As the population continues to age, the demand for long-term care in Canada continues to grow.
In Ontario, waitlists for long-term care homes have been a longstanding issue.
One in five seniors in Ontario that are over the age of 80 years have complex care needs, which may require them to be in a long-term care home [1]. However, the system was not developed to manage the current or future needs of our population.
Estimates suggest that tens of thousands of people in Ontario are waiting for a long-term care home at a time, with one report noting 50,000 people were waiting for a long-term care home in 2025 [1].
Average wait times can range from one to three years, though they may exceed five years in certain regions [1]. Conversely, individuals may classify for crisis placements where they have urgent needs and wait times may be reduced to 3 to 6 months [1].
Several factors contribute to the delays observed. These include limited availability of beds in preferred or nearby homes, increased demand due to aging demographics, and staffing shortages in long-term care homes.
As a result of these delays, individuals may remain in hospitals longer than medically necessary under an Alternate Level of Care (ALC) status or will have to stay at their home while they await placement. This increases the risk for caregiver burden.
Bill 7: More Beds, Better Care Act, 2022 was introduced in Ontario [2], in response to hospital overcrowding and long-term care bottlenecks.
This legislation was designed to free up hospital beds occupied by ALC patients. This provision to authorize certain actions to be carried out without the consent of the patients in hospital.
According to the bill, the “actions include having a placement co-ordinator determine the patient’s eligibility for a long-term care home, select a home and authorize their admission to the home.
They also include having certain persons conduct assessments for the purpose of determining a patient’s eligibility, requiring the licensee to admit the patient to the home when certain conditions have been met and allowing persons to collect, use and disclose personal health information, if it is necessary to carry out the actions” [2].
However, reasonable efforts must still be taken to try obtaining the patient’s consent [2].
The goal is to improve patient flow in hospitals while also ensuring that people are receiving care in more appropriate settings.
These changes have been viewed as controversial as they limit patients’ choices in selecting a preferred LTC home. They may lead to placements which are far from family and support networks.
Additionally, given the challenges and long wait times associated with long-term care access, families may explore alternative living arrangements.
Retirement homes, assisted living and supportive housing, complex continuing care, and home care services with support personnel such as personal support workers, nurses, and therapists, may also be options which individuals consider.
It is important to ensure an individual is receiving the right level of support in the appropriate care setting.
Our Occupational Therapists (OT) and case managers (CM) can assist with navigating such decisions and facilitating necessary assessments from qualified professionals as well as completing documentation required for applications. Our OT and CMs can assess functional abilities and provide insight into the level of support an individual may require.
For individuals and families navigating this journey, understanding your options and seeking guidance from professionals can make a meaningful difference.
Making these decisions can be a difficult and an overwhelming process, you don’t have to go through this alone.
References
[1] OLTCA. (2023). The Data: Long-Term Care in Ontario. https://www.oltca.com/about-long-term-care/the-data/
[2] Calandra, Hon. P. (2022). More Beds, Better Care Act, 2022. Legislative Assembly of Ontario. https://www.ola.org/en/legislative-business/bills/parliament-43/session-1/bill-7