When a parent needs more help than the family can give, there are three main places that help can come from: care at home, assisted living, or long-term care. Each one suits a different person at a different stage, and each is paid for differently.
We are a private home care agency. We would still rather you chose the option that fits, and sometimes that is not home.
The short version
- Care at home suits someone who is safe at home with help at set times.
- Assisted living suits someone who can still make their own decisions but needs a supportive building, meals and some personal care.
- Long-term care is for someone who needs professional nursing care and supervision around the clock.
Each has a publicly subsidized route, through your health authority, and a private-pay route, where you deal with the provider directly. The province puts the difference simply: publicly subsidized services “are accessed through the health authority” after a formal assessment, while private pay services “are accessed by the individual directly from the service provider” and the government “does not provide any financial assistance”.
Care at home
Who it suits
Someone who wants to stay at home and can be safe there with help at particular times of day: getting up and washed, meals, medication reminders, a bath, company, a break for the family member who does most of the caring.
How you get in
Publicly funded home support starts with your health authority. You, your doctor or another health care professional can ask for an assessment, and a health authority professional decides whether you qualify and how much help you get. The general rules include being a Canadian citizen or permanent resident, living in BC for at least three months, and being 19 or older, with some exceptions. Access is by priority, based on urgency, so there can be a wait.
Private home care needs no assessment from the health authority. You contact an agency directly and agree the hours and the tasks with them.
What it costs
Publicly funded home support has a daily rate set from your income under the Continuing Care Fees Regulation, and never more than the actual cost of the service. It is free if you receive the Guaranteed Income Supplement, certain other federal allowances, BC income or disability assistance, or a War Veterans Allowance. Our guide to publicly funded home support explains the rate in more detail.
Private home care is charged by the hour at the agency’s own rate, with no government contribution. Ask for the total hourly cost and everything that can be added to it; our questions to ask a home care agency lists what to check.
What is and is not included
Home support covers personal care such as bathing, dressing, toileting, grooming, mobility and eating, with some meal preparation, clean-up and laundry where they support safety. How much help you get is set by the assessment, not by what you would like.
Private care covers what you agree with the agency. Plenty of families use both: public home support for the essential personal care, private hours for the rest.
What neither gives you on its own is a person in the house all day and all night unless you arrange and pay for every one of those hours.
Assisted living
Who it suits
Assisted living is a private unit with a lockable door, in a building that provides meals, housekeeping, activities, a 24-hour emergency response system and some personal care. The province describes it as being for adults “who can live independently and make decisions on their own behalf but require a supportive environment due to physical and functional health challenges.”
What “registered assisted living” means
In BC, assisted living is defined in the Community Care and Assisted Living Act, and every assisted living residence, publicly subsidized or private pay, must be registered with the Assisted Living Registry. The Registry assesses applications, monitors residences, investigates complaints about health or safety, and publishes reports on substantiated complaints.
A retirement or independent living building that offers housing and hospitality but no personal care is a different thing. The BC Seniors Advocate notes that those tenancies are covered by the Residential Tenancy Act.
The limits on care
This is the part families most often learn too late. The Act says a registered assisted living residence must not allow a person to live there if they:
- are unable to make, on their own behalf, the decisions needed to live safely;
- cannot recognize an emergency, take steps to protect themselves in one, or follow directions in one;
- behave in a way that puts the health or safety of others at risk; or
- need unscheduled professional health services on a regular basis.
There is one exception, for the first point only: a spouse who lives in the unit and can make those decisions for the person.
In practice, this means that when dementia progresses, or medical needs grow, a person may have to move on from assisted living. If that is likely within a year or two, it is worth knowing before the move rather than after.
How you get in
For a publicly subsidized unit, you go through your health authority’s home and community care office. To be eligible you must need both assisted living services (help with things like bathing, dressing or managing medication) and hospitality services such as meals and housekeeping, be able to make your own decisions (or have a spouse living with you who can), be at risk where you live now, and agree to pay the assessed rate. Units are offered on a priority basis, those with the greatest need first, and the wait depends on where you want to live and what is available. You keep receiving support at home while you wait.
For private pay assisted living, you apply to the residence directly and pay its price, with no government help and no health authority assessment.
What it costs
Publicly subsidized assisted living costs 70 per cent of your after-tax income, divided by twelve, as a monthly rate. A couple sharing a unit pays on their joint income.
- In 2026, the minimum monthly rate is $1,253.80 for one person and $1,909.80 for a couple.
- The maximum is not one provincial figure. It is set from the market rent for housing and hospitality where you live, plus the actual cost of the personal care you receive. Your health authority can tell you what it is for a particular residence.
- The residence may add up to $18 a month for hydro or heat, and may ask for a refundable security deposit of half your monthly rate.
- Optional extras such as cable, internet, hair care, extra housekeeping, personal laundry and transportation are charged on top if you choose them.
Private pay assisted living is priced by the residence. The residency agreement is where the services, the exclusions and every extra charge are written down, so read it closely before signing.
What is and is not included
Included: the unit, two meals a day (one of them the main meal), weekly housekeeping, towels and linen laundered, access to laundry equipment, basic activities, the emergency response system, and regulated assisted living services, which may include help with bathing, grooming, dressing and mobility.
Not designed for: someone who regularly needs unscheduled professional health care, or who can no longer meet the conditions above.
Long-term care
Who it suits
Long-term care provides 24-hour professional supervision and care for people with complex needs who can no longer be cared for at home or in assisted living. The province lists people who are cognitively impaired from moderate to severe, who have severe behavioural problems on a continuous basis, who are physically dependent with needs that require professional nursing care, or who are clinically complex.
How you get in
For a publicly subsidized bed, your health authority assesses you. You must have been assessed as needing 24-hour professional nursing supervision and care that cannot be met at home or in other housing, be at significant risk where you are, have an urgent need, have had medical causes investigated and treated, and have no caregiver, a caregiver who can no longer provide care, or a caregiver whose own well-being is at unacceptable risk.
Then:
- You choose up to three preferred care homes from those that can meet your needs, and your place on the waitlist dates from that choice.
- The main rule for who is offered a bed is time waited, with room for people at intolerable risk and for reuniting spouses.
- If you can wait safely at home, you get support there. If you cannot, you are offered a bed in an interim care home and keep your place on the list.
- Once offered a bed in a preferred home, you have 48 hours to accept and move in. For an interim home it is 72 hours. Turning down an interim home does not take you off the list.
What it costs
The client rate for publicly subsidized long-term care is set from your income and goes towards the cost of your housing and care:
- With an after-tax income of $19,500 a year or more, you pay 80 per cent of it, divided by twelve.
- Below $19,500, you pay your after-tax income less $3,900, divided by twelve. That deduction is set so most people keep at least $325 a month.
- In 2026, the minimum monthly rate is $1,507.70 and the maximum is $4,142.60. The minimum is adjusted each year with Old Age Security and the Guaranteed Income Supplement; the maximum with the Consumer Price Index.
To be charged less than the maximum, you (and your spouse, where it applies) need to have filed a tax return, give a Social Insurance Number, and sign a consent letting the Canada Revenue Agency release your income information. If paying the rate would cause serious financial hardship, you can apply to the health authority for a temporary reduction.
Private pay long-term care homes charge whatever their rate is, and you pay the full cost of care and accommodation. The home does its own assessment of whether it can meet your needs. A facility caring for three or more unrelated adults must be licensed under the Community Care and Assisted Living Act or the Hospital Act.
Paying privately while you wait for a subsidized bed should not change how long you wait, but it does not guarantee that your subsidized bed will be in the same home. If the private home also has subsidized beds, you can name it as one of your three preferred homes.
What is and is not included
Included: the room, a care plan, meals including prescribed therapeutic diets, nutrition supplements in the care plan, routine laundry, hygiene and routine medical supplies, incontinence management, planned activities, clinical support such as rehabilitation and social work, and a basic wheelchair if you need one.
Charged as optional extras if you want them: a personal phone or cable, hearing aid batteries, personal transportation, specialized wheelchairs, brand-name supplies you prefer, and companion services, among others.
How to decide
These questions sort most situations:
- Can the person make the everyday decisions needed to stay safe? If not, and there is no spouse living with them who can, assisted living is not available to them under the Act. The realistic choices are usually home with enough support, or long-term care.
- Do they need someone nearby at night? If a few planned visits a day keep them safe, home care works well. If they need someone awake and close by every night, home care means paying for those hours too, which costs far more than the long-term care maximum.
- Do they need nursing care and supervision through the whole day? Then long-term care is usually the right answer. Your waitlist date is the day you choose your preferred homes, which comes after the assessment, so it pays to start early.
- Is the family caregiver coping? The long-term care criteria count a caregiver at unacceptable risk, or one who can no longer provide care. Say so in the assessment.
- What does the person want? If they want to stay at home and it is safe, that wish deserves weight. When it is no longer safe, it is kinder to plan the move than to wait for a crisis to make it.
Long-term care is the better fit for someone who needs round-the-clock nursing supervision. Assisted living is the better fit for someone who needs some personal care and a supportive building, and still makes their own decisions. Home care fits best in between, and alongside: before a move, while on a waitlist, or for good.
If you are weighing home care, our dementia guide covers when home stops being the right answer for someone living with dementia.
Where to start
Your health authority’s home and community care office. Every publicly subsidized option, including home support, assisted living and long-term care, starts with an assessment there.
- Fraser Health: call the Access Line: Home and Community Care at 1-855-412-2121, seven days a week, 7am to 9pm, or book a phone appointment online.
- Vancouver Coastal Health: call the home and community care access line for your area, listed on that page.
Have the person’s BC Services Card, their doctor’s name and number, their medications, their income information and their most recent tax return or notice of assessment ready. A family member can sit in.
The Office of the Seniors Advocate BC. Its Long-Term Care and Assisted Living Directory lists publicly subsidized homes and residences, with information that includes long-term care wait times. Its information and referral line, 1-877-952-3181, is open 8:30am to 4:30pm, Monday to Friday.
The Assisted Living Registry. Check that a residence is registered, and read its complaint reports, before you sign.
HealthLink BC at 8-1-1. A toll-free call from anywhere in BC. A health service navigator can give you health service information and connect you with a registered nurse at any time, every day of the year. Interpreters are available in more than 130 languages.
This is general information, not advice about your situation. Rates are updated every year and rules change too, so confirm the details with your health authority. Rates checked against the BC Home and Community Care Policy Manual, chapter 7, effective January 1, 2026.
