support centre). These community organizations exist in every region of Quebec. 

For more details about your rights and recourses, see our article Housing for Seniors: Your Rights and Recourses. 

Other housing options

Seniors have other housing options, including: 

• in-home support services,
• a private senior’s residence (RPA),
• an intermediate resource (RI).

To compare your options, see our article Housing Options for Seniors Who Can No Longer Stay at Home.