The City of Toronto operates 10 long-term care homes. Learn more about the quality care and services the City provides as a leader in excellence and groundbreaking services for healthy aging.

The City is committed to healthy, safe and positive environments in which to live, visit and work. Behaviours that violate respect will be dealt with immediately. If you see or hear something of concern, please speak to a staff member.

  • Every person who lives, works or visits a City of Toronto long-term care home is entitled to be treated with respect and dignity and should show respect. Kindness, courtesy, and concern for others are all important aspects of this commitment.
  • SSLTC have zero tolerance for lack of respect, abuse and violence in the workplace.
  • Everyone is expected to be considerate, treat others in a respectful manner and show proper care and regard for the property of others and for City property.
  • Lack of courtesy, violation of rights, rudeness, bullying, violence and/or any form of abuse by any person to any person will not be tolerated.
  • Individually and together we are responsible to demonstrate respect to all those we come into contact with – residents, clients, families, volunteers, members of the public, managers, staff and each other – this expectation includes respect for lifestyle, cultural and religious beliefs.

Seniors Services and Long-Term Care (SSLTC) have been Accredited with Exemplary Standing to reflect compliance with evaluated criteria of the national accreditation program.

Accreditation Canada’s Qmentum® Long-Term Care program is customized to meet the care needs and core values of long-term care (LTC) homes, with the purpose of guiding continuous quality improvement. The program is founded on the principles of people-centred care and co-designed with insight and guidance from a diverse group of LTC stakeholders.

Accreditation Canada is a not-for-profit, independent organization accredited by the International Society for Quality in Health Care (ISQua).

As recognized leaders in behavioural support programs, Seniors Services and Long-Term Care (SSLTC) have a long history of demonstrated knowledge of dementia, delirium and mental health in the delivery of care.

Interprofessional care teams are knowledgeable in:

  • most prevalent types of responsive behaviours and personal expressions
  • potential triggers and underlying causes
  • disease processes
  • stages and progression
  • diagnostic and clinical assessment process
  • cognitive or neurological symptoms
  • treatment interventions
  • person-centred interactions to address resident needs
  • strategies to promote optimal quality of life

All City of Toronto long-term care homes have behavioural support programs.

In addition, Bendale Acres, Cummer Lodge and Kipling Acres have ministry-designated Behavioural Support Transition Units (BTSUs) that provide time-limited specialized care to support residents presenting with complex responsive behaviours and personal expressions. The goal of BTSUs is to reduce the incidence and prevalence of responsive behaviours so that residents can transition to a lower level of care once they have achieved their clinical goals.

Palliative and End-of-Life Care Program

The palliative and end-of-life care program is a holistic approach to care offering long-term care residents, and their loved ones, specialized care and services which are resident-centred, compassionate, coordinated and focus on managing and supporting the needs of residents who are facing a serious, life-limiting illness.

Palliative Approach

A palliative approach to care focuses on improving the quality of life of long-term care residents facing a life-limiting illness by providing a continuum of care and services that address their physical, emotional, social and spiritual needs, while respecting their expressed values and preferences.

A palliative approach to care is not limited to end-of-life care; it begins on admission and continues throughout the resident’s journey. It focuses on providing residents with the best quality of life possible, according to their wishes, expressed values and preferences, in alignment with standards of care and practice.

End-of-Life Care

End-of-life care occurs in the last part of a long-term care resident’s journey when death is expected, usually the last 3-6 months of life. It focuses on dignity and supporting both the resident and their loved ones. Long-term care residents will be cared for in a holistic manner that supports their comfort by relieving the symptoms and stresses they may be experiencing at end-of-life. End-of-life care helps loved ones prepare, make important decisions, and ensure the resident’s wishes are respected.

Team-based Approach

Each of the City’s long-term care homes has a dedicated interprofessional care team including primary care providers (physicians, nurse practitioners, nurses), personal support workers, counsellors(social workers/social service workers), physiotherapists, occupational therapists, dietitians, complementary care assistants, spiritual  care advisors, volunteer coordinators and recreation staff. The team members involved in a resident’s care will depend on the resident’s specific care needs, preferences and wishes.

Palliative & End of Life Care Plans

Each resident has an individualized plan of care created with input from the resident and/or their substitute decision-maker(SDM), their loved ones and the care team.

Care plans are developed based on assessments of the resident’s physical, cognitive, social, emotional, and spiritual needs and preferences, as well as the resident’s values, strengths, and wishes.

Managing Symptoms

The care team closely monitors residents and provides the right support to keep them as comfortable as possible. We focus on relieving pain, discomfort, and other symptoms based on each resident’s needs and wishes.  Common symptoms at the end-of-life include tiredness and fatigue, drowsiness, nausea, changes in appetite, shortness of breath, pain and feelings of anxiety or sadness. Identifying symptoms early helps us provide the best care and support.

Grief & Bereavement Support

Grief is a natural and personal reaction to the death of a loved one. It is important to have support and a space to share your feelings. Staff, including a counsellor(social worker/social services worker) is available to speak with you and your loved ones whenever needed.

Advance Care Planning (ACP)

ACP are conversations to help residents and/or their substitute decision-maker (SDM) prepare for future healthcare decisions. It involves sharing and discussing the resident’s wishes, values, and beliefs to ensure that they receive the care they want, especially if they are unable to make decisions for themselves later on. ACP is not a single event; it is an ongoing conversation that can change as a resident’s needs change.

Goals of Care (GoC) Conversations

The GoC discussion helps residents with life-limiting illnesses and/or their SDM understand their illness and treatment options. It also allows the interprofessional care team to learn about the resident’s values, preferences, and goals of care. These conversations focus on the resident’s values, beliefs, wishes and what they consider important for their quality of life, while understanding their current health conditions, prognosis, and potential outcomes of treatment decisions. The GoC discussion helps guide decision-making and aligns available treatment options with the resident’s goals.

How can I support the resident?

  • Talk to the resident about their wishes and values while they are still capable.
  • If they want to choose their SDM, encourage them to create a Power of Attorney for Personal Care (POAPC).
  • Respect their autonomy – decisions should be based on the resident’s wishes, not your personal preferences.
  • Ask staff to speak to the counsellor(social worker/social services worker) if you have any questions about capacity, decision making, or legal roles.

We are here to support both residents and loved ones in ensuring care decisions are made appropriately and respectfully.

Are there any resources I can use to help support the resident with advance care planning conversations?

Check out these helpful resources:   

Capacity

An individual is capable of making a decision if they can:

  • understand the information about their care.
  • appreciate what could happen because of their decision (or if they choose not to decide).

By law, every person is presumed capable, unless there is clear evidence that they are unable to make a specific decision.

Substitute Decision-Maker (SDM)

A SDM is a person who is legally allowed to make healthcare and personal care decisions for someone who is not capable of making those decisions on their own.

SDMs are not chosen by staff or loved ones – they are determined by Ontario law. The Health Care Consent Act, 1996, provides a specific order of who can act as the SDM as follows:

  1. Court-appointed guardian (if one exists).
  2. Someone legally named in a Power of Attorney for Personal Care (POAPC). There can be more than one POAPC.
  3. A family member, based on the legal list starting with spouse, then children, parents, siblings etc.)

If no one is available, the Office of the Public Guardian and Trustee may step in.

Power of Attorney  for Personal Care (POAPC)

A POAPC is a legal document where an individual chooses someone to make care decisions for them if they become incapable. This person has the legal authority to make decisions about health and personal care. If a POAPC is not in place, the SDM will be the highest-ranking person on the legal list.

Can I make decisions for the resident just because I’m their spouse or child?

Not necessarily. You are only the SDM if:

  • the resident is incapable of making the decision.
  • you are the highest ranking person on the legal list.
  • you are able, willing, and available to act as the SDM.

What if I disagree with the resident’s choices?

  • As long as the resident is capable, their decision is final – even if loved ones disagree.
  • If the resident becomes incapable, the SDM must follow the wishes the resident expressed when they were capable.
  • If no prior wishes were expressed, the SDM must act in the resident’s best interests.

The best course of action if you have concerns about the decisions the resident is making, is to speak with the care team about your concerns.

What if there is conflict between SDMs?

If there are two or more equal ranking SDMs (e.g. multiple children), they must agree on the decision. If they cannot agree, the Office of the Public Guardian and Trustee may be required to make decisions instead.

What You Should Know About Falls*

  • National data indicates that over half of long-term care residents fall each year and 40% will fall two or more times
  • Long-term care residents who fall are very susceptible to injury and hospitalization
  • Many falls can be prevented through assessment of risk and implementing standard and individualized interventions

Factors that may Cause Falls

Biological Factors: Environmental Factors:
  • Decreased muscle mass and strength
  • Decreased postural control
  • Slower reaction and movement times
  • Improper gait
  • Decreased balance and coordination
  • Poor vision or hearing
  • Improper footwear
  • Loose-fitting clothing
  • Medication
  • Clutter
  • Poor nutrition
  • Incorrect use of mobility devices

Preventing Falls

    • Wear proper footwear with rubber soles, ensure laces are tied, velcro closures preferred
    • Wear comfortable clothing that does not drag on the floor
    • Learn to use your cane, walker, or wheelchair safely
    • Keep mobility devices within arm’s reach
    • Do not reach for items if you feel unsafe
    • Ensure mobility devices are safety-checked, adjusted, and regularly maintained
    • Maintain proper posture when using mobility devices
    • Change positions slowly to avoid orthostatic hypotension and dizziness
    • Maintain your strength and balance with daily exercise

    Mobility Devices

    • 84% of residents living in City long-term care homes use mobility devices.

    Canes

    • Used to widen the base of support
    • Hold in the opposite hand to the affected leg
    • Top of the cane should reach the crease of your wrist with a slight bend in the elbow

    Walkers

    • Offer stability and security
    • Top of walker should reach the crease of your wrist with a slight bend in the elbow

    Mobility Device Tips

    • Maintain good posture (stand up straight with eyes looking forward NOT downward)
    • Walk slowly
    • Learn and practice how to properly use your device.
    • Adjust the device as needed, preferably by an Occupational or Physiotherapist
    • Monitor your device for wear and tear on brakes, wheels, and handles.

    *Adapted with permission from a resource produced by Achieva Health.

    The City’s long-term care homes provide spiritual and religious care as part of the inter-professional team. Within each of our LTC homes there is a Spiritual & Religious Care Advisor available to support residents and their loved ones in meeting their spiritual and religious care needs. The Advisors coordinate with multi-faith community leaders to ensure that the residents’ traditions and beliefs are respected. All LTC homes have regularly scheduled worship services for residents and it is possible to make additional arrangements for spiritual and religious care from other community faith leaders or a lay visitors.

    The City is improving care, services and quality of life for Two-Spirit, Lesbian Gay, Bisexual, Transgender, Queer, Intersex and gender- and sexuality-diverse (2SLGBTQI+) residents living in long-term care homes, and for Toronto seniors, with ground-breaking programs and initiatives. Find out more about the City’s commitment to inclusive care and services for 2SLGBTQI+ seniors. 

    The Capital Renewal Plan will modernize and improve the design of homes while advancing our vision to be leaders in excellence and ground-breaking services for healthy aging. The plan keeps beds in service at each site for as long as possible in order to minimize disruption. Residents will continue to receive excellent care and service throughout the redevelopment program. City Council has directed staff to:

    1. Proceed with the recommended staged approach to address mandatory redevelopment
    2. Enter into discussions with the Ministry of Health and Long-Term Care and Local Health Integration Networks to negotiate bed allocations and movements between locations, and to schedule redevelopment projects
    3. Enter into discussion with Humber College Lakeshore Campus regarding opportunities for a teaching long-term care centre of excellence
    4. Explore opportunities to add affordable housing on the sites being redeveloped.

    In addition to approving the Capital Renewal Plan, Council adopted the George Street Revitalization plan which will include a long-term care home, emergency shelter, and community hub to better meet the needs of homeless, vulnerable and elderly individuals.

    The Capital Renewal Plan is based on the following Guiding Principles:

    • Deliver current level of service (2,641 Ministry approved beds) to support high-quality specialized resident-focused care while seeking to maximize cost savings and efficiencies.
    • Promote and preserve partnerships, including ethnocultural, volunteer and community linkages.
    • Respond to emerging community needs and serve vulnerable individuals.
    • Minimize resident disruption related to capital renewal.
    • Advance the Toronto Seniors Strategy with a City-wide commitment to CARE (Compassion, Accountability, Respect and Excellence) by strategically locating its homes throughout the City and by providing community hub space in support of healthy aging.

    The five (5) City of Toronto long-term care homes identified for mandatory redevelopment are:

    In 2018 City Council adopted the goal to maximize the potential number of long-term care beds which could be located on the sites requiring redevelopment. Based on the sites identified at the time, this could represent an increase of 978 beds to the existing inventory of 2,600+ beds, and would be the first increase (37 per cent) in City-operated long-term care beds in approximately 30 years.

    At this time, the addition of new LTC beds is on hold pending a revised capital funding model with the province.

    Statement of Information Practices

    Seniors Services and Long-Term Care (SSLTC), a Division of the City of Toronto is the Health Information Custodian for ten (10) long-term care homes. This means, under the Personal Health Information Protection Act, 2004 (PHIPA), SSLTC has the responsibility to ensure that personal health information is collected, used, stored and shared with full regard for the protection of privacy and the confidentiality of personal health information. This obligation to protect the privacy of personal health information extends to persons who act as agents of the Ministry of Healthy (MOH) and Ministry of Long-Term care (MLTC).

    Access

    Individuals who wish to access or correct their personal health information, or have questions about how it is collected, maintained, used or disclosed, are encouraged to contact the long-term care home’s management team.

    Individuals may also make a written request for access or to correct personal health information under PHIPA.

    Complaints

    SSLTC is committed to resolving all concerns or complaints and encourages individuals to first contact the department involved. An individual’s concerns or complaints about access or privacy practices within SSLTC may be directed to the Department Manager. For general concerns or complaints about privacy practices, individuals are encouraged to contact the SSLTC Privacy Office at SSLTCPrivacy@toronto.ca.

    Individuals may also submit a complaint regarding access or privacy practices of SSLTC directly with the Office of the Information and Privacy Commissioner (IPC):

    Information and Privacy Commissioner / Ontario
    2 Bloor St. E., Suite 1400
    Toronto, Ontario M4W 1A8
    Phone: 416-326-3333
    Email: commissioner@ipc.on.ca

    Contact Information

    If you have any questions about our information practices, feel free to contact:

    Manager, Privacy and Clinical Information Management
    1530 Markham Road, Unit #502 – 5th Floor
    Toronto, Ontario M1B 3G4
    Phone: 416-392-8490
    Fax: 416-392-8457
    Email: SSLTCPrivacy@toronto.ca

    • For 2025-26, each of the City of Toronto’s 10 long-term care (LTC) homes have submitted a Quality Improvement Plan (QIP) to Ontario Health
    • The QIPs demonstrate our commitment to collaborate with residents, families, caregivers and external partners to improve healthcare outcomes
    • The QIPs are available from the Administrator, are posted in each of the LTC homes, and will be available soon for download on the LTC home’s website.

    Seniors Services and Long-Term Care (SSLTC) welcomes opportunities to enhance our knowledge in pursuit of excellence in the services that we provide. We know that research is an integral component of knowledge building in pursuit of that excellence.

    To that end, we have developed formalized processes related to the submission of research proposals these are based on our ethics statement and ethics decision-making principles. This framework guides us to ensure that any research that is approved to be conducted within our division meets the highest standards for health care research and also meets the more specific criteria established by Seniors Services and Long-Term Care.

    All research proposals must have prior ethical approval from an accredited university, teaching hospital or national granting agency before the proposal will be submitted to the division’s own Ethics and Research Committee for consideration. All approved research must be conducted in a way that ensures minimal disruption to residents, clients, families and staff and provides learning and potential future benefit related to the enhancement of long-term care. All approved research must comply with the requirements of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and the Personal Health Information Protection Act (PHIPA).

    If you are interested in collaborating with the City in research that would build knowledge in the pursuit of excellence in long-term care and services for seniors, email SSLTCResearch@toronto.ca for details about the application process.

    COVID-19 Resource Guide

    The COVID-19 pandemic has been exceptionally challenging for our long-term care residents, staff and families. In particular, social isolation and loneliness present health risks for residents who have experienced long periods of separation from family and friends and limitations on group dining and programming. Preventing loneliness is as important as helping residents with their physical care; even more so during periods of outbreak when contact with others is limited to reduce the risk of virus spread. The tips and strategies provided in this guide below are intended to improve the quality of life of residents affected by pandemic-related restrictions.

    These downloadable resources have been made possible by funding support from Healthcare Excellence Canada and the collaboration of a working group representing the City’s directly-operated LTC homes.

    See how the Resource Guide is being used within the long-term care home setting.

    Reports