The Stages & Steps to Choosing a Dementia Home
by Joy Birch, President, Highview Residences
The hope for this article is to offer practical tools, gentle guidance, and thoughtful starting points as you search for a home for someone you love who is living with dementia.
You may want to save this, print it, or share it with others involved in the decision. And if it helps, we would truly value your feedback.
Through years of walking alongside families, we’ve found that most journeys include five stages. Every situation is different—but this framework can help bring some clarity to what can feel overwhelming.
The stages are:
Discovery – information gathering
Financial review
Home visits
The waiting list
Saying yes and moving day
Stage 1 – Discovery and Information Gathering
This stage can be short or long, depending on your circumstances.
Some families begin exploring options early, soon after a diagnosis. Others arrive here more urgently, when a situation changes quickly and decisions are needed right away.
The goal of this stage is to:
understand the language and options
identify what matters most to your loved one and your family
begin to see the differences between types of homes in Ontario (long-term care and retirement living)
To help organize this stage, you may find it useful to create a few simple lists.
A) Online Research
Start with a simple search:
“dementia home + [your city]”
Make note of what comes up. Which homes appear consistently? Begin exploring their websites.
Top homes to explore:
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Also take time to read reviews.
Google Reviews can be helpful—look for overall patterns rather than focusing on one or two comments.
Indeed reviews (from staff) can also offer insight into the culture of the home. How people feel about working there often reflects the experience of those living there.
B) Word of Mouth and Conversations
If you know someone who has walked this path, reach out.
Ask simple questions:
What home did you choose?
What mattered most to you?
What do you wish you had known earlier?
Also consider location. Is it easy for family and friends to visit regularly? Proximity often matters more than we think.
C) Trusted Sources
There may be people in your life you trust who can help guide you.
Name | Phone | Their suggestion
Lawyer
POA
Family doctor
Estate planner
Financial planner
Minister / Priest
Home care agency
Social worker
Neurologist
Geriatric physician
VON
Home and Community Care
Hospital discharge planner
Family
D) What Matters Most in a Home
Take a moment to reflect on what is truly important.
What feels essential? What would simply be nice to have?
You may want to mark:
must-have
nice-to-have
not important
Some ideas to consider:
Private room
Private bathroom
Preferred location
Dementia-specific home or continuum of care
Accessible outdoor space or gardens
Ease of visiting (routes, parking, transit)
All-inclusive care or a la carte services
Ability to care through all stages, including end of life
Meals that feel like home
Meaningful daily activities
Consistent staffing and nursing presence
Welcoming spaces for family visits
Ability to bring in additional care if needed
Laundry and housekeeping
Safety and security
Bathing and personal care approaches
Pets
Stage 2 – Financial Review
Understanding cost is an important part of the decision.
In Ontario, the two main options are:
Long-term care (government-funded, with set fees)
Retirement homes (private pay, with varying levels of care and pricing)
If you are considering a retirement home, it’s important to understand:
what is included in the monthly fee
what services are additional
how costs may change if care needs increase over time
You may want to ask:
“If my loved one needed full support—mobility, feeding, bathing—what would the monthly cost be?”
Consider budgeting for:
Personal care
Continence care
Medication management
Bathing and mobility support
Meals and snacks
Specialized diets
Skin or wound care
Housekeeping and laundry
Dementia-specific programming
Staffing ratios
Even if these are not needed today, planning ahead can bring clarity and peace of mind.
Some families choose a retirement home as a temporary step—receiving care now while waiting for a long-term care placement.
Stage 3 – Shortlist and Home Visits
At this point, you may be ready to narrow your list.
Choose your top 3–5 homes and schedule visits.
Bring a list of questions and take notes. It can be helpful to visit with another person so you can reflect together afterwards.
But also—pause when you walk in.
Take a breath and notice:
How does this home feel?
Many people say they “just knew.”
Homes to visit and dates:
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Stage 4 – The Waiting List
Waiting lists are a reality.
For retirement homes:
ask how long the wait is
whether there is a fee to join
what happens when a room becomes available
what happens if you decline
A common approach is to join the waiting list for your top three choices.
For long-term care:
applications are completed through Home and Community Care
a coordinator will guide you through the process
How do I know when it’s time?
This is one of the hardest decisions families face.
Your loved one may want to remain at home—and that desire is deeply human.
At the same time, dementia can affect memory, insight, and decision-making. Often, the responsibility shifts to family or a substitute decision-maker to step in and make decisions with care and intention.
If you’re unsure, it can help to look at changes related to safety, health, and caregiver capacity.
What if it becomes urgent?
Sometimes things change quickly—a fall, a health event, or caregiver exhaustion.
If this happens:
contact homes directly and let them know your situation
connect with your Home and Community Care coordinator
consider short-term or interim options
Families will sometimes move into a retirement home while waiting for long-term care, so that care needs are met right away.
Stage 5 – Saying Yes and Moving Day
When a room becomes available, you may need to decide quickly.
It can feel difficult to say yes.
But many families who wait too long find that circumstances change suddenly, and choices become more limited.
If you do say yes, the next steps typically include:
an assessment
completion of admission paperwork
setting a move-in date
The move itself can feel overwhelming. There are services that specialize in supporting transitions—they can make a meaningful difference.
A Gentle Reflection
Many families later share:
“We didn’t realize how much better things could be.”
Often, when someone moves earlier in their journey, they are better able to settle in, build relationships, and experience daily life with more ease.
And for families, there is often a shift—from constant worry to being able to simply be present again.
This article is meant as a guide.
There will always be questions that are unique to your situation—and we are here to help.
You will find additional resources on our website, and you are always welcome to reach out.
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.