Toronto’s top doctor says there is “no easy answer” for people wondering if they should remove their loved ones from long-term care homes in the wake of COVID-19. 

Speaking at a news conference at city hall on Monday afternoon, Dr. Eileen de Villa said the answer to this “very complex question” will depend on a number of factors.

“Ultimately the decision to remove your loved one from a long-term care home or a retirement home is a personal decision,” she said.

According to the city’s latest data, there have been 135 cases of COVID-19 in Toronto’s long-term care homes and 15 reported deaths.

The provincial government confirmed Monday that there are currently 46 outbreaks at long-term care facilities across the province.

At a long-term care home in Bobcaygeon, Ont., 26 patients have died following an outbreak of the virus.

De Villa said while it is understandable people have questions about whether their loved one should stay in these facilities in the wake of the pandemic, anyone considering this option should make sure they understand the specific daily care needs of their family member before making a decision. 

“Typically, people in long-term care homes are receiving specialized care that is not possible, or at best, challenging to provide within a home setting. Residents of long-term care homes are often frail with many complex underlying health issues and equally complex health care needs,” she said.

 “I would advise anyone considering this step to speak with the long-term care director at the home to inform your decision and to understand the specific daily care needs of your loved one.”

Dr. Asenath Steiman, a geriatrician at University Health Network and Sinai Health System and the clinical lead of the independence at home community outreach team, said for some who are not currently working, they may be in a better position to provide personal care to their loved ones.

 “I think it is going to be very individualized,” she told CP24.com. “Really the main issue is going to be could the care needs of that patient be met out of long-term care.”

She said people need to have up-to-date information about their family member’s care needs, as those routines and needs may have changed since they were first admitted to the home.

Another issue is that the community resources that are typically available to those who need home care, such as assistance from personal support workers, may not be readily available in the current climate, Steiman said.

“The services are still happening but… it might be a little different,” she said. “The resources that are usually there might be strained.”

Steiman said people also need to consider what type of impact the move will have on their loved one, adding that patients with dementia often struggle in new environments.

“It could make things worse temporarily in that new environment,” she said. “They (caregivers) should be prepared for that.”

Another major issue, Steiman noted, is whether the bed will be held for the patient when the pandemic is over.

“The fact that they are going to be leaving long-term care, are they going to be losing their bed now,” she asked. “Will they have somewhere to go back to?”

She said while many facilities will hold beds for patients who require hospitalization, it is not clear how many long-term care homes will opt to hold beds for those who elect to leave.

Steiman said people should get a clear answer to the question before making the decision to remove their loved one from long-term care.

For those who choose to keep their loved ones in long-term care, de Villa said strict protocols are in place to ensure that residents are protected during the pandemic.

She said staff members are directed to work in only one long-term care setting to prevent further spread and staff members are screened for symptoms of illness when they enter the building and when they finish their shift.

She said residents are given twice daily checks for any new onset of symptoms and any resident who displays symptoms are isolated immediately.

Non-essential visitors have also been barred from entering the buildings.

“I understand that it is difficult and worrisome to not be able to visit our loved ones at this time,” de Villa said.

 “I can tell you this; staff  at long-term care and retirement residences are, in my experience, deeply, deeply committed tothe wellbeing of their residents. I know they will do whatever they can to help you stay connected.”

De Villa urged members of the public to continue social distancing to keep essential workers, including long-term care staff, healthy.

“I would like to take this opportunity to thank each and every person working in a long-term care homeor a retirement home caring for our loved ones,” she said.