Advice From Your Advocates
Advice From Your Advocates
Elder Care Around the World: Lessons from Canada
What can the U.S. learn from Canada when it comes to elder care? In this continuation of our look at elder care around the world, Attorney Bob Mannor sits down with Amy Friesen, founder of Tea and Toast, to uncover how families navigate the challenges of long-term care north of the border.
From the stark differences between Canada’s public and private systems to the emotional weight of cross-border planning, Amy shares how her personal journey inspired her to guide families through elder care with compassion and clarity. Together, Bob and Amy explore why holistic planning, care navigation, and early preparation are crucial for families facing dementia, aging, and long-term care decisions.
Whether you’re caring for a loved one in the U.S. or Canada, this episode offers eye-opening insights, practical takeaways, and a reminder that pre-planning isn’t just about logistics—it’s about peace of mind.
Host: Attorney Bob Mannor
Guest: Amy Friesen
Executive Producer: Savannah Meksto
Assistant Producers: Samantha Noah, Alecia Campbell, Shalene Gaul
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ABOUT US:
Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
We also help families dealing with dementia, Alzheimer’s disease, Parkinson’s disease, and other illnesses that cause memory loss. We take a comprehensive, holistic approach, called Life Care Planning. LEARN MORE...
You're listening to Advice from your Advocates, a show where we provide elder law advice to professionals who work with the elderly and their families.
Speaker 2:Welcome back to Advice from your Advocates. I'm Bob Manor. I'm a nationally board certified elder law attorney in Michigan and we have this podcast to talk about all the senior issues, particularly anything related to long-term care and dementia and all those types of things. I'm really excited about our podcast today. I think it's really interesting. It's a continuing series to talk about how different countries deal with these long-term care issues, and so today we've got Amy Friesen on and Amy founded Tea and Toast. Amy, first of all, hi, and can you do a quick introduction of yourself?
Speaker 1:Hi there, Bob. Thanks for having me. Absolutely so. I run a company called Tea and Toast. We're here in Ottawa, Ontario, Canada, and we help seniors and their families figure out elder care planning from a standpoint of housing and care purposes.
Speaker 2:And so in our conversations previously we've talked about how there is some distinct differences between how the United States deals with what you call housing and I might call placement, and we're going to get into that conversation. But tell us a little bit about Tea and Toast, how you came up with that name and what more you do. You know what services you provide.
Speaker 1:Absolutely Thanks for that. So I developed Tea and Toast after having almost 10 years in the retirement home industry here, which is our private industry for housing, senior housing and I was really finding that a lot of people were able to find what they needed and they were really, really stressed. And so, seeing that and seeing this elder care planning industry sort of come online in Canada it is much bigger in the States from what I understand so seeing it kind of come online, I wanted to jump in and help and so I formed up TNTOS and called it TNTOS, after painstakingly trying to figure out what to call it, because it's familiar for seniors TNTOS is super comforting, but for those seniors that are eating TNTOS multiple meals, multiple days, it could be a red flag for their family members or their caregivers. So it's really just to get people thinking about it. I kind of say you know, if you're in the know, you're in the know.
Speaker 1:So I've been running TNTOS here for 11 years now and we really specialize in elder care planning, which is basically setting people up for success and whatever that success looks like to them, because everybody's different, and so we really go in to try to make a plan, educate people most of what we do is education on the industry how the government part of the industry works, when to move, why to move, how to move all of that, and then also, if they want to stay home, how to stay safe at home, who to recommend to put grab bars in, and things like that. So really a full holistic type of service for them.
Speaker 2:You said something a minute ago that I'd like to explore a little further. You said coming online in Canada. So I'm wondering what that means. In my imagination, I'm thinking that and this could be completely wrong, so that's why I'm asking the question that what you're saying was it was more of a family thing, where we were able to try to take care of our elders within the family, and now it's getting to be more where we have some other options of caregiving. Is that what you meant by that, by coming online? Tell me a little bit more about when you said you thought that the United States had kind of more developed that.
Speaker 1:Sure, yeah, so what you said is true as well. Right, we have lots of people that have been caring for their elders for years and generations. What I meant by coming online is that, as elder care planners and advocates, the industry here is in its infancy, and so I have a lot of colleagues in the States and there's a lot more agencies like myself. We're sort of like brokers right for retirement and living, long term care or whatnot in that field sort of, and so the US industry in that is much larger, and so here we're, just like I said, coming online. There's not very many of them. They're starting to come up now, which is why I also formed up my national organization as well, so that we could connect the dots for the caregivers and they didn't have to look everywhere to try to find us, because, honestly, even me trying to find my own colleagues was difficult, so I can only imagine for the caregivers.
Speaker 2:That's very interesting. So, like you say, there's and I'm curious if I'm reading this right or understanding this right In the United States there is a whole industry of helping people find the right housing setting, the right what I might call placement in some kind of caregiving setting, and I have an understanding of how they are paid. So I'm going to ask you a blunt question about how do you get paid for this?
Speaker 1:Well, we have multiple ways. We're a hybrid service. I think we're probably the only one anywhere, and so in Ottawa, where I'm at, we actually have contracts with most of the retirement homes, and so most of that most of our clients that are going through a search our contracts with the retirement homes actually cover it, and so that doesn't really exist anywhere besides here and maybe Montreal Otherwise. Yeah, so otherwise, though, we have paid for service for elder care, planning, our long term care, navigation, different service consulting that we offer.
Speaker 2:Gotcha.
Speaker 2:Yeah, that's how those services that are sort of placement services work in the United States, that they end up the first option that you gave.
Speaker 2:Typically they're paid by the place that they end up renting from and they get sort of a commission on it, and so that works out well for the families, because then they don't have to come up with an upfront payment. Not knowing, you know, it's less scary to them to enter into that. Talk to me about your care navigation, and I particularly want to talk about that because that's a word that we use in our law office, and so you know it's unusual, even in the United States, for a law office to have what we call care navigation, where we have social workers on staff and we help with all the decisions around caregiving and long-term care and all the things that can happen over a span of time, both from the standpoint of finding care, getting good care, making sure that the care is, you know, advocating for better care, all of those types of things. And so we offer that service too as part of our law firm, and I think that you do something similar, and I want to hear more about what your care navigation service looks like.
Speaker 1:Sure, firstly, that's amazing. I'm so happy to hear that you guys are offering that as well and and it's really kind of akin to what you're saying we are making sure that people not only are covered for the care that they have today, but for tomorrow as well. And, however, that kind of fans out and so lots of people plan they're completely independent and they're planning they want to stay home and it's like, okay, how do you keep them safe? How do we make sure falls are lower risk and things like that? Then, when you're looking at things like progressive diseases, like dementia and Parkinson's and things like that, how do we plan for now so they don't have too much care where it feels weird and like too much, all the way to the future, where they have all of the care they need and then hopefully not having to move again if they don't want to do that, if we make sure that the plan is there in the first place, the other part is is when you're dealing with couples and partners, one often has higher care needs than the other one and the other one's often the caregiver, and so if they're looking to move, for instance, how do you balance that in a retirement home specifically so that the caregiver doesn't feel like they're living in a hospital setting and their needs aren't being met as an independent person, but the care needs of the other person are being met and vice versa.
Speaker 1:We don't want two independent either, and so balancing that as well. And then, lastly, from hospital, how do we look at the family unit holistically, including spouses and partners, dogs and cats being close to family, all those stuff all together? Because when people are discharged from hospital, family, all those stuff all together. Because when people are discharged from hospital, the hospital is looking at one person as the patient. That's it right. And how do we get this person out of hospital? And so we want to look at the whole picture, because if you don't look at the whole picture, another move might be imminent.
Speaker 2:Absolutely. That's great, that's fantastic. I you know you probably maybe use this term to. I call that holistic planning. We're looking at the whole picture.
Speaker 1:Yeah, absolutely.
Speaker 2:Um, so uh, I like what you said there and I want you to maybe expand on it about okay. You know, families often are at least in my experience families are often, um, when they hit this crisis, they're most focused on the next four weeks, and so I think, as planners, we got to be helping the family focus on okay, but what about six months from now? Well, you know what about, and so I always ask and this is again a very blunt question I have to ask my clients. But you know, what do we think is the life expectancy? Because sometimes they tell me that it's very short, or they really very strongly believe it's very short. Then we're looking at less planning, but if they say I don't know, it could be 10 years, then we've got to plan out for 10 or 20 years. And so what I heard from you is that part of your planning is not just thinking about today, but thinking about the long-term plan.
Speaker 1:Well, when a crisis hits, all hands are on deck, everybody's in the crisis, everybody's moving work schedules, moving other schedules. Everybody's in the crisis, everybody's moving work schedules, moving other schedules. Everybody's in and nobody can really think clearly. And I think that that's the hidden value of of businesses like ours the two of ours and others that we can keep a clear mind and direct our clients through the actual search process or through the process as a whole and really bringing up questions that most times they don't think about. Right, because we're asking them about life expectancy. In a way, we're asking them about what's going on, what their care needs are now, if there's anything progressive or we should consider, and so by doing that, we're actually planning out further, thinking about all of these different things.
Speaker 1:Will this person need what's called a two person transfer down the way? Are they going to be a really heavy care client? Okay, well, this home they're thinking about may not fit. Let's go to this home and then they can stay longer because that's their plan. Or, wait, their plan is long term care afterwards. Okay, maybe we don't need all that care, maybe we need to have something more so today, and then their long-term care plan will kick in, and so it's all about strategy for the families.
Speaker 2:I know that one of your services that I want you to expand on is cross-border planning, and so that's particularly relevant for us here in Michigan, because obviously we have a lot of people that go back and forth between Michigan and Canada and so if we've got people in Michigan that have parents in Canada, that might be something that can be really helpful, because it's very challenging, because the rules and everything is a lot different and the terminology and everything's a lot different. So talk to us about your cross-border planning options.
Speaker 1:It can be really difficult when the caregiver is not in the same country, regardless of which country. When we have the senior, the family member, here. We work with caregivers all over the world, to be honest, and so often they can't be there all the time, and so if they're in this transition, they really need hands-on eyes eyes on someone that they can trust. That's going to not only educate them about the system and so that they can understand it in comparison to their own system, because a lot of people think that the systems work the same, and they don't. They don't even work the same between provinces, right? So, really educating them and keeping them in the loop for each step OK, you know, I met mom and dad. This is our next plan. Ok, we did this. This is our next plan Even to the fact of you know, if someone is looking to make a move, we can even do a virtual tour.
Speaker 1:If the family can't get here, we can do a virtual tour where I take them around on my phone, essentially, and show them as we're touring to really involve them as much as possible, and then the end piece is really connecting all of those dots, right? So if they're not here, if they're not able to be. You know who's going to do the moving. Is there a house to sell? All of these other professionals to bring them all in? Just surround the senior and help them out, so that the family can have some peace of mind as well.
Speaker 2:So you know I mentioned that this is part of our series to talk about how different countries handle this long-term care issue. I'd like you to tell me a little bit more and, as we discussed before we got on the podcast here, that every province is a little bit different, and so I understand that you have a national presence in Canada, but your primary focus is Ontario, is that right?
Speaker 1:Yes, yep.
Speaker 2:Talk about Ontario and I know you said that there's sort of the subsidized and the non-subsidized, and so if you can kind of describe those options that you have in there in Ontario, Sure.
Speaker 1:So we have a public and a private housing system in Ontario and in Canada in general, and so for the public system you need to go through a qualifying and you need to be accepted. We call that system our long term care housing, and so you need to go through those processes. Our waitlist here could be as small as six months, but our average is about five years to get into a long-term care home. And so the long-term care homes one of the reasons are financial. The government does cover a good portion of it, and so people can be in a long-term care home in a basic suite for around $2,000 a month, including all of their care, even their incontinence things, and so that's really great for a lot of people. Who one? You know we pay for this stuff in our taxes, but also there's a lot of people that don't have enough money for the private system.
Speaker 2:The private system. Can I ask you a couple of questions about that? Sure, yeah. So you said that there could be a six-month to five-year waiting list. Is that dependent on the facility or dependent on the specific housing option?
Speaker 1:So each person chooses up to five long-term care homes to put on their list and so, depending on what they've chosen if they've chosen the more popular ones and there's a longer wait list, you know whatnot if they've chosen the more popular ones and there's a longer wait list, you know whatnot. And so we do have a crisis situation that if things kind of go haywire and they need care right away, we have an escalation system as well, but many people are on for many years, but the kind of the issue there is that you can't qualify for long-term care until you need the care, and so then then you need to wait another five years. So what do you do?
Speaker 2:Which is challenging. I just have lots of nuanced questions here. So could you get on that list and list one of the places that has a short waiting list and then get on a waiting list for the place that you really want to go to later or once you're on somewhere? They don't put you on another waiting list.
Speaker 1:So when you pick your five you kind of like them right, and so if you end up in your third choice, you can still remain on the list for your top choice.
Speaker 2:So you could move. You could go somewhere that has a shorter waiting list and then, once you get to the top of the waiting list, move to your preferred location.
Speaker 1:That's right. But you know also, as you and I know a lot, it's moving is difficult, especially if you're advanced, right Well, especially if your care is advancing, that you are eligible for long term care, then it might, you know, it might be a good process to wait for, but it might be too much to make that move when it comes up.
Speaker 2:Sure. So then, with long term care, housing, and so the subsidized what are the requirements? So the subsidized, what are the requirements? Did they look at your assets or income at all? Or you just get on the waiting list because you're a citizen of Canada?
Speaker 1:for generality you kind of need to be in that one person transfer. So you need enough care that someone's helping you physically and then if you need the further subsidized, then they'll look at finance.
Speaker 2:So tell me more about that. I'm curious about that. It's based on need, and what I mean by that is physical need, right, and then is it based on financial need, and then is it based on financial need Not to get accepted into the home.
Speaker 1:But if you want the extra subsidies, one of the rooms we have basic, semi-private private. In the basic room there's two beds per room and that is the room style you would go into. If, for instance, your social service money that you get, for instance, if you're on a budget from the government is $1,500 a month, that room is 2000, you need a subsidy for that. So in order to do that, you need to go into that basic room and they would look at finance for that purpose to give you extra subsidy to give you extra subsidy to lower it below the 2000.
Speaker 1:That's right. Extra subsidy to lower it below the $2,000? That's right. So they would. If you're getting it below the $2,000, essentially they're taking what comes in every month. So here it's OAS and CPP, like our government pension systems, and so they would take that, the home would take that and they'd give you an allowance of around $140 a month for incidentals.
Speaker 2:Okay, Thank you for letting me ask all the questions. Now talk to us about private pay options.
Speaker 1:So private is what's called a retirement home. They're more. They're a social atmosphere. So they're I call long-term care a medical atmosphere, more and social for retirement. And so the retirement homes, here specifically many of them, can offer the high care levels that long-term care can offer. It's just private pay. And so in a retirement you're looking at your own private suite, regardless, studio, one bedroom, two bedroom, depending. You can add on care, but you can go in at independent and go all the way up to a two person transfer along, you know, all the way up that line. And then you have the social activities, the meals together, the outings, things like that. Know a little bit more about you, amy. What was your?
Speaker 2:personal journey to get to where you are. This sounds like an amazing service and really important for the you know residents of Ontario. So tell us a little bit more about you and how you got to where you are.
Speaker 1:I really wanted to make an impact and I didn't know what I wanted to do after my university degree, and so I stumbled upon this psychology of aging and into this retirement industry and I really fell in love with it. I lost my grandparents pretty early in my life and it was sort of like being around 100 grandparents every single day, and so I really enjoyed that. And then, as I move forward, I also have a marketing degree. So as I move forward, I also have a marketing degree. So as I move forward, I really started enjoying that sales aspect and helping people find their new home or their next home, and so I really wanted to do more for that. And I was getting frustrated because clients and families were frustrated because they couldn't find what they needed, and I really thought it could be much easier than what was happening. And so that's really what brought me to opening up Tea and Toast.
Speaker 1:And when the industry started to develop, for a long time there wasn't very many of us. There was me and a couple of others, and when it started to develop, then I thought to myself you know, I really want to be able to connect across Canada because I have clients that get referred to me, but their loved one is in Vancouver or their loved one's in Alberta, and so we I just I developed elder care planners of Canada, which are a bunch of small businesses like myself with the with the same mission, mission all connected together so that we can work together in a bigger atmosphere and and essentially look bigger right, so that we can help clients with transfers across provinces, but also then we're able to work with EAPs and different things like that. So, because they need a Canadian presence, not just one Ottawa business, right, so as much information and education as we can get out there for everyone, but in this industry very specifically, that's great.
Speaker 2:I'm glad that you were able to make that national like that. And and education, as we can get out there for everyone, but in this industry very specifically, that's great. I'm glad that you were able to make that national like that and make those connections, because those are so important to be able to provide those services to families where you know people just aren't all going to be in the same place and so if you just say, okay, well, once you leave Ottawa, good luck to you, and so it's great that you had that passion to provide that service on a national basis.
Speaker 1:Even when people call us and maybe we can't help them, the way that they need my mandate for my team is that they leave with something. They leave with some form of education or direction and that's really what Eldercare Planners of Canada was built on or direction, and that's really what Eldercare Planners of Canada was built on that if someone comes to me and they need help from somewhere else, I'm not going to just let them go by the wayside and figure it out. I'm going to find it for them, Because our you know, our whole mission is to make their lives easier in eldercare Nice.
Speaker 2:One of the things I know that helps a lot of families that you wrote a book, and so tell us about your book Breadcrumbs.
Speaker 1:Sure. So Breadcrumbs was really a compilation of my stories from being an elder care planner and also some extra information for caregivers. And then there's some Ontario very specific information about retirement, living, long term care, just to give a bit of a nuance to that, and I use it for examples. And so the book is really to meet people where they are. So we spoke about education.
Speaker 1:There's lots of readers, there's lots of people that don't want to call anybody and they're not ready, and if I can sneak a book into their you know nightstand and they can read about it and start knowing that they're really not alone. And we're all just learning this system. Long term care homes haven't been around that long, maybe since the 60s, and so we're all just learning it. There's just not enough generations of knowledge yet, and so this is one way to be able to meet people where they are, where they can just read it on their own time. They don't have to talk to anyone, they don't have to look for anything, they just have some extra knowledge and I'm hoping at the end of the day, they really understand that they're really not the only ones dealing with this stuff.
Speaker 2:Well, thank you so much, Amy Friesen from Tea and Toast, for providing us with this great information and just kind of the compare and contrast to what we do in the United States. Check out her book Breadcrumbs. That's something you can get on Amazon.
Speaker 1:You can.
Speaker 2:Also on your website and the website is wwwteantoastca, so if you're in the United States, don't confuse it with com. It's ca. And you can also find her on Instagram at instagramcom slash teantoast Ottawa. It was great to talk to you, amy. Any final thoughts you want to leave our listeners?
Speaker 1:Just that you know, pre-planning does make quite a difference, and it's so much easier. Although people aren't there yet, in the thinking, it's much easier to pre-plan than to react in a crisis. So make sure that you're putting things together now, when you have the time to do it.
Speaker 2:Thanks so much, amy from Tea and Toast. If you enjoyed this podcast, don't forget to subscribe. You can find us at Advice From your Advocates at any place that you listen to podcasts. You can also find us on YouTube if you want to watch us talk in addition to hear us, or you can go to our website at manorlawgroupcom. Thanks for listening and we'll see you next time.
Speaker 1:Thanks for listening. To learn more, visit manorlawgroupcom.
