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Message from the Premier
My mom is 89 and my dad is 91. They are determined to remain in their home and continue to take care of themselves for as long as possible, but that isn’t easy. My sisters and I talk with them about this a lot. As time goes on, they do need more support. And they need different kinds of support — from our family, from the community, at home and in our health care system.
Ontario is aging faster than ever before with older people in Ontario now outnumbering younger ones for the first time in our history. Across Ontario, there are now more than two million seniors and their families trying to navigate this next phase of life as best they can. Our shared challenge is to find out what works best, what comes next and what it really means to age with confidence, respect and dignity.
That’s why Ontario needs this Action Plan for Seniors.
Seniors quite literally built our province. Every day, as we work to implement our plan for a fairer, better Ontario, we are building on the foundation that they have laid over decades of achievement, sacrifice and hard work.
I believe that seniors deserve the very best care and support we can provide. That is why, through this new strategy, we have made it our goal to help ensure that every senior can continue to live life to the fullest as part of a healthy and vibrant community. Through a series of actions to better support aging adults, including bolstering community engagement, programs and health system supports, I know we can achieve our goal.
Our efforts to better support seniors are part of our ongoing work to build a fairer society. We want every person in Ontario to benefit from the wealth of opportunities that our province has to offer, no matter their age.
For seniors, their families and friends, this vision of fairness means people will have choices to remain healthy and independent in their communities and with regards to the kinds of services and care that the province offers. It means that we, as a society, will seek their guidance and respect their wisdom. It means that all of us who right now are helping our parents, grandparents, aunts and uncles, brothers and sisters, friends and neighbours as they age will feel supported, and confident that when we join their ranks, we too will get the care and support we need.
Our seniors raised us, taught us and did their very best for our province. In return, we will do our very best to make sure that Ontario continues to be the best place to live for everyone at every age.
Premier of Ontario
Message from the Minister of Seniors Affairs
I am pleased to join Premier Kathleen Wynne in releasing Aging with Confidence: Ontario’s Action Plan for Seniors, which outlines our government’s ongoing plan to help Ontario seniors remain independent, healthy and socially connected at all stages of their lives.
Our government builds every day on the foundation seniors have created over decades of achievement. We value and respect the contributions they have made, and continue to make, to a strong, diverse and inclusive province. It is our goal to help all seniors age well and with independence, able to take advantage of the opportunities that arise in their later years, and to be supported through the challenges.
As a government, we are committed to helping all Ontario seniors live their best lives.
Earlier this year, Premier Wynne made history with the creation of the first-ever standalone Ministry of Seniors Affairs, which I am privileged to lead. As Minister of Seniors Affairs, I have travelled across this province to listen to seniors directly and I have come away with a profound admiration of their optimism, resilience and experiences. This has given me a better understanding of the challenges that seniors in Ontario face. We are also committed to working with stakeholders, community partners, and members of the public to ensure that seniors of diverse backgrounds, identities, and lived experiences—including Indigenous peoples, people with disabilities, the LGBTQ2S community, women, and members of racialized populations—are benefiting equitably from government supports. Together, we are working to create fairness and opportunities for seniors, ensuring that all older people in Ontario ― our parents, grandparents, aunts and uncles, our brothers and sisters, friends and neighbours ― are able to benefit from a wide range of seniors' programs and services.
Aging with Confidence outlines our plan to continue moving forward, while building on the significant progress already made. This is a road map, not a destination. This strategy represents a coordinated approach that is designed to meet the needs of our diverse and aging older population.
Our goal is to ensure that seniors today ― and all of us who will one day join their ranks ― are able to age with respect and dignity, and remain healthy, independent and as active as they wish.
Minister of Seniors Affairs
Message from the Minister of Health and Long-Term Care
After a lifetime of working hard and building Ontario up to the thriving society it is today, we owe it to Ontario seniors to ensure they have the support they need to enjoy a high quality of life, right until the end of life.
Meeting that responsibility is fundamental to who we are as Ontarians. Part of meeting that commitment is ensuring that every single person has access to the health services they need to meet their unique needs. As Minister of Health and Long-Term Care, I am proud of the health care system we have built to support Ontario seniors. However, as demographics shift and society modernizes, I know there is more we can do to better support healthy aging.
In recent decades, medicine and health care have advanced significantly. Not only is life expectancy longer, but our years of good health can be stretched further. Even when chronic conditions develop, independence and quality of life can and should still be expected for much longer than in previous generations. By investing in the services and supports that ensure seniors stay independent, healthy and active, safe and socially connected, all of Ontario continues to benefit from the tremendous knowledge, compassion and experience that seniors have to share.
Seniors have been contributing to their communities all their lives and they can continue to do so if they have the right services and supports in place. Through Aging with Confidence: Ontario’s Action Plan for Seniors, Ontario can continue on a path of fairness and strength as our population ages.
Dr. Eric Hoskins
Minister of Health and Long-Term Care
Ontario’s fastest growing age group
Seniors (65 years and older) are the fastest growing age group in Ontario. In 2016, 16.4% of Ontario’s population was 65 years or older. By 2041, it is projected that 25% of Ontario’s population will be 65 years or older, almost doubling from 3 million seniors in 2016 to 4.6 million seniors.
Ontario’s seniors population is becoming increasingly diverse. The number of visible minority seniors (65+) in Ontario increased by 44% between 2011 and 2016, compared to a 16% increase among non-visible minority seniors.
In terms of living arrangements for Ontarians aged 65 and older, 93% are living in private households Most (63%) of these live with a partner or spouse, 23.5% live alone, 11% live with other relatives, and 1.9% live with non-relatives.
In 2013-2014, the following percentages of Ontario seniors (65 years and older) reported having the following conditions: 18.4% diabetes, 7.3% Chronic Obstructive Pulmonary Disease (COPD), 7.4% asthma, 46.8% arthritis, 48.7% high blood pressure, and 7.2% mood disorder.
In 2013-2014, 45.8% of seniors (65 years and older) perceived their health to be ‘very good’ or ‘excellent’ and 21.9% perceived their health to be ‘fair’ or ‘poor’; 67% perceived their mental health to be ‘very good’ or ‘excellent’, while 6.5% perceived their mental health to be ‘fair’ or ‘poor’.
Diverse needs, diverse opportunities, stronger seniors
Until quite recently, seniors was a catch-all phrase that many people used to describe anyone over 65, retired and enjoying their golden years. But the way society looks at seniors ― and the way seniors regard themselves ― is changing rapidly, especially with seniors living longer and often in better health than ever before. Overall, many seniors do not see themselves as seniors. 87% surveyed feel a lot younger than their actual age.
People are moving into a new chapter of life as they age, embracing new opportunities and continuing to contribute to their communities, society and the economy. In Ontario, seniors deserve to be supported and recognized as the positive force they have always been ― a true strength of the province.
Aging also comes with challenges. In order to remain independent, many seniors with time will need support, whether from family or friends, or through a diverse range of programs and services. Ontario’s vision is to help seniors remain independent, healthy and active, safe and socially connected. Aging with Confidence is the province’s ongoing plan to support the older and aging population that it serves.
The province recognizes that individuals have different backgrounds, health needs, education, finances, family and social connections ― all of which impact their later years. And certainly people age differently. A 68-year-old man with kidney disease may require more or different types of support than his energetic 86-year-old neighbour. Regardless of individual circumstances, all seniors deserve the best of what Ontario has to offer, from supports that allow independent living in the community, to programs and services that promote active engagement.
The government reviewed Census data, demographic projections and research studies, and carried out a public opinion survey of Ontario seniors to determine how to best meet their evolving needs. It heard directly from seniors about the challenges experienced with aging and their aspirations for their later years ― as well as their concerns about how the challenges of aging might affect their aspirations.
First and foremost, people want to live independently for as long as possible. A clear majority of seniors want to age at home or in a community setting, get around on their own, and stay involved with family and friends. Yet half say they expect to need help within five to ten years to do so.
Seniors want to remain socially connected and engaged no matter where they live. Most report having a good network of friends and family; however, approximately one-quarter live alone and say they sometimes feel isolated. Many report having access to community services; however, more than two-thirds say they would have problems if they could no longer drive. Seniors who engage in daily activities ― social, community, physical and intellectual ― report being happy, engaged, confident and optimistic; however, not everyone is happy or comfortable with aging.
Many seniors identify specific challenges. Ageism remains an issue. Almost three-quarters of seniors surveyed feel there is little appreciation for older people’s skills and wisdom, and almost half say that they sometimes feel invisible. Just over half report suffering from a longstanding illness, disability or infirmity, and 74%percent are concerned with memory loss. Over half worry about losing control of their lives as they get older, and one-third worry that others will take advantage of them. On the other hand, seniors’ growing use and comfort with technology offers new opportunities to reduce isolation, and to build connections and a sense of community.
Ontario is a place where seniors feel supported in living independent, healthy and active, safe and socially connected lives.
Aging with confidence: guiding principles
All seniors deserve to be involved and included in their communities. Any physical and social barriers to that involvement should be addressed.
Seniors' needs are affected by their individual circumstances for example, their health, language, gender, ability, Indigenous identity, ethnicity, religion, sexual orientation or geographic location. Programs and services should recognize this diversity, and be accessible, equitable and culturally appropriate.
Choice and Self-Determination
Seniors should be enabled to make choices and determine what is right for them. Measures to strengthen their capacity to do so should be taken. In cases where seniors require help from friends, family and caregivers, the needs and desires of seniors should be prioritized.
Safety and Security
All seniors deserve to be safe and secure from physical, psychological and financial abuse. Programs and supports across Ontario’s health, social, community, financial and justice systems should protect vulnerable older adults from these harms.
Seniors have different evolving needs at different times in their lives. Aging with Confidence builds on successful initiatives that were launched through Ontario’s 2013 Action Plan for Seniors. It introduces new programs and services representing our ongoing commitment to provide further support for Ontario seniors.
Building on a strong foundation:
In 2012, the province asked Dr. Samir Sinha, who is Director of Geriatrics at Sinai Health System and the University Health Network in Toronto, to develop a strategy to help older Ontarians stay healthy and stay at home longer. The resulting Sinha Report: Living Longer, Living Well offered 169 recommendations in a range of areas, and informed next steps.
In 2013, Ontario’s Action Plan for Seniors was launched with three overarching goals: to help seniors be healthier and stay at home longer, to promote senior-friendly communities that enhance well-being and participation, and to help seniors live safely, independently, and with dignity.
Ontario has made, and continues to make, significant progress based on the recommendations and actions of these two documents, and this progress is detailed throughout Aging with Confidence.
Supporting seniors at all stages
Profile: Florence is 75. She is one of more than two million seniors who call Ontario home. She is a widow in good health, is safe and happy, busy with family and friends, and active in her neighbourhood. She lives alone with three children out of town.
Progress to date:
- reduced residential electricity bills by 25% on average under Ontario’s Fair Hydro Plan
- introduced the Ontario Seniors' Public Transit Tax Credit
- championed Canada Pension Plan enhancement
- removed the Ontario Drug Benefit Program deductible and reduced the co-payment for 44,000 low-income seniors
- introduced the free shingles vaccine for seniors aged 65-70
- supported age-friendly communities through the Age-Friendly Community Planning Grant Program which has provided $1.5 million in funding over two years for 56 projects in 85 communities across Ontario. Eighteen of these communities have now been designated World Health Organization (WHO) Age-Friendly Cities.
- launched Ontario’s Strategy to Combat Elder Abuse
- released A Guide to Programs and Services for Seniors in Ontario, available in 16 languages
All seniors, regardless of their needs, want a high quality of life ― one that maximizes their health, safety, and connections with family, friends and community. The following actions are designed to help all older Ontarians, no matter where they live in the province, to age well and confidently.
A "one-stop" website (available now at Ontario.ca/AgingWell) has been developed to provide information, all in one place, about government services, programs and supports for seniors across the province. People can also get this information by phone at 1-888-910-1999 or by calling 211 ― which offers information 24 hours a day in over 150 languages.
Better community transportation options
Older people tend to outlive their decision to stop driving by a decade. The government will make it easier for seniors who live in communities currently underserved by public transportation to connect with the services and supports they need. In recognition of challenges faced by those living in northern communities in particular, services in Northern Ontario will also be improved.
More age-friendly communities
The government will expand the successful Age-Friendly Community Planning Grant Program by including a new implementation stream to make communities more accessible and inclusive for seniors of all ages and abilities. Ontario has already introduced several initiatives to support the creation of 85 age-friendly communities.
Age-friendly communities are accessible and inclusive, with programs and services woven together to help people age actively and well. Ontario supports the global movement 8 to 80, which aims to create safe and happy public spaces for anyone between these ages.
The Peterborough Age-Friendly Business Recognition Program received $50,000 as an age-friendly grant recipient. The City of Peterborough and County of Peterborough partnered with the Peterborough Council on Aging (PCOA) and the Alzheimer Society of Peterborough, Kawartha Lakes, Northumberland and Haliburton to undertake planning activities for the development of an Age-Friendly Communities, Business Recognition Program. This business recognition program has made 'no cost' or 'low cost' changes to accommodate older customers. Some examples include wide and clutter-free aisles, large print signs, accessible washrooms, good lighting, and respectful staff to assist seniors.
Free high-dose flu vaccine
An annual influenza vaccine is the best defence against the flu and its complications. That is why, beginning in the 2018-19 flu season, a high-dose influenza vaccine, targeted to protect seniors, will be available free of charge as part of the Ontario Universal Influenza Immunization Program. There are over 18,000 emergency department visits related to flu every year. It is expected that the high-dose flu vaccine for seniors will help limit hospital trips for this population. For this flu season, Ontario seniors can continue to the flu shot from their primary care providers or at their local pharmacy.
Enhance education about powers of attorney
A public education campaign will raise awareness among seniors of how important ― and easy ― it is to set up Powers of Attorney (POA) and to encourage them to choose who can make personal care and financial decisions on their behalf, if necessary. Over one-third of seniors have not designated a trusted POA. As part of this campaign, easy-to-use and accessible resource materials, including a revised POA document and information about how people can prevent POA misuse, will be made available on ontario.ca/AgingWell.
Expansion of consumer protection programs for seniors
The government will launch a consumer protection pilot program aimed at protecting seniors’ hard-earned money through education and awareness, as well as through enhanced assistance and intervention programs for seniors who have fallen victim to consumer threats or scams. Unfortunately, seniors are a key target group for consumer scams.
Strengthening elder abuse prevention
The government will continue to strengthen its work to prevent and respond to elder abuse. Actions will include public education, service provider training, research, and improved community response, to better support abused older adults. This also includes dedicated efforts to address violence against older women, and support older people in Indigenous communities. Elder abuse is never okay. Seniors deserve to live safely and without fear in their homes and in their communities.
Supporting seniors living independently in the community
Profile: Elena is 68 and lives alone. She is a retired office administrator, enjoys a variety of hobbies and volunteers with young immigrants. She lives on a tight budget, and is eager to meet new people and to stay active in her community.
Progress to date:
- expanded rent control to include all private market rental units in Ontario including retirement homes
- introduced over 2,000 free Exercise and Falls Prevention classes for seniors
- invested $11.5 million annually to support 263 Seniors Active Living Centres across Ontario
- invested $5 million to fund more than 900 community projects through the Seniors Community Grant Program that engaged over 250,000 seniors across the province
- established regulatory protection including a bill of rights for residents of retirement homes.
Seniors are living longer and more actively than ever before. Many will remain independent at home and in their communities, and many will want new opportunities to learn or to meet new people or to plan for the future. The following actions will help seniors remain active, healthy and socially connected.
Social connectedness has proven to be vital to seniors' health and well-being. Those with close connections and relationships tend to cope better with health conditions and experience fewer mental health issues, like depression. Social isolation can cause physical risk and put seniors at increased risk of elder abuse.
The vast majority of seniors surveyed want to age at home and in the community; however, more than half of those surveyed already say they will need help over the next five to ten years to do so, particularly with access to services, transportation, housing options, wellness, social connections and active engagement.
More Seniors Active Living Centres
The government is increasing Ontario’s network of Seniors Active Living Centres by 40, to more than 300 Centres provincewide. These popular community hubs provide seniors with a range of social, recreational and wellness programs, as well as educational and support services.
More community engagement opportunities
Ontario’s Seniors Community Grant Program is being extended and enhanced to support larger projects that will benefit more seniors over a longer term. Since 2014, this program has funded over 1,300 grassroots projects in hundreds of communities that have helped more than 435,000 seniors to learn, volunteer and be socially involved.
Through the Seniors Community Grant Program, Habitat for Humanity recently received $8,000 to help expand its volunteer program and involve 50 seniors in the Kingston region in helping to build more affordable housing in their community.
Staying physically strong
An active lifestyle can help prolong independence, help manage chronic illnesses and prevent other health conditions. A new Active for Life Recreation Stream for seniors, under the Ontario Sport and Recreation Communities Fund will provide more recreational activities to help up to 20,000 older Ontarians prolong their physical and mental health, stay mobile and reduce the risk of falls.
Engaging seniors through the arts
Engagement with the arts is known to generate positive outcomes for seniors, including reducing isolation, promoting self-confidence and building a sense of community. Participating in arts activities and art therapy have been demonstrated to be beneficial for both physical and cognitive ailments associated with aging. The government will create a fund to support professional arts programming and art therapy for seniors in community settings (such as Seniors Active Living Centres), retirement homes, hospitals, and long-term care homes, as well as build capacity for seniors to engage in arts organizations in their communities.
Helping seniors with technology
Ontario’s Change the World program will launch a special project to link youth volunteers with seniors to help seniors build their understanding and enable their use of technology. It will help reduce seniors’ social isolation and facilitate meaningful volunteering experiences for youth.
Supporting seniors to become mentors
A senior-youth mentorship program will be established to help build relationships and encourage shared knowledge between generations. This will support 20 to 30 projects across the province.
Seniors requiring enhanced supports at home and in their communities
Profile: José is 72. He has lived with his partner in a small, split-level home for the last 25 years. One month ago, he had a fall that caused him to require surgery. He now needs more support but not at the level provided in long-term care. He and his partner are worried they won’t be able to afford to live in a retirement home, but like the support and community it could provide. For the time being they hope they can access the temporary care José will need at home and in their community to support his recovery.
Progress to date:
- more than doubled home care funding between 2003/04 and 2017/18, from $1.2 billion to almost $3.0 billion. Funding for home and community care has increased by about $250 million per year since 2013
- enabled two million more nursing and therapy visits and 12 million more personal support worker hours in the last decade, creating greater access to nursing care, physiotherapy, personal support and caregiver support
- established community paramedicine programs
- supported the growth of physician house calls
- increased the minimum wage for personal support workers to $16.50 per hour
- launched a strategy to help people with dementia and those who care for them
- introduced family caregiver work-leave protection and proposed the Ontario Caregiver Tax Credit
The vast majority of seniors want to age in place at home. Their ability to do so safely and independently may depend on a number of factors. For example, some seniors will initially have no debilitating issues, but may experience declining health over time; others will enter their senior years with already-existing health conditions or disabilities. Many will eventually require some form of assistance from either family members or friends, or more formal care services and supports, to remain at home. The following actions will help to support them.
Although age does not define health, health tends to decline with age, and health issues become more common and more severe, particularly among people aged 75 and older.
According to the 2012 Canadian Survey on Disability, 37% of Ontario seniors reported suffering from a disability. Of these, 32% said it was mild, 20% called it moderate, 20% called it severe, and 28% called it very severe.
Support for more naturally occurring retirement communities
The government will continue supporting "naturally occurring" retirement communities, such as apartment buildings or housing developments, where many seniors already live close to one another. The Local Health Integration Networks (LHINs) will explore ways to further support seniors who live near one anotherby providing more on-site services to meet seniors’ needs. These types of communities promote social interaction and fight isolation, allow residents to stay in their homes longer and enjoy a higher quality of life and a greater level of independence. LHINs will also work locally to support communities of seniors from specific ethno-cultural backgrounds to ensure age-friendly buildings are providing culturally appropriate care.
Oasis is a grassroots, naturally occurring retirement community that developed organically in an apartment building in Kingston, Ontario. The senior residents themselves developed and now manage all aspects of programming, including community meals, social activities, an onsite personal support worker, and a participatory decision-making model where all seniors have a voice.
Increasing access to in-home health care
The government is improving seniors’ access to house-calls by expanding the program beyond physicians to include additional healthcare providers such as social workers, therapists and nurses. This will cut down on the need for seniors to travel to their healthcare provider when they are ill and help them stay healthy in the comfort of their own homes.
Increasing access to geriatric care
Ontario will strengthen the healthcare workforce’s ability to provide specialized care in geriatrics by increasing training opportunities for healthcare providers, including physicians, personal support workers and nurse practitioners.
Providing more home care hours
The government is expanding home care across Ontario. Seniors requiring home care will benefit from an estimated 2.6 million additional hours this year, including personal support services, nursing, physical and speech therapy, and respite services for caregivers.
Expanding seniors supportive housing
The government is providing additional support to people leaving hospital with over 500 transitional care spaces. These spaces will provide support and rehabilitation to 1,700 people who are ready to leave hospital, but need some additional assistance before they can return home. The province is also helping seniors who require assistance with health care or activities of daily living, such as bathing or meal preparation, and cannot afford to live independently, by providing 200 new subsidies to better access affordable housing as well as home and community care supports.
Increasing support for caregivers
A new provincewide organization will be launched to provide caregivers with supports and resources, including a single point of access for information in areas such as training in multiple languages, local programs and peer support.
Making the quality of care more consistent
The province is strengthening home care by introducing new guidelines for home care assessment and planning based on the level of care needed by the individual and their caregivers. This will provide more predictability in the homecare hours that seniors can expect to receive, and ensure they get the most appropriate care and greater consistency in the way home care services are delivered, no matter where they live in the province.
Helping people with dementia
The province is investing more than $100 million over three years to improve access to quality care for people living with dementia and their care partners. The first year of Ontario’s dementia strategy is focused on expanding and enhancing existing services such as community dementia programs. More than 194,000 Ontarians currently live with dementia, and the number is expected to rise to over 300,000 over the next two decades.
Enhancing self-directed care
Ontario is creating new, innovative self-directed care models to provide eligible clients and caregivers with more control over their care. This will include the establishment of a new personal support services organization in early 2018.
Seniors requiring intensive supports
Profile: Wilfred is 89. He enjoys listening to music and being outdoors. He needs long-term care to help manage complex physical and cognitive issues caused by a severe stroke five years earlier. He does not have trusted family or friends to help him make decisions or manage his affairs. His care providers are also noting that he struggles with more behavioural issues as his dementia progresses. Wilfred and his care providers want him to live as well as possible in the long-term care home he has come to love as his new home, in the community in which he has always lived.
Progress to date:
- From October 2003 through to October 2017, more than 10,000 new LTC beds have been developed and more than 13,500 older LTC beds have been redeveloped
- launched a $20 million grant program to improve fire safety in retirement homes through sprinkler retrofits
- added 75 nurse practitioners to long-term care homes across the province
- increased investments in Behavioural Supports Ontario to provide enhanced supports for long-term care home residents with challenging behaviours such as dementia
- added almost 900 new specialized staff to care for residents with responsive behaviours
- implemented 11 specialized units to support complex residents in long-term care homes
- increased funding by $15 million to support meals, including ethno-cultural and special diets
- reduced inappropriate anti-psychotic usage, with Ontario trending below the national average since 2011/12
- decreased the number of long-term care residents experiencing physical restraints (6.0%), placing Ontario below the national average of 7.4%
Some seniors with complex needs caused by cognitive and physical decline, and conditions such as dementia, will require a higher level of support as they age. Many will require ongoing and intensive care that is currently provided in long-term care homes.
As a result of successful investments in home and community care, Ontario seniors are entering long-term care homes later than ever before, often with more medically complex conditions and care needs. Also, the growing diversity of Ontario seniors means that special attention is needed today and in the future to better meet their diverse language, food and program needs.
Modernizing long-term care homes
Ontario is supporting the redevelopment of more than 30,000 existing long-term care beds in more than 300 long-term care homes by 2025, eliminating all four-bed wards in the province’s long-term care homes. Residents will benefit from increased privacy, better sleep, safety and comfort, with environments that enable the delivery of better care.
Reducing the wait for long-term care
Recognizing that Ontario’s population is aging and creating more demand for long-term care, the province will create 5,000 new long-term care beds by 2022. The province will prioritize placing those with the highest need, as well as those within hospitals who are ready to be discharged and require a long-term care home. New beds that serve specific cultural needs, including those of Indigenous populations, will also be prioritized. Over the next decade, the government will create over 30,000 new long-term care beds to keep pace with the growing and changing needs of an aging population. These new beds are in addition to the 30,000 existing beds that are being redeveloped, as referenced above. Further planning work is required with the long-term care sector to meet this longer term commitment.
More staffing and support in long-term care
Recognizing that the needs of long-term care residents are becoming more complex, the province will increase the provincial average to four hours of direct care per resident per day, once fully phased in, to ensure that residents in Ontario’s long-term care homes receive the highest quality of care. This will mean an additional 15 million hours of nursing, personal support and therapeutic care for long-term care residents across Ontario. This will also ensure that every long-term care home in the province has staff with specialized training in behavioural supports and in palliative and end-of-life care.
Further discussion and planning is required on how to best staff the more diverse and medically complex needs of residents. Additionally, challenges with respect to human resource availability of people who work in seniors care, particularly in long-term care and home care, requires further focus. The government intends to provide additional detail on the outcomes of these discussions as part of the 2018 Budget.
Both residents and staff would benefit from increased staffing levels. For example: increased flexibility for the provision of meals, dressing or bathing at the time of day that suits the resident; reductions in readmission to hospital for minor conditions that can be treated within the home; improved quality of work for staff; reduction in inappropriate use of anti-psychotics, falls, restraint usage, pressure ulcers, pain and depression.
Promoting innovation in long-term care
Ontario is introducing innovative technologies to all long-term care homes to help create a modernized and efficient system. This includes supplying all homes with electronic clinical support tools to ensure standardized, high-quality care is delivered to residents with a range of complex diagnoses. The province intends to build on this innovation by introducing virtual consultations for specialized resources, such as pharmacy.
Culturally appropriate long-term care
In consultation with long-term care providers and residents and families, Ontario will provide more access to culturally appropriate homes, and in-home supports such as culturally appropriate meal preparation and support in the resident’s language of choice.
Strengthening safety for long-term care home residents
The government is committed to the safety and security of long-term care residents. That is why, on September 27, 2017, it introduced Bill 160, Strengthening Quality and Accountability for Patients Act, 2017. This Bill, if passed, would strengthen the long-term care inspection and enforcement framework.
Protecting vulnerable seniors
Protecting vulnerable seniors: Ontario’s Office of the Public Guardian and Trustee (OPGT) acts as a public guardian for over 13,500 mentally incapable adults and touches the lives of more than 50,000 of Ontario’s most vulnerable citizens. To better safeguard the interests of these citizens, the government will strengthen Ontario’s Office of the Public Guardian by improving its customer service offerings through the creation of a contact centre, improved information management and modernized service delivery. This will help to support anticipated increases to case volumes and complexities. It will also ensure that as client demands increase with the aging population, OPGT will continue to meet its service standards and legislative requirements.
Improved end-of-life care
Ontario is partnering with local communities to build more hospice beds across the province. This expansion will provide compassionate palliative and end-of-life care for more than 2,000 additional people and their families each year, closer to home.
Towards the vision
Aging with Confidence is a made-in-Ontario plan. It is another step forward in the government’s ongoing commitment to support seniors so they can remain independent, healthy and active, safe and socially connected.
Each and every initiative is designed to either address the challenges ― or seize the opportunities ― presented by an aging society. Our goal is to continue to make Ontario the best place in the world to grow older.
Discussion questions on long-term care capacity and staffing
In order to continue strengthening the quality and availability of intensive supports to seniors who need them, we would value your feedback and would like to hear about your experiences and perspectives.
Capacity and infrastructure
- What can be done to ensure it is viable for smaller long-term care homes to stay in their community rather than amalgamated into larger facilities?
- What can be done to ensure affordability for long-term care homes to remain and expand in places where land costs are high?
- What is a reasonable distance for family to have to travel to visit with their loved ones in long-term care?
- Currently most long-term care homes are stand-alone buildings. Is it more desirable for long-term care homes to be part of a broader community (i.e. hub) and be co-located with community health clinics, retirement homes/seniors buildings, Seniors Active Living Centres, daycares, etc.?
- As the province builds new capacity, what can be done to ensure it is building the long-term care homes that will meet the social and medical needs not just for today, but for tomorrow’s long-term care residents? What can be done to ensure more beds for people who require specialized care; for example, residents with dementia or who require daily dialysis?
- While new capacity is being built, do Ontarians want their government to assess and evaluate alternative models to long-term care and home care such as self-directed care, Program of All-Inclusive Care for the Elderly (PACE), and increased use of transitional capacity?
- What can be done to balance the desire of the health care system to move people into the most appropriate setting as efficiently as possible, with the desire of Ontarians to have a great degree of choice over their long-term care home?
Quality and staffing
- What can be done to strengthen the quality of care while reducing the reporting burden that long-term care homes face?
- What has been your experience accessing intensive supports and/or long-term care for you or your loved one?
- How should quality be measured in the services you or your loved-one are accessing?
- If offered the choice, would you prefer to go to a home with specialized care supports further from your community? Or to a home without those supports but closer to your community?
- What can be done to encourage service providers to support diversity, including by providing services in languages other than English? Could technology support this goal?
- What should be done to determine the risk skill mix(es) for the increasingly medically and socially complex needs of Ontario’s long-term care residents?
- What can be done to better plan and encourage people to choose a career path in seniors’ health care and support recruitment and retention in long-term care and home care?
- What is the role of volunteerism in long-term care and home care? How can we better leverage the energy of younger people to fight the risk of isolation?
Hearing your perspectives and experiences will help the government develop a strong plan to improve the quality and availability of intensive supports for seniors who need them, and ensure that residents of long-term care homes have access to an average of four hours of direct care each day. We welcome all input, including on matters not addressed in the above questions. Please send your comments to LTC.Info@ontario.ca.