Recurrent themes from the GLTCRC include violence in long- term care (LTC), elder abuse and medical management, including medication use, restraints, consent and capacity and the management of dementia and psychiatric illness.

A prominent theme in this year’s reviews was the challenges associated with transitions of care. When the decision is made that a person requires LTC, they should be placed in a LTCH, not temporarily housed in a setting that cannot provide the requisite care. Once there, they require the prompt attention of the care team, including the physician, in order to ensure a safe and successful move. This settling in period is recognized as being a time of risk for delirium, behavioural changes and for violent interactions with other residents. A coordinated, proactive approach can reduce this risk.

The elderly as a population present challenges in the management of complex medical and psychiatric conditions; they are best served by a multidisciplinary team of providers with specialized skills. This starts at the level of training and finishes with oversight and effective quality review.

The GLTCRC appreciates the many Ontarians involved in the provision of care to the elderly. These individuals have taken on the responsibility for this valuable, and at times vulnerable, segment of our population, and they do so with considerable skill and dedication. It is hoped that the work of this committee will be of assistance to them and to the families of those whose deaths have been reviewed.