Accessing Long-term Care in Ontario

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Accessing long-term care in Ontario is a comprehensive process. This article will shed light on the process.

Once the decision is made to access long-term care in the community a very comprehensive process begins.  A Community Care Access Center (CCAC) care coordinator will be assigned to the patient and family who are requesting the placement.  A home visit is made and an assessment completed. The assessment that is carried out by the care coordinator determines if the patient is eligible for placement or not.  

Leading up to the decision to place a patient in long-term care family members and/or the patient may notice the patient may be experiencing challenges with caring for themselves. Activities of daily living like bathing, eating, locomotion, mobility, and toileting are increasingly difficult for the patient to manage.  Instrumental activities of daily living like banking, meal preparation, grocery shopping, transportation, light housekeeping also present challenges.

The care coordinator will conduct various assessments that will enable them to decide if the patient is eligible for long-term care. If the patient is not eligible, the care coordinator is required to provide information about all the available community resources in the patient’s geographic area. For example, it the patient is receiving Community Access Care services perhaps the services such as personal support, nursing, occupational therapy, physiotherapy, social work might need to be increased. Adult day programs might need to be added or increased. Adult day programs are programs that provide various activities for the elderly at various locations and times for a fee.

The care coordinator must also complete a capacity assessment if there is any question as to the patient’s understanding and appreciation to make decisions about long-term care. A behavioural assessment is also conducted on all patients requesting long-term care. Now if the patient is deemed incapable, the care coordinator is obligated to call the appeal board to help the patient appeal the decision of incapacity. The substitute decision maker or power of attorney of personal care are to be notified so they can contact the appeal board.

There are various documents that are required to be signed by the patient and/or substitute decision maker. The patient and/or family are then directed to select five long-term care homes. There can be a combination of homes in or outside of the person’s geographic area. The legislation used to allow for only three home choices but wait times are quite long from months to years. So, the more choices a patient has hopefully the wait time diminishes. It is also very important to have the patient and/or family members go out and visit the homes. Visits can be arranged by contacting the homes and setting up a visit. There are also virtual online tours of the homes but it really helps to go and visit the homes in person.

Once the choices are made and ranked in order form 1-5, the forms must be sent back to the Community Care Access Center, so that the homes will be prioritized.

The family doctor, nurse practitioner, or nurse is also required to complete a health assessment form that must be returned to the CCAC. Once all of the forms have been returned, the CCAC collates the documents and sends them off to the appropriate CCAC. The homes review the documents and makes a determination about eligibility for their respective home.  If the patient is not eligible a letter is sent out the patient the substitute decision maker, or the power of attorney for personal care.

If the patient is accepted into the home, they will be contacted by their CCAC coordinator and the patient has 24 hours to make a decision to go to the home and then up to five days to move in. If for some reason the patient, substitute decision maker, or power of attorney declines the bed offer, the file is closed and there is a waiting period of three months to reapply. The three month period might be waived if the decline was due to extenuating circumstances.

I hope this article shed some light on accessing long-term care in the province of Ontario.

….Dedicated to Mr. Ross.  Thank you for your kind words.


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