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.
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:
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.
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.
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 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.
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.
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.
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 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.
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.
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.
We are here to support both residents and loved ones in ensuring care decisions are made appropriately and respectfully.
Check out these helpful resources:
An individual is capable of making a decision if they can:
By law, every person is presumed capable, unless there is clear evidence that they are unable to make a specific decision.
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:
If no one is available, the Office of the Public Guardian and Trustee may step in.
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.
Not necessarily. You are only the SDM if:
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.
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.
| Biological Factors: | Environmental Factors: |
|
|
*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:
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:
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.
Seniors Services and Long-Term Care holds a number of Service Accountability Agreements with Ministry funding partners:
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).
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.
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
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
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.
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.