The conversation often starts with a single worry. Maybe a parent is recovering from surgery and the house feels less manageable than it used to. Maybe you’ve noticed the fridge holding food nobody is eating, or a medication routine that’s slipping. Maybe your spouse is carrying more than anyone should carry alone.
Whatever brought you here, you’re probably asking the same question thousands of Ontario families ask every year: What kind of help is actually available — and what’s the difference between the public system and going private?
This guide answers that directly. No jargon. No pressure. Just a clear look at both options so you can decide what makes sense for your family.
How Ontario’s Public Home Care System Works
Ontario’s publicly funded home care is coordinated through Home and Community Care Support Services (formerly known as the LHINs). If your loved one qualifies, a care coordinator assesses their needs and arranges a support plan — typically including personal support workers, nursing, and some therapy services.
For families who qualify, this can be genuinely helpful, and it comes at no direct cost to the client. But there are real limitations that families often discover only after they’re already in a difficult moment.
What families commonly experience with public care
- Waitlists averaging 4 to 6 weeks in parts of Durham Region before services begin
- Visit times set within system capacity — not always when your family needs them most
- Caregiver consistency can be difficult to maintain; familiar faces may change frequently
- Support is focused on essential medical and personal care needs — not always broader daily living
- Changes in condition don’t always mean the care plan updates quickly
None of this is a criticism of the people working within the public system — they work hard in demanding conditions. But the system was built for volume, and that means individual flexibility is limited by design.
What Private Home Care Looks Like
Private home care is arranged directly between a family and an agency, bypassing the public waitlist entirely. Because you’re funding it yourself (or through insurance or benefits), the terms are set around your family’s needs rather than system-wide capacity.
That flexibility shows up in ways that matter day to day.
- Faster start times. Private support can often begin within days of your first call — critical when a hospital discharge date is approaching or safety concerns can’t wait.
- Care built around the person. Schedules, routines, and support types are shaped around your loved one’s habits, preferences, and household rhythm — not a standardised template.
- Broader scope of support. From personal care and homemaking to dementia care, skilled nursing, and palliative support — private care can blend services under one coordinated plan.
- Continuity of caregivers. Families can request consistent caregivers, which builds trust — especially important for someone living with memory changes or anxiety about new people.
- A plan that adapts. When a condition changes, a well-organised private agency updates the care plan — rather than waiting for a new public assessment cycle to catch up.
“The question for most families isn’t really public versus private. It’s: what does my loved one need right now, and which system can actually provide it in time?”Carevo Home Health Care
Side by Side: A Clear Comparison
Here’s how the two options stack up across the areas families care about most.
| What families ask about | Public Home Care (HCCSS) | Private Home Care (Carevo) |
|---|---|---|
| Cost | Free for eligible clients | Paid by family, insurance, or benefits |
| How to access | Assessment + eligibility required | Direct contact with agency |
| Wait time | 4–6 weeks in some areas | Often within days |
| Scheduling | Set within system capacity | Built around the household |
| Caregiver consistency | Varies; can change frequently | Families can request consistency |
| Types of support | Essential personal care & nursing | PSW, nursing, dementia, palliative, respite |
| Adapts to changing needs | Requires reassessment | Nurse-led plans updated as needed |
| Family communication | Varies by coordinator | Named contacts, regular updates |
Does Private Care Have to Replace Public Care?
No — and for many families, it doesn’t. The most practical approach is often a combination of both.
Public care may cover a baseline of essential support. Private care fills the gaps that matter most: the morning routine nobody else can cover, the overnight support a spouse desperately needs, or the consistent dementia care that requires the same calm face every single day.
Thinking of it as a blend — rather than a choice between one or the other — often leads to a much more sustainable plan.
Three questions to guide your decision
If you’re trying to figure out what your family actually needs, start here:
- How urgent is the need? If safety is a concern today, a 4–6 week wait isn’t realistic.
- How specific are the care needs? Dementia, post-surgical recovery, and palliative care often require more personalised planning than the public system can provide.
- How much can the family coordinate? Some families can manage a patchwork of services. Others need one organised team with a clear point of contact.
What Does Private Care Cost in Ontario?
Private home care in Ontario typically ranges from around $35/hour for personal support up to $55 or more for skilled nursing. The final cost depends on the type of support, the number of hours, and how complex the care needs are.
Many families approach it practically — starting with the most critical hours of the day, such as mornings, evenings, or overnight, and adding more as the situation becomes clearer. Some private insurance plans cover a portion of home-based care, and certain eligible expenses may provide tax relief.
The goal isn’t always the fewest possible hours. It’s the plan that prevents repeated crises, caregiver burnout, and the unsafe gaps that tend to lead to hospital visits.
How Carevo Supports Families Across Central East Ontario
Carevo Home Health Care serves families in Durham Region, Peterborough, Northumberland County, and the Bay of Quinte with a structure built around nurse-led coordination, licensed and bonded caregivers, and care plans that adapt as a loved one’s needs change.
Services include personal care and PSW support, skilled nursing, dementia and Alzheimer’s care, palliative care, and respite for family caregivers. Everything is coordinated through named contacts who keep families informed — not left to wonder what’s happening at home.
The first conversation costs nothing. It’s a chance to talk through the situation, ask questions, and understand what home support could realistically look like for your family — without pressure to commit to anything.
Not sure where to start? Let’s talk it through.
Speak with the Carevo care team for a free, no-pressure consultation. We’ll help you understand your options and what support could look like for your loved one.