Living in a long-term care home
Information for residents, caregivers and visitors.
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Long-term care homes are homes above all — places where people can live comfortably while having their care needs met.
Each resident in a long-term care home has an individual plan of care. A plan of care is a written document that tells the people looking after you what kind of care you need and how that will be provided. This includes:
- your health conditions
- the medications you need to take
- your dietary requirements
- how much help you need with daily living
- your risk of falling
- exercises prescribed by your physiotherapist
- religious practices
Your individual plan of care must be reviewed every six months, and updated as required.
Different long-term care homes will offer a range of activities, from communal dining and in-home social activities to group outings. Where available, homes may offer additional services, such as hairdressing, for a fee.
Roles in long-term care
Along with doctors and nurses, here are some of the roles (and terminology) you’ll encounter in a long-term care home:
- administrator – a staff member who oversees the long-term care home and is responsible for its management
- allied health care providers – other health care professionals who provide support to residents, such as physiotherapists and social workers
- director of nursing and personal care – a registered nurse who supervises and directs the nursing and personal care staff and the care they provide
- medical director – a physician who is in charge of matters relating to medical care in the long-term care home and works in consultation with the Director of Care and other health professionals in the home
- personal support worker (PSW) – a staff member who provides personal care services, but who is not a nurse. PSWs usually help with day-to-day needs such as bathing, meals and eating, routine housekeeping and routine daily activities
- recreation staff – staff members who organize recreational activities for residents, such as for social purposes, physical activities, hobbies and crafts, birthday celebrations and religious ceremonies
- substitute decision maker – if you are a resident, you may need to designate someone who can legally make decisions on your behalf in the event that you become incapable of making those decisions yourself
Residents have a right to receive visitors.
At the same time, every long-term care home is required to develop and implement a visitor policy.
Visitor policies must be clear about the home’s practices for dealing with a variety of situations, including:
- daily visitor access
- visitor access during disease outbreaks, or in cases where a resident is isolating
- maintaining a written record of a resident’s caregiver
- public health measures, including infection prevention and control practices
- any screening or testing requirements of visitors that may be in effect
Homes must make sure all visitors have access to the visitor policy and provide any education or training visitors need — such as how to follow infection prevention and control practices.
A special note about caregivers
Caregivers are essential visitors, designated by a resident or their substitute decision maker, to provide support or assistance to residents, such as:
- direct physical support
- helping with feeding
- hygiene or cognitive stimulation
- social and emotional support
Examples of caregivers include:
- family members, friends or a person of importance to a resident
- privately hired caregivers
- paid companions
It’s up to the resident or their substitute decision-maker to designate a caregiver — not the home. Ask your home for its procedure around designations, but as a general rule, you should always make your designation in writing.
Family and residents’ councils
All long-term care homes are required to have a residents’ council. Some may have a family council as well.
Residents’ councils are independent from the home's administration and staff. They are made up of residents who speak on behalf of all residents to support their interests.
Residents’ councils meet regularly to give the home advice and recommendations on what residents would like to see done to improve care or the quality of life in the home, including:
- sponsoring and planning activities
- collaborating with community groups
- reviewing the home's financial documents and operations
- working to resolve disputes
Learn more from the Ontario Association of Residents’ Councils.
Family and friends of long-term care home residents can form and run a family council. These groups focus on improving residents' quality of life and care, while providing support to one another.
Not all long-term care homes have a family council, but all must offer an opportunity to form one.
Learn more from Family Councils Ontario.
Outings and absences
Day trips and vacation
Residents may leave their long-term care home for various reasons, including:
- daytime outings
- vacations to visit family or friends
- to remain active in the community
These outings have time limits.
- Casual absences should not exceed 48 hours per week.
- Vacation absences should not exceed 21 days per year.
Residents planning to take a day trip or a short vacation may also be subject to additional public health measures.
Medical and psychiatric absences
If you need to leave your long-term care home to receive medical or psychiatric care at a hospital, you can keep your bed in the home as long as you return within:
- 30 days, for a medical absence
- 60 days, for a psychiatric absence
If your medical or psychiatric absence is longer, you will be discharged from the long-term care home. However, if this happens, you will be placed in the “re-admission” category on the home’s waiting list, which is prioritized for admission.
Discharge and re-admissions
Residents may discharge themselves from a long-term care home at any time.
If you have been discharged from a long-term care home and want to be re-admitted, contact your local Home and Community Care Support Services organization.