What to Expect from a First In-Home Care Assessment

The first in-home assessment is the meeting that turns a stack of worries into an actual care plan. It's usually free, it's not a sales call, and it's the single most useful hour a family spends in the whole home-care process. Knowing what to expect makes it more productive — and quieter than you'd think.

Two kinds of assessments — they're different

There are two paths into home care in Ontario, and each has its own first assessment.

1. The Ontario Health atHome assessment (publicly funded)

After you call Ontario Health atHome at 310-2222 (no area code) or 1-833-515-1234, a care coordinator is assigned. They will:

• Phone first for an intake conversation.
• Schedule an in-person assessment, usually in the home.
• Use a standardized clinical tool (the interRAI Home Care assessment) to score functional ability, cognition, medication use, behaviour, and safety.
• Decide eligibility for publicly funded services and propose a care plan: how many PSW hours, what nursing visits, what therapy referrals, what equipment.

This is a clinical assessment, not a sales meeting. The care coordinator works for the public system and isn't trying to sell anything. The outcome is a publicly funded care plan, an assigned service provider organization, and a start date.

2. The private agency assessment

If you reach out to a private home-care agency (like Oliveth Care), the first assessment is usually:

• A short phone intake — what's going on, who needs help, how soon.
• A free in-home visit by a care coordinator from the agency, typically within 48 hours.
• A conversation, not a checklist. You'll walk through the home, talk through the daily routine, identify what's working and what isn't.
• A proposed plan: caregiver match, hours, schedule, and a clear quote.

Most families do both, in either order. The Ontario Health atHome assessment unlocks any publicly funded hours; the private agency assessment covers the rest of the week and any 24-hour or live-in needs.

Before the visit — what to have ready

You don't need to prepare like an exam, but a few things in one place save time:

• Current medication list with doses and frequency. (Take a photo of pill bottles if simpler.)
• Recent medical information — hospital-discharge summary if applicable, specialist names, family doctor, conditions or recent diagnoses.
• A description of a typical day — sleep, meals, mobility, bathroom, social contact. The more honest, the better.
• What's hard right now — be specific. "Mom can't get out of the tub safely" is more useful than "the bathroom is a problem."
• Family situation — who's the primary family caregiver, who else helps, who's far away, who's overwhelmed.
• What you've already tried — Lifeline alarms, grab bars, an adult day program, a previous caregiver.
• Any equipment in the home — walker, cane, wheelchair, hospital bed, commode, lift.

Who should be there

Ideally:

• Your loved one, of course — they're the person being cared for.
• The primary family caregiver(s) — typically an adult child, spouse, or both.
• One quiet observer if the person being assessed has cognitive changes — someone who can fill in details if memory wobbles.

Avoid making it a full family meeting. Three or four people is plenty; eight is too many and the conversation will fragment.

What happens during the assessment

Plan on 60–90 minutes for a thorough first visit. The flow is roughly:

1. Introductions and goals. What does the family want out of this — keeping mom safe at home, post-surgery support, respite for an exhausted spouse, dementia-related supervision.
2. Health and routine. Conditions, medications, sleep, appetite, mood, falls, hospital visits, recent changes.
3. Function. Bathing, dressing, toileting, mobility, transfers, eating, meal prep, errands — what's independent, what's hard, what's been given up.
4. Cognition and behaviour. Memory, orientation, wandering, anxiety, agitation, social engagement.
5. The home walk-through. Bathroom, bedroom, stairs, kitchen, entryway, lighting, flooring. The coordinator is looking at fall risks, accessibility, and where care will actually happen.
6. Family situation. Who lives in the home, who's the primary caregiver, what they can keep doing and what they can't, what hours of the week are hardest.
7. The plan and the numbers. What level of help is recommended, how often, what hours, who pays, what the schedule looks like, when care can start. For private care, a written quote.
8. Next steps. Who calls whom, when the caregiver will meet your loved one, what paperwork still needs to happen.

Good questions to ask any assessor

• Who actually delivers the visits, and what training do they have?
• Will the same caregiver come every visit, or does it rotate?
• What happens if the caregiver is sick? Who covers?
• What's the minimum visit length and minimum weekly commitment?
• How are care plans adjusted as needs change? Who do we call?
• For public assessments: how long is the wait list for the recommended services?
• For private assessments: what are evening, overnight, weekend, and holiday rates? What's the cancellation policy?
• Are there funding programs I should look into (Ontario Seniors Care at Home Tax Credit, Veterans Independence Program, Disability Tax Credit)?

What you should walk out with

A useful first assessment ends with:

• A clear written care plan or proposed schedule.
• A start date — usually within 48 hours for private care, longer for public.
• A named caregiver (or a near-term match) for private care, plus a backup plan.
• Honest answers to the questions you came in with.
• A sense of relief, not pressure. You should never feel rushed into signing the same day.

After the assessment

Care should be reviewed regularly — formally every few months, and informally any time the situation changes. A reassessment after a fall, a hospital admission, a new diagnosis, or a change in the family-caregiver situation is normal and expected. Don't wait for a crisis to call.

If you're starting this conversation now, the free in-home assessment is where we begin. No pressure, no obligation — just a real conversation about what would actually help.

Sources & further reading

• Ontario Health atHome — Getting Started, Making a Referral
• interRAI — Home Care assessment instrument overview
• Ontario Society of Occupational Therapists — Manage at Home