Start by being honest about the level of help your parent actually needs, because that decides everything else. A few hours of companionship, meal prep, and light housekeeping is a very different arrangement than daily personal care or scheduled nursing visits. In our experience, families who write down a typical day, where the real gaps are, when they happen, how often, pick better than families who shop on price first.
For publicly funded home and community care in St. Thomas, the arranger is Ontario Health atHome. They assess needs and coordinate government-funded visits, and it's worth calling them early even if you expect to hire privately, since the two often work side by side. Long-term care placement is also handled through Ontario Health atHome and is income-tested. Retirement and assisted living, by contrast, are mostly private-pay in Ontario.
Location matters more than people expect. St. Thomas is compact, so most agencies can reach the neighbourhoods around the downtown core, the streets near St. Thomas Elgin General Hospital, and the newer areas on the edges of town without trouble. If your parent lives on a rural property in Elgin County, ask specifically about travel time and whether the same worker can consistently make the drive. Consistency of caregiver is one of the strongest predictors of a good experience, so ask how the agency handles scheduling and last-minute call-offs.
Our default advice here: if the needs are still mostly about safety, company, and a few tasks, try home care before considering a move. It's usually gentler on your parent and often more affordable at lighter hours. The honest trade-off is that as care needs climb toward around-the-clock support, home care hours add up, and a move to Assisted Living can become the calmer, more predictable choice. Independent Living is worth a look too if the real issue is isolation rather than hands-on care. Prioritize, in order: the right care level, reliable availability, then location and budget.