What exactly is Complex Continuing Care?

Complex continuing care is a higher level of care than what is provided by long-term care centres and other nursing facilities. Generally, patients require 24-hour nursing care and access to complex medical and diagnostic services not offered elsewhere. Patients may have physical, cognitive or behavioural conditions that limit their ability to live independently in the community.

While we are able to offer a number of therapy options to patients, complex continuing care is not rehabilitation. We don't provide the same intensive therapy as other Toronto Rehab programs. Instead, our goal is to help each patient to achieve their best possible quality of life. Therapy programs are personalized to meet individual patient needs. To ensure each patient has opportunities to participate in a variety of stimulating activities, our therapists, wellness partners, volunteers and chaplains work closely together to provide patients with therapeutic, leisure and spiritually-based programs and activities.

Our Low Tolerance Long Duration (LTLD) rehabilitation program is a recent addition to our existing therapy programs in Complex Continuing Care and provides a longer course of rehabilitation than other traditional rehabilitation programs, with patients spending shorter periods of time in therapy each day. It addresses the needs of individuals whose lives have been affected by a neurological injury or illness or by a complicated medical illness, surgical procedure or trauma.

Co-payment fees are determined and set by the Ontario Ministry of Health and Long-Term Care. Toronto Rehab must charge the co-payment fee just as all Ontario complex continuing care facilities do. A patient may request a reduction or exemption based on income.

Patients who are capable of making their own health care decisions have the legal right to make informed health care treatment decisions. Patients or their substitute decision-maker can legally consent to, or refuse, treatment once they have been informed of their choices and appreciate the consequences of each choice.

Under the Ontario Health Care Consent Act, patients admitted to this program who are incapable of making health care decisions for themselves or about their own care, must have a substitute decision-maker. The substitute decision-maker may be a holder of a continuing Power of Attorney for Personal Guardian. Patients who are capable of making their own health care decisions can also complete an Advance Directive for Health and Personal Care and state in this directive their wishes for future treatment should they become incapable of making such decisions. Toronto Rehab will respect all valid Advance Health Care Directives (AD).

Discussions about treatment decisions will take place upon admission with the attending physician and can be discussed with other members of the team as appropriate. Documentation of treatment decisions will guide the physician and team during the patient's stay on the unit and in the event that the patient requires acute treatment.

The average length of stay for patients in Complex Medical Services is about 225 days. For those participating in the Low Tolerance Long Duration (LTLD) rehabilitation program, the expected length of stay is approximately four months.

Patients are generally considered ready for discharge when they consistently no longer need the level or scope of care and services provided by the Complex Continuing Care program. They may return to their own home, or may be discharged to another appropriate discharge destination where the level of care they now need can best be met.

You can support your loved one's care in many ways: by attending family conference meetings; by visiting whenever possible and by becoming actively involved in Complex Continuing Care life at the E.W. Bickle Centre for Complex Continuing Care. You are also encouraged to participate as a member of or as an attendee at the Patient Family Council which holds monthly meetings. The Patient Family Council assists and advises program leadership on matters relating to patient care and services to promote the highest quality of care for patients and families.

At any given time there may be a short waiting list though admission can be processed fairly quickly.

Yes, we do offer tours of our facilities. Please contact the admissions coordinator at 416-597-3422, ext. 2504 for details.

Please go ahead and refer this person. The definition of someone requiring Complex Continuing Care is broad and so our admissions team reviews each application thoroughly. If the person is not right for our program we will explain why.

Yes. We schedule regular onsite appointments for patients to see medical specialists such as an otolaryngologist (ENT), gynecologist, and urologist. Appointments may be scheduled in clinic areas or at the bedside if necessary. We also offer specialized dental, chiropody, optometry, audiology, AAC, and wheelchair seating services.

What therapy services are available to patients?

While we do offer limited physiotherapy and occupational therapy services, the Complex Continuing Care Program is not a rehabilitation program. Instead it is the focus of this program to help each patient achieve an optimal quality of life. We do this, in part, by providing patients with therapeutic and leisure activities. Patients in the Low Tolerance Long Duration rehabilitation program spend shorter periods of time in therapy each day over a longer period of time than traditional rehabilitation programs.

Similar to other patients in the program, patients in the dialysis stream must require specialized medical and nursing care. Patients must also be able to tolerate transport three times a week between the E.W. Bickle Centre for Complex Continuing Care and the University Centre, where the dialysis suite is located. Transportation is provided by private ambulance.