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A Call for Renewed Collaboration Among Ministries and Caregivers

The care of our elders is arguably the most heavily regulated of sectors, at least when it comes to those who live within a long-term care setting funded through our ministries of health.

Regulations, of course, ensure that one of the most vulnerable segments of our population is protected; a segment that deserves nothing short of reverence for the contributions they made to the creation of opportunities so many take for granted today.

But in such a heavily regulated system a very real risk exists that in the process of inspection, monitoring and reporting, an adversarial relationship can unintentionally be cultivated among caregivers and their overseers.

In Ontario, the Long-Term Care Homes Act, 2007, which governs the oversight of the province’s long-term care homes, is written in a punitive fashion that permits no flexibility among compliance officers to consider circumstances or to allow judgment.

The care needs of our aging population are growing ever more complex and the capacity of our long-term care providers to tackle the pressures of a stressed-out health-care system is more important than ever.

In light of the evolving reality of the sector, it’s imperative that a spirit of collaboration once again becomes the standard to which the caregiver/ministry relationship is held.

We like to think this is the way things are but we know from recent discussions with people connected to the sector that this isn’t always the case and indeed, adversarial is a word that front-line team members often use to describe their dealings with ministry inspectors, at least here in Ontario.

We speak with the front lines all the time, digging into their lives and the roles they play in the lives of the elders they serve.

Person-centred care, resident choice and empowerment; these words often spring up in our conversations and we’re confident in saying the vast majority of people working in the sector have the best-interests of the people they care for at heart each and every day.

So when a caregiver says a ministry inspector diminishes her work by failing to speak with residents during home visits and instead simply refers to a check-sheet in an impersonal and subjective process, we grow concerned that person-centredness is not reflected during this important period of oversight.

Fantastic work is being done to change the views of elderhood in our communities, but there is so much more to be done. The process is in its infancy, but it is happening.

We envision a time when ministry inspectors will arrive unannounced in a long-term care home and be welcomed by residents and team members.

In the process of inspecting the details of a home’s operation they will also seek and hear resident accounts of their lives and experiences; the triumphs of strength and empowerment we hear about every day.

One day the ministry will base funding not on a set of rules, regulations and codes, but on living experiences, quality of life, innovation and first-hand evidence of providers putting living first for the elders they serve.

A truly collaborative approach among all stakeholders — elders, caregivers, families and ministry bureaucrats and politicians — is the key to bringing this vision to life.

We’d love to hear where you see this happening already so we can share the story. Comment below or feel free to contact kristian(at) to offer your insights.


Great article! Having worked in LTC and Retirement as an RN for more than 25 years I've seen my share of changes in that time ... not all bad but certainly not all good either. 

Increasing amounts of required documentation to support evidence and practice has resulted in the depletion of good old fashioned bed-side nursing care in many instances and caregivers are often too busy to take the time, sit down with a resident and enjoy meaningful conversation. Unparralleled amounts of time are spent filling out forms and papers by nurses who frequently miss their breaks, skip meals and rush from task to task in order to get everything done in the 8 hours or so of their shift.

At Schlegel Villages I have seen true Resident-centred care taking place in an environment that honours the wisdom and knowledge of the Residents it serves. Here, their individual life stories are as valuable and essential as the medication pass, the documentation and the shift-to-shift reports. Being open and transparent with Ministry Inspectors fosters honest relationships and a willingness to both share what we do well and learn how we can do it better. 

Only as we continue to strive for excellence and truly put Living First will we change the culture of aging and ultimately each residents' quality of life. 


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