Retirement Home Regulations in Ontario

At retirement homes, you can live and receive care services like nursing and personal assistance in your golden years of life. Here, the rights of the residents are guaranteed by the law. In Ontario, retirement homes are regulated and must follow legislation called the Retirement Homes Act, 2010. This Act provides protection and safeguards for retirement home residents, so they can live their remaining life with dignity and make informed choices about their care.

This Act is enforced by the Retirement Homes Regulatory Authority (RHRA) and sets out a Residents’ Bill of Rights. Retirement Home Operators must post these rights in the retirement home and ensure that staff members receive training about the retirement home regulations. This Bill of Rights aims to ensure that retirement homes are like real homes for the seniors who reside there.

The retirement homes should:

• Display the Bill of Rights in a position where it is easily visible to staff members and the residents.
• Ensure that the Bill of Rights is followed by one and all.
• Make temporary rules to protect residents during health emergencies such as the COVID-19 pandemic.

Now let us see what this Residents’ Bill of Rights is all about! It includes the followings rights for Retirement Home residents:

1. Respect and Dignity: The senior has the right to be treated with respect, and the staff must be polite to them. The resident’s dignity and rights as a person, along with their wishes, must be respected by the staff.
2. No Abuse: No one should be allowed to abuse the senior physically, sexually, financially, verbally, or emotionally whatever the circumstances.
3. No Neglect: The owner and the staff at the retirement home cannot neglect the seniors by failing to give them the treatment, services, care, or help that they may need for their health, safety, or well-being. It is also considered negligence when someone puts the resident’s health, safety, or well-being at risk by not doing something.
4. Proper Care: The seniors have the right to receive the care they need, including:

• A proper place to live.
• Enough healthy and good food to eat.
• Assistance with drinking and eating if required.
• Clean clothes to wear.
• Help with looking tidy and clean.
• Staff should also look after any special needs they might have.

5. Safe and Clean Home: The retirement home must be clean and safe, and everything should function correctly i.e. Smoke alarms must work, fire exits should be distinctly marked, and stairways must be clear and impediment free. When a resident falls ill, the staff must take special care to stop the infection from spreading, such as washing their hands, using masks and gloves, and isolating the sick person. The building should be clean, without bad smells, and access to good air supply and regular garbage removal.
6. Citizens’ Rights: As a citizen, the resident has the responsibilities such as respecting other people’s rights and freedoms and following Canada’s laws. And they also retain all their rights as citizens, including:

• Democratic rights, such as the right to vote.
• Equality rights, such as the right to be protected against discrimination.
• The right to practice their religion.
• The right to express themselves.
• The right to meet anyone they wish or join any organization or group.
• The right not to have their possessions searched or taken without their permission, except as allowed by law.

7. Knowing their Caregivers: The seniors have the right to know who is looking after them, no matter who they work for or how they are employed. People who are responsible for their medical and personal care include:

• Doctors
• Director of Nursing and Personal Care.
• Registered nurses and registered practical nurses.
• Personal support workers or health care aides.
• Volunteers

8. Privacy: The seniors have the right to privacy. They should feel that they are being treated with respect while being given medical care, being medically examined, when their personal needs are being looked after i.e. when being dressed or bathed.
9. Participate in Decisions: The residents have the right to be involved in decision-making related to all the aspects of their life in the retirement home, such as their treatment or care. The retirement home should respect their right to participate by:

• Telling them about the Residents’ Council.
• Make sure they are informed about any changes in process or consideration.
• Giving them the needed information to help them understand the issues.
• Giving them a chance to speak.
• Listening to what they have to say.
• Trying to accommodate their wishes.

10. Personal Belongings: The seniors have the right to keep personal things in their room, such as a favorite quilt, cushion, books, pictures of their family, children or grandchildren, memorabilia, their furniture, computer, or television. It is their choice, as long as their belongings do not interfere with the safety or rights of other people in the retirement home.
11. Involvement in Plan of Care: The seniors have the right to be fully involved in their plan of care, from making of the program to right through to when it is being carried out or changed. They also have the right to consent to treatment, take part in all their care decisions, and the privacy of health information.
12. Independence: The seniors have the right to get help to become as independent as they can by improving their ability to walk, go to the bathroom on their own, do exercises, play games, craft, and take part in other available activities. They retain this right, even if they have cognitive or other disabilities or are incapable of leaving their room without help.
13. Restraint: The residents have the right to be free of restraints, except in the few situations where the law allows some level of it. A restraint is anything that limits movement and prevents them from doing something they may want to do, such as: 

• Medication or drugs
• Wheelchairs with lap belts.
• Mittens that prevent them from scratching themselves.
• Bed rails that keep them from falling out of bed.
• Locked doors

But there are some types of restraints that retirement homes are never allowed to use, such as:

• Roller bars on wheelchairs, commodes, and toilets.
• Restraints that only can be released with a separate device like a key or magnet
• Sheets, wraps, or other items are used, to wrap them to prevent them from moving.

If they are mentally capable, no one can restrain them, put them in a locked unit, or prevent them from leaving if they do not agree. The residents may want a friend, family member, or advocate to help them decide whether they should allow restraints to be used on them. They can change their mind about the restraints.

They may need a restraint for their safety. This type of restraint is sometimes called a Personal Assistive Services Device (PASD). These are devices that help them with their daily activities. Restraints should not hurt them or make them uncomfortable. If they are to be put in restraints, their healthcare providers must check on them frequently. In an emergency, restraints can sometimes be used for a short time without getting consent.

It can happen if there is no other way to stop them or someone else from being seriously harmed. The law calls this the caregiver’s “common law duty”. The restraints could be physical devices or drugs or being put in a locked area, only under a doctor’s advice. Safety measures, like locks, push-button devices, and barriers at stairways, entrances, and exits, are not restraints unless they stop the resident from leaving when they want to.

If they are being restrained or confined against their will in a retirement home, there may be legal steps they can take and get advice from a lawyer.

14. Communicate and Visit in Private: The residents have the right to meet and talk with people in private. Because this is their home, they can invite family, friends, or anyone else to visit them. If they want to speak to someone alone, they have the right to do this. They have the right to keep their mail private. No one is allowed to open their mail or read it unless they want them to.
15. Visitors during Critical Illness: The seniors have the right to have their family and friends with them when their health is critical. If they want, they can be with them night and day and can stay as long as the residents want.
16. Designated contact person: The seniors have the right to choose a person that the retirement home must call right away if they ever go to a hospital or move to another retirement home.
17. Raising concerns: They have the right to speak freely. No one is allowed to punish them for speaking out or making a complaint. They can talk about things related to them and suggest changes to the retirement home’s rules and services they live in. They can do this for themselves or others. Many people make decisions that affect them. They may want to give them suggestions or tell them their concerns. Some of these people are the members of the Residents’ Council or Family Council, staff at the retirement home, and government officials.
18. Friendships: They have the right to make friends and can spend time with them. They also have the right to be involved in any activities offered at the long-term care home if they wish. It can be an important part of their life at the retirement home.
19. Lifestyle and Choices: The seniors have the right to live their life in the manner they wish. The retirement home should respect their personal preferences and habits.
20. Residents’ Council: The residents have the right to participate in the Residents’ Council. Every retirement home must have one. Only residents of the retirement home can be members of the Residents’ Council. Joining the Residents’ Council is a good way to meet people and have a say in how the retirement home is run.
21. Intimacy: They have the right to be alone with their spouse or a person who is important to them. It does not matter whether they are married or not, and it does not matter whether the other person is of the same or opposite sex. The retirement home must have a place where they can meet in private and be intimate if they wish.
22. Sharing a Room: The senior has the right to share a room with another resident, so long as they both agree and space is available at the retirement home. The person the resident shares with could be just a friend or someone they are romantically involved with. The resident can choose to share their room with someone of the same or opposite sex. It does not matter whether they are married to each other or not.
23. Personal Interests: The seniors have the right to do things that interest them and are important to them, either inside or outside the retirement home. They may want to continue their hobbies, follow their religion, and do other activities.
24. Written Policies: The resident has a right to be told in writing how to make a complaint about problems in the retirement home. If they are expected to follow a rule, the retirement home must inform them about the rule in writing. All policies about vacations, visiting hours, discharge, and the use of restraints should be explained. The retirement home’s policies must follow the law.
25. Managing Money:  The seniors have the right to manage their money while they are in a retirement home if they are mentally capable of doing so. Being able to manage their money includes deciding how they will pay their bills at the retirement home and whether they will have a trust account. It also means understanding what can happen if they keep large amounts of cash with them or in their room. Even if they are not capable of making other kinds of decisions, they might still be capable of looking after their financial affairs.
26. Going Outside: They have the right to go outside to enjoy nature, fresh air, and outdoor activities whenever possible. They have the right to come and go from the retirement home as they wish if they are mentally capable. If they are not mentally capable, they have the right to use the protected outdoor area if they desire, as long as the retirement home has one.
27. Bringing People to Meetings: They have the right to bring along people who are important to them when they have meetings with the retirement home staff. Having people to support them at meetings can be helpful for many reasons.

If a senior believes his or her rights in the Bill of Rights are infringed or the retirement home is not following retirement homes regulations, they can choose any of the options below:

1. Making a complaint to the retirement home
2. Making a complaint to the Ministry of Long-Term Care
3. Suing the retirement home for breach of contract
4. Consider other options: Depending on what their complaint is about, they may be able to take their complaint to other places such as the Police, the Patient Ombudsman, Professional Colleges or Bodies, or Human Rights organizations.

They may get legal help and information from:

• Advocacy Centre for the Elderly (ACE) provides legal services to seniors living on a low income. It focuses on areas of law that are of special importance to seniors.
• Community legal clinics give free legal advice, but not all can help with problems in retirement homes. 
• Legal Aid Ontario
• Law Society Referral Service is an online service that gives the complainant, the name of a lawyer who will speak with them for up to 30 minutes for free.