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.
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.
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*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 groundbreaking programs and initiatives. Find out more about the City's commitment to inclusive care and services for 2SLGBTQI+ seniors.