Choosing a LTC Home2022-07-04T15:57:05-04:00

CHOOSING A LONG-TERM CARE HOME

Our Wayfinding volunteers can help you understand how to navigate the long-term care home system. Contact us by email info@concernedfriends.ca or call our answering service to leave a message at 416-489-0146 (toll-free at 1-855-489-0146). The phone is monitored Monday to Friday and a volunteer will respond within 48 hours.

lady in wheelchair

This page provides guidance in choosing a home and a checklist for what you should be looking for and the right questions to ask. This information is based on industry knowledge and represents the expressed opinions of Concerned Friends volunteers.

Most people start by choosing a few facilities that are close to a family member’s home and easily accessible by public transit. Ask your friends and networks about homes they might be familiar with. If you have no one with firsthand experience, your local Alzheimer’s Society may be a good source of information, even if your loved one does not have dementia.

To locate the long-term care homes within a given radius, this interactive map is searchable by postal code.  This site provides information such as number of total beds, who operates the home, home type (for-profit, non-profit, municipal), whether the facility is accredited and/or designated under the French Language Services Act.

The site also links to inspection reports including complaints and critical incidents from recent years. Pay special attention to “Orders of the Inspector.” An Order is issued for more serious incidents and requires the home to comply by a specific date. In the past, most homes received annual inspections. Inspections have been drastically reduced by the current provincial government.

Health Quality Ontario provides data on wait times for admission to long-term care homes, the quality of resident care, and other measures of long-term care home performance.

Applying for Admission to LTC

The Government of Ontario website provides information about how to apply for admission to long-term care.

To find your local Home and Community Care Office (formerly known as CCAC and LHIN)

  • Call 310-2222 (no area code required) OR
  • Enter your postal code on this interactive map. You can apply for up to 5 homes. Do not list a home where you wouldn’t want to live. If you refuse a bed offer, you risk losing your place on waiting lists for all the homes to which you have applied.

Once you’ve created a list of homes, call each home to schedule a tour. Be sure to ask who will provide the tour–if it’s a volunteer, follow up with the Director of Care to verify any important concerns or for additional questions. Try to visit during mealtime or group activities. Also try to ensure your tour includes a typical resident floor and the secure unit for residents who require more supervision.

If English is not the resident’s first language, ask whether an interpreter will be available when necessary for your loved one.

Request contact information for a member of the Resident Council and/or Family Council and ask them about their experiences with the home.

Bring a support person to take notes so that you can fully observe and assess.

During the tour, use all your senses. Try to assess the quality of care, as well as the physical environment.

First Impressions:

  • Does the atmosphere feel homey? Or does it feel chaotic?
  • Do the residents look happy and well cared for?
  • Is there a lot of unnecessary noise?
  • Are there lingering odours?
  • What is the predominant language of residents/staff?
  • Do you observe residents in restraints or who appear to be over-medicated?
  • Does the staff appear friendly, helpful, and courteous to residents?
  • Do staff appear to know residents’ names?

You may find it helpful to take a copy of the following list with you. This is a long list of possible questions. Highlight the ones most important to you and add questions of your own.

CHECKLIST OF ITEMS TO CONSIDER WHEN SELECTING A LONG-TERM CARE HOME

Physical Facility

  • Are visitors screened at entry to the Home?
  • How many residents live in each home area or pod?
  • Is there a separate unit for persons with dementia or behavior problems?
  • How many floors are there? Is there a sufficient number of elevators?
  • Does the home have air conditioning? Are resident rooms temperature controlled?
  • Does the home have a current emergency plan, including details for evacuating all residents?
  • Is a public bulletin board visible and does it include the following?
  • Residents’ Bill of Rights
  • Monthly program of activities
  • Formal complaint process for residents and family members
  • Emergency Evacuation Plan
  • Recent accreditation and/or inspection report
  • Minutes of recent Resident Council and Family Council meetings

Community

  • What are the visiting hours? Are there any restrictions about visiting?
  • Is there a functioning Family Council?
  • How is the community involved with the home? Is there a volunteer group?

Daily Life for a Resident

  • Are residents’ rooms inviting?
  • Are the size of the rooms and access to the washrooms satisfactory?
  • How many share a washroom?
  • What furnishings are provided by the Home? Are they in good repair?
  • What furnishings can residents bring?
  • Can residents personalize their room (i.e., hang pictures)?
  • Can residents connect a telephone, cable/satellite TV? Is there a technology support person available?
  • Is a call bell or communication device within easy reach in resident rooms and common areas?
  • Is there equipment to assist people with physical disabilities? (built-in or portable transfer lifts?)
  • What personal belongings may residents bring?
  • Is there an option for keeping personal belongings secure (locked drawers)?
  • Is there adequate storage for seasonal clothing?
  • How does the staff handle residents going into another resident’s room?
  • Is there privacy in the resident’s room?
  • Are areas provided in the home for private visits with residents?
  • Is shared accommodation available for couples?
  • Is the resident/family responsible for personal supplies? (i.e., tissues, lotion, toothpaste)
  • What are the rules regarding smoking, alcoholic beverages, and cannabis use?
  • What is the policy regarding pets in the Home?
  • What is the policy for short stay absences, vacations, and medical leaves?

Activities

  •  Is there a full-time Activity Director on staff? What activities are offered to residents? Request a monthly program of activities.
  • Are there programs and services available to meet diverse cultural needs?
  • Is there a social worker and/or spiritual care practitioner?Meal Services
  • Are residents taken regularly (daily?) to activities if they cannot go on their own?
  • Are activities provided at the bedside for residents if needed?
  • Are safe outdoor areas easily accessible to residents? How often are they taken outside?

Meal Services

  • What are the hours when meals and snacks are served?
  • Ask to see a sample menu. Do the meals seem varied and appealing? Are there choices available on the menu?
  • Are special diets accommodated?
  • If you can, tour at mealtime to see if meals are served in an orderly and respectful way.
  • Are residents with feeding problems assisted in a timely manner?
  • If a resident misses a meal, will one be offered later?
  • Can residents dine in their own rooms?
  • Can residents bring in their own food?
  • Are family members or friends able to have an occasional meal with the resident?

Staffing and Staff Training

  • What is the ratio of personal support workers to residents? The ratio will be different during the day and at night.
  • How many registered nurses are there during the day, evenings, overnight?
  • What training is compulsory for all staff?
  • Are staff trained to work with visually impaired and hearing-impaired residents?
  • Are staff trained in managing difficult and aggressive behaviours?
  • Does the home have a behavioural support program for highly aggressive residents?
  • Does the home have an infection prevention and control specialist on staff?

Medical Care

  • Is there a nurse practitioner on staff who provides regular care to all residents?
  • Who are the physicians that service the home? How often do they visit?
  • Is a physician on call 24 hours a day? What is their response time?
  • Is there good communication with the medical team?
  • Do residents have access to a palliative care program in the home?
  • Is there a designated palliative room?
  • Are family members provided palliative care information and support to make end-of-life care decisions?
  • Are there provisions for family members to stay overnight with a seriously ill or dying resident?

Approach to Care

  • What is the home’s policy on cardiopulmonary resuscitation? (You will be asked to decide, upon admission about the level of restorative care to be administered.)
  • Are residents and family (or substitute decision makers) actively involved in the case conferences and planning for the resident’s care?
  • Are the quarterly resident assessments and care plans available to residents and family (or substitute decision makers)?
  • How often are the care plan review meetings held?
  • Does the home focus on individual needs? For example, if a resident wishes to go to bed at a specific time, would that be accommodated?
  • How often are residents bathed? Do residents have a choice of showering or bathing?
  • What are the home’s policies on restraints and medication to manage behaviour?

Additional Services

  • Are physiotherapy, occupational therapy, speech therapy, and other support services available at the resident/family request? How are these services arranged and funded? How frequently are they available?
  • Are dentists and dental hygienists available to provide dental care? Who arranges for this? How are these services funded?
  • What foot care is provided?
  • Can residents bring in paid personnel/service providers to supplement care? If so, are background checks a requirement?