The Ministry of Long-Term Care in Ontario is planning to test a new system to help people find spots in long-term care (LTC) homes that match their culture, religion, language, or ethnicity, and there is an open call for comment [HERE](https://www.ontariocanada.com/registry/view.do?postingId=49135&language=en#:~:text=The%20Ministry%20of%20Long%2DTerm,religious%20and%20linguistically%20appropriate%20care.). This project, called the Long-Term Care Homes Cultural Pilot Project, will try to make it easier for people to get into homes where they feel more at home culturally.

Some LTC homes in Ontario focus on serving specific cultural or religious groups. But recently, these homes have seen fewer residents who match the culture they aim to support, and fewer spots are available that meet applicants' cultural needs. This makes it harder for these homes to offer the cultural, religious, and language support their residents need.

The current system puts people on a waiting list for LTC homes based on how urgently they need a spot. In this pilot project, the Ministry wants to test a new way of organizing these waitlists for people in crisis (those in category 1). For the homes selected to participate, people on the crisis waiting list who share the culture or religion that the home primarily serves could be prioritized, even if others on the list are also in crisis.

To make this pilot work, the Ministry would change the rules for ranking applicants. In designated homes, people with an urgent need for care would still be ranked first, but if two or more people have the same level of urgency, the applicant who matches the home’s cultural focus would get priority.

The goal is to see if this new ranking system can help improve access to culturally appropriate long-term care for Ontarians.

[CLICK HERE](https://www.ontariocanada.com/registry/view.do?postingId=49135&language=en#:~:text=The%20Ministry%20of%20Long%2DTerm,religious%20and%20linguistically%20appropriate%20care.) to read the full proposal or to comment.  Comments are open until November 26.

New Pilot to Prioritize Cultural Matches in Long-Term Care Homes in Ontario

*Disclaimer: Elderado is not suggesting or encouraging the use of cannabis in any form.*

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https://youtube.com/shorts/kvrZWjkM1kA?si=K_Im89xmuicpk84G
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Since the legalization of recreational cannabis in Canada in 2018, its use among seniors has been steadily increasing. Cannabis, once a taboo topic, is now becoming a conversation starter, including in settings like long-term care homes where health, comfort, and quality of life are key concerns. But with this rise in popularity comes questions about the rules and regulations surrounding cannabis use in these environments. Can residents of long-term care homes in Ontario legally use cannabis, and if so, under what conditions?

**The short answer is, sort of - the Fixing Long-Term Care Act states:**

*(2) Nothing in this Regulation prevents a resident from cultivating, acquiring, consuming, administering, possessing, storing or disposing of recreational cannabis in accordance with the licensee’s policies and procedures as required by subsection (1).*

**One long-term care home told us:**

*"Residents are able to consume alcohol and cannabis unless the doctor deems that it would not be safe due to a health condition/medication. Residents would either store their alcohol/cannabis locked in their room, or locked in the medication room with the nurse, depending on a capacity assessment that is completed (goes over risk, abilities, etc.). Residents have choice and can consume at their leisure, however there are rules in place for where they can/can’t."*

In this blog, we'll explore the key regulations and considerations related to cannabis use in long-term care homes in Ontario, referencing both the [Cannabis Control Act](https://www.ontario.ca/laws/statute/17c26) and the [Fixing Long-Term Care Act](https://www.ontario.ca/laws/statute/21f39). We’ll also look at the increasing usage of cannabis by seniors, supported by recent studies.

### The Growing Popularity of Cannabis Among Seniors

Since Canada legalized cannabis in 2018, the stigma around its use has slowly faded, and many people, including seniors, have begun exploring its potential benefits. According to a [2021 study by the Canadian Institute for Health Information (CIHI)](https://www.cihi.ca/en/drug-use-among-seniors-in-canada), the use of cannabis among seniors (aged 65 and older) more than doubled from 2017 to 2019. Many seniors are turning to cannabis as an alternative treatment for conditions like chronic pain, insomnia, and anxiety, with both recreational and medicinal cannabis use rising.

A 2020 study published in the [*Journal of the American Geriatrics Society*](https://agsjournals.onlinelibrary.wiley.com/journal/15325415) found that 15% of Canadian seniors reported using cannabis, with most of them doing so for medical reasons. For long-term care residents, the potential benefits of cannabis include helping to manage pain, reduce the need for opioids, and improve overall well-being.

### The Cannabis Act and Long-Term Care Homes

The [Cannabis Act](https://laws-lois.justice.gc.ca/eng/acts/c-24.5/), which came into effect in October 2018, legalized the recreational use of cannabis across Canada. It allows adults to possess and share up to 30 grams of dried cannabis or its equivalent in other forms, grow up to four plants per household, and purchase cannabis from licensed retailers. However, the act also gives provinces and territories the authority to implement additional rules and restrictions, particularly when it comes to where cannabis can be consumed.

In Ontario, cannabis use is regulated by a combination of laws, including the **Cannabis Control Act, 2017**, the **Cannabis Licence Act, 2018**, and the **Smoke-Free Ontario Act, 2017**. While adults are generally allowed to use cannabis in private residences, the rules for public consumption are stricter and aligned with those for tobacco. In institutional settings like long-term care homes, the regulations can vary depending on the facility’s policies and whether the use is recreational or medicinal. Exemptions to public consumption rules may apply in certain long-term care or retirement homes under specific conditions. 

### The Fixing Long-Term Care Act, 2021

The **Fixing Long-Term Care Act, 2021** is a key piece of legislation in Ontario that governs long-term care homes. It establishes standards for the safety, care, and rights of residents in these facilities. When it comes to cannabis use, long-term care homes must balance the residents' rights to make personal choices with the need to ensure the safety and well-being of all residents.

There is no blanket prohibition on cannabis use in long-term care homes, but individual homes may have specific policies that residents must follow. These policies are usually designed to ensure that cannabis use does not interfere with the care environment, the safety of residents, or the legal obligations of the home. For instance, some homes may require residents to consume cannabis only in designated areas, and smoking or vaping cannabis indoors is generally prohibited under Ontario’s Smoke-Free Ontario Act.

### Medicinal Cannabis in Long-Term Care Homes

For residents who use cannabis for medical reasons, the situation can be more straightforward. Under Canadian law, individuals with a medical authorization can legally access cannabis products to treat various health conditions. Long-term care homes in Ontario are required to accommodate residents' medical needs, including those who have been prescribed cannabis by a healthcare professional.

However, the use of medical cannabis in long-term care homes may come with additional regulations. Homes must ensure that cannabis products are stored securely, administered safely, and do not pose a risk to other residents. In some cases, residents may be required to provide a medical prescription, and the home’s staff may be involved in managing the resident's cannabis use, similar to how they handle other medications.

### Key Considerations for Residents and Families

If you or a loved one is considering using cannabis while living in a long-term care home in Ontario, here are a few key points to keep in mind:

1. **Check the Home's Policies**: Each long-term care home may have its own rules about cannabis use. Be sure to ask about these policies before bringing cannabis into the home.

2. **Consider Medical Authorization**: If you plan to use cannabis for medical purposes, having a prescription from a healthcare provider can simplify the process. It also ensures that the long-term care home is aware of your medical needs and can provide appropriate support.

3. **Respect Other Residents**: Remember that cannabis use, especially smoking or vaping, can affect others. Be mindful of the designated areas for cannabis use, and always follow the home’s guidelines.

4. **Safety First**: Long-term care homes have a responsibility to maintain a safe environment for all residents. This means that cannabis products, like any other medications, must be stored securely to prevent accidental ingestion by others.

### Conclusion

The **Cannabis Act** provides the legal framework for cannabis use across Canada, while the **Fixing Long-Term Care Act** governs how long-term care homes manage cannabis use among residents. If you or a loved one is living in a long-term care home and considering cannabis, it’s important to understand the home’s policies and ensure that your use complies with all laws, rules, and guidelines.

Cannabis use among seniors has been on the rise since its legalization in 2018, with many finding it beneficial for managing chronic pain and other health conditions. While cannabis is generally legal in Ontario, the use of cannabis in long-term care homes is subject to specific regulations that balance individual rights with the safety and well-being of all residents.


Can Cannabis Be Used in Long-Term Care Homes in Ontario?

Wellesley Central Place is hosting a Pride Party, and you're invited!

**Who?** You are invited.

**What?** 2SLGBTQI+ Rainbow Seniors at Pride.  It's a free events highlighting local queer performances with food, ice cream, music, & Special Guest Sofonda!

**When?** Saturday, June 15, 2024 from 1:00PM–3:00PM.

**Where?** The Rekai Centre at Wellesley Central Place, 160 Wellesley Street East, Toronto. ([Google Maps](https://maps.app.goo.gl/dRdqJynijwZrkr6V6))

**Why?** For a celebrations of 2SLGBTQI+ Rainbow Seniors at Pride.

[HERE](https://www.rekaicentre.com/assets/pdf/Rainbow%20Seniors%20Event%20Rekai%20&%20Pride%20Toronto%20June%2015th,%202024.pdf) is a link to the invitation.

![image](https://storage.googleapis.com/elderado-prod/wd5STLTB-Rainbow%20Seniors%20Event%20Rekai%20%26%20Pride%20Toronto%20June%2015th%2C%202024.jpg)

## Home to the first 2SLGBTQI+ Rainbow Wing in Long-Term Care in North America

The Rainbow Wing at Wellesley Central Place became the first Long-Term Care Home in North America to offer a wing designated to members of the 2SLGBTQI community in 2022. To facilitate this change staff were provided cultural education about providing care for the 2SLGBTQI+ community. Additional support and programs catering to the inclusive needs of our residents continue to be offered to staff. The physical changes to the Rainbow Wing have already begun with reflective artwork. The Rainbow Wing helps Wellesley Central Place to provide residents as well as the general community with the assurance that they offer an inclusive environment that respect and values the needs of the 2SLGBTQI+ community.

## The Rekai Centres

The Rekai Centres, a non-profit, charitable corporation owns and operates two Long-Term Care Homes in downtown Toronto. The Rekai Centres strive to enrich the lives of their residents by transforming its long-term care model, ensuring that they remain part of their downtown community.



2SLGBTQI+ Rainbow Seniors at Pride

Are Resident Support Personnel going to replace PSWs in long-term care?

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https://www.youtube.com/shorts/HtoTdasmDgg
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## Resident Support Personnel

Resident Support Personnel, or RSPs, provide some personal support services to low-risk residents (for example, helping brush a resident's hair or teeth).  RSPs have acted as a stopgap solution to help support largely understaffed healthcare teams in long-term care.  The Ministry is [currently seeking feedback](https://www.ontariocanada.com/registry/view.do?postingId=47253&language=en&fbclid=IwZXh0bgNhZW0CMTEAAR0ZB031hmid1fBlfbG9NBkPVE7foLL7Tm9eZUUN8QisQVM_3zHwSY28TJk_aem_AaNyWe0hS4HlwIlMPMzxEPvJRYhj-jwt77cqZ0igHr20qbDLMX1N60Gw_tkbfMO3icDkxNxmeZ-caP0SWm9EqsKU) to amend the Fixing Long-Term Care Act, 2021 to give RSPs a more formalized role.

The Ministry is working to stabilize the role of resident support personnel beyond July 1, 2025. To achieve this, they consulted the Regulatory Registry from September 29, 2023, to November 20, 2023. The consultation focused on whether these personnel should be allowed to permanently provide personal support services to low-risk residents or if their role should be limited after July 1, 2025.

The feedback from the consultation generally supported maintaining the role of resident support personnel in long-term care as a supplement to personal support workers. Key points from the feedback include:

- Resident support personnel provide timely care and help reduce the workload of personal support workers and nurses, allowing them to focus on specialized tasks.
- This role offers a pathway for individuals to enter and explore careers in the long-term care sector.
- Concerns were raised about whether resident support personnel have sufficient training to provide direct care without supervision.
- There is a call for the Ministry to provide additional guidance on the role of resident support personnel.

## Resident Support Personnel Plan

The Ministry is planning to change a rule so that long-term care homes can keep using resident support personnel after July 1, 2025. Here's what they are proposing:

- Long-term care homes can hire people to work as resident support personnel, even if they don't have personal support worker education, as long as they have the right skills and the Director of Nursing agrees.
- The Director of Nursing will make sure that the right staff member is assigned to each resident, based on their care plan and needs.
- Resident support personnel can help low-risk residents with personal care, but they might be supervised by a nurse or personal support worker, depending on the resident's needs.
- Resident support personnel cannot provide personal care to high-risk residents.
- Care plans must always be based on what residents need and prefer, including their choice of caregiver (like a nurse or personal support worker).
- The ministry will give guidelines to homes on how to safely use resident support personnel, including what tasks they can and cannot do.
- The ministry also supports resident support personnel in becoming personal support workers through the Learn & Earn Accelerated Program, and they will look for more ways to help them advance their skills.

![image](https://storage.googleapis.com/elderado-prod/uI8BgDxO-EN%20-%20Addendum%20Resident%20Support%20Personnel%20Approach%20in%20Practice%20y%C3%8C%C2%81%20Flow%20Chart.png)
[CLICK HERE](https://www.ontariocanada.com/registry/showAttachment.do?postingId=47253&attachmentId=61023)


## What do you think?

What do you think of the plan to formalize the role of RSPs in long-term care?  Is it a good idea to improve staffing levels, or a slippery slope that could leave us with even fewer healthcare professionals in long-term care homes?  

Want your voice heard?  Make sure you respond to the [public call for comment](https://www.ontariocanada.com/registry/view.do?postingId=47253&language=en&fbclid=IwZXh0bgNhZW0CMTEAAR0ZB031hmid1fBlfbG9NBkPVE7foLL7Tm9eZUUN8QisQVM_3zHwSY28TJk_aem_AaNyWe0hS4HlwIlMPMzxEPvJRYhj-jwt77cqZ0igHr20qbDLMX1N60Gw_tkbfMO3icDkxNxmeZ-caP0SWm9EqsKU) that's open until June 15, 2024.

The Role of Resident Support Personnel in Long-Term Care Homes

You need to file a complaint about something in a long-term care home, how do you do it?

# How do I file a complaint about long-term care?

1. File the complaint with the long-term care home.
2. Contact the Long-Term Care Family Support and Action Line.
3. Escalate your complaint to the Patient Ombudsman.

## 1. File the complaint with the long-term care home

The first step is filling the complaint with the home.  Every long-term care home is required to post the process to file a complaint in a place where it is easy for residents and the public to see.  If you can't find the process, speak to office staff at the home. If your complaint is in regard to harm or risk of harm to a resident, the home must investigate the complaint right away. They must also immediately send the complaint to the Ministry of Long-Term Care.

For all complaints, a member of staff must let you know that the home has received your complaint within 10 business days.

If the home finds your complaint is valid, they must call or write to let you know:

- what they are doing to resolve your complaint now
- what they plan to do to resolve your complaint in the future
- when you can expect the complaint to be resolved

If the home believes there is no cause for complaint, they must explain why.

## 2. Contact the Ministry of Long-Term care with your complaint 

If you are not happy with the home’s response to your complaint, the next step is to contact the Ministry of Long-Term Care.  For the quickest response, call the Long-Term Care Family Support and Action Line at: 1-866-434-0144.  The Long-Term Care Family Support and Action Line is available 7-days a week from 8:30 a.m. – 7:00 p.m.

If your concern is not time sensitive, you can contact the Ministry of Long-Term Care by email, at mltc.correspondence@ontario.ca, or by mail, at:

Director
Long-Term Care Inspections Branch
Long-Term Care Operations Division
Ministry of Long-Term Care
438 University Avenue, 8th floor
Toronto, ON M7A 1N3

## 3. Escalate to the Patient Ombudsman

If you weren't satisfied after speaking to the home, and the Long-Term Care Family Support and Action Line didn’t resolve the issue, you can escalate it to the Patient Ombudsman.  You submit your complaint online [HERE](https://www.patientombudsman.ca/Complaints/Make-a-complaint/Submit-Complaint) or call 1-888-321-0339.  The Patient Ombudsman acts as a neutral body of last resort for complaints about the healthcare system in Ontario.


*Find more information about filing a complaint about something happening in a long-term care home in Ontario on [Ontario.ca.](https://www.ontario.ca/page/long-term-care-home-complaint-process)*

How to file a complaint about long-term care in Ontario?

In Ontario, there are significant differences between long-term care homes and retirement homes, primarily in terms of the level of care provided, the regulatory framework, and the cost structure. Understanding these differences is crucial when making decisions about senior living options.

**1. Level of Care**

***Long-Term Care:*** These are designed for individuals who require 24-hour nursing care, supervision, or higher levels of personal care. They cater to residents with significant health challenges, including chronic illnesses, disabilities, or cognitive impairments like dementia.

***Retirement Homes:*** Retirement homes are generally suited for seniors who are more independent but may still require some assistance with daily living activities. These homes offer a more residential environment with optional support services like medication management, meal preparation, and housekeeping.

**2. Regulatory Framework**

***Long-Term Care Homes:*** They are highly regulated by the Ontario government under the Long-Term Care Homes Act. This act sets stringent standards for care, staffing, resident rights, and facility operations.

***Retirement Homes:*** Retirement homes are governed by the Retirement Homes Regulatory Authority (RHRA) under the Retirement Homes Act. The regulations are less stringent compared to long-term care homes and focus on safety and consumer protection.

**3. Cost and Funding**

***Long-Term Care Homes:*** 
The cost of living in a long-term care home is partly subsidized by the provincial government. Residents pay a co-payment for room and board, but the care services are covered by the government.

***Retirement Homes:*** Retirement homes are primarily privately funded by the residents. Costs can vary significantly based on the type of accommodation and level of services provided. There is no government subsidy for these costs, though in specific situations some residents may qualify for financial assistance programs.

**4. Admission Process**

***Long-Term Care Homes:*** Admission to a long-term care home is coordinated through Ontario Health atHome in Ontario, and there is usually waiting list. Ontario Health atHome assesses each individual’s care needs to determine eligibility.

***Retirement Homes:*** Admission to a retirement home is typically a private arrangement between the resident (or their family) and the home. There's more flexibility in choosing a home, and no formal health assessment is required for admission.

**5. Lifestyle and Environment**

***Long-Term Care Homes:*** These homes focus more on healthcare and personal support, with less emphasis on lifestyle and social activities compared to retirement homes.

***Retirement Homes:*** They often offer a wider range of social, recreational, and cultural activities, promoting a more active and community-oriented lifestyle.

Understanding these differences helps in making an informed decision based on the specific care needs and lifestyle preferences of the individual.

*With Elderado you can compare all 1,400 long-term care & retirement homes in Ontario.  [Get started HERE.](https://elderado.ca/get-started)* 


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