Managing the transition to a CHSLD

What is a CHSLD?

A long-term care facility (CHSLD) is an institution that provides care and services to people with functional or psychosocial impairments who can no longer remain in their natural living environment, despite the support of their family and friends.

The services offered include room and board, assistance, supervision, nursing and medical services, pharmaceuticals, psychosocial services and rehabilitation.

Three types of CHSLDs

There are three types of residential and long-term care centres in Québec:

• Public CHSLDs. Entirely managed by the government, their costs are determined by the government according to specific criteria (type of room, income and assets of the person, etc.).
• Contracted private CHSLDs, run by private owners who receive a subsidy from the Ministère de la Santé et des Services sociaux. The costs and admission requirements are the same as for public CHSLDs
• Non-contracted private CHSLDs, run by private owners who do not receive any subsidies from the Ministère de la Santé et des Services sociaux. Admission requirements, operations, and prices may vary from one centre to another

In 2020, Québec had 313 public CHSLDs, 59 private CHSLDs under contract, and 40 non-contracted private CHSLDs. A process is currently underway to bring non-contracted private CHSLDs under contract.

How do you secure a place in a CHSLD?

Securing a place in a CHSLD varies depending on the type of CHSLD you are looking for. For private CHSLDs that are not under contract, you must apply directly to the facility.

For public or private CHSLDs that are under contract, the process is as follows:

1. Apply for admission through the CLSC
2. Undergo a medical assessment
3. Have your application reviewed, taking into account your preferences
4. Obtain the beneficiary’s consent for admission
5. Admission of the beneficiary when a bed becomes available

Please note:

• A waiting list for a place in a CHSLD shows the number of people registered for a place
• It is possible to estimate the amount of the contribution
• Visits to assess the quality of living environments, by region, are available online

Managing the transition to a CHSLD

As a caregiver, the prospect of managing the transition of someone you are caring for to a CHSLD can be difficult:

• It is often the culmination of a search for other types of accommodation, such as intermediate resources, family-type resources, and private seniors’ residences
• When the application for admission to a CHSLD is submitted, 41% of people are in a hospital, 12% in a private seniors’ residence and 24% at home. The current situation of the person you are caring for may already be delicate
• The person whose transition to a CHSLD you are managing may not be elderly. Unfortunately, this is sometimes the case when there is no better option
• You are anticipating consequences related to this transition. A change to a long-term care facility can trigger certain emotions, particularly given the situation of the vast majority (85%) of residents

There are solutions to help manage the transition. You can prepare for the move in detail and/or use a checklist to prepare for their arrival at the CHSLD.

Questions and possible solutions

My father has found a place. I feel very guilty. Is there any help available?

You are by no means alone in this situation. Some people describe moving into a CHSLD as a form of exile. There are solutions available to help you deal with feelings of guilt. In addition, preparing for the move of the person you are caring for could make the transition easier. Finally, you could discuss this aspect with the spiritual care provider assigned to your father’s centre.

My sister tells me that some care services are at her expense. Is this normal?

Some care and services are not included in the contribution, such as hairdressing, foot care, and Internet access. If your sister is referring to dental care, it should be covered, in whole or in part, under the Programme québécois de soins buccodentaires et de soins d’hygiène quotidiens de la bouche en CHSLD.

I’ve heard about CHSLDs that have a specific culture…

It’s true, we’re talking about “supraregional ethnolinguistic” CHSLDs. For example, in eastern Montréal, there is the CHSLD Dante for Italian clients, and the CHSLD Polonais Marie-Curie-Sklodowska for clients of Polish and Slavic origin.

I witnessed a situation that really concerned me. It involved a person on the same floor as my sister. What should I do?

You could talk to the care team and work together to find solutions. If your concern persists, you can contact the complaints and service quality commissioner of the CISSS or CIUSSS responsible, or the Ombudsman as a second resort.