Elder Care Home Safety in Canada: Preventing Falls, Infections, and Risks at Home or in Long-Term Care

Discover how to keep seniors safe in Canada’s homes and long-term care facilities. Learn about fall prevention, infection control, and caregiver support with practical tips and updated safety standards.

Caring for older adults in Canada has never been more important. With nearly one in five Canadians now over the age of 65, safety in elder care settings is a growing concern. Whether a senior is living independently at home, supported through community care, or residing in a long-term care facility, the risks they face—such as falls, infections, and medication errors—can have life-changing consequences.

This article explores the most pressing safety challenges for seniors in Canada and explains practical ways to reduce those risks. We’ll look at differences between home care and facility care, the most common dangers, and what families, staff, and policy makers can do to keep older adults safe.

Understanding Elder Care Settings in Canada

Canada offers a range of care options for seniors, from living at home with supports to more structured facility-based care. Understanding these settings helps families make better safety decisions.

Home Care and Aging in Place

Many seniors prefer to remain at home for as long as possible. Home care services can include personal support workers, nursing visits, or rehabilitation professionals who come to the home. Aging in place offers comfort and independence, but it also brings safety challenges. Risks like poor lighting, clutter, or missed medications can increase the chance of injury.

Assisted Living and Retirement Homes

Assisted living and retirement residences bridge the gap between independent living and long-term care. They typically offer meals, housekeeping, and some personal support. Safety standards can vary depending on the province, since these facilities are often regulated differently from publicly funded long-term care homes. Families should ask about emergency procedures, staff training, and building safety features before choosing this option.

Long-Term Care Facilities

Long-term care (LTC) homes serve seniors with complex medical and personal care needs. These facilities are regulated by provincial governments and often receive funding support. The federal government plays a role in setting national expectations through initiatives like the proposed Safe Long-Term Care Act, while provinces handle day-to-day licensing, inspections, and staffing requirements.

The sector has faced serious scrutiny in recent years, especially after the COVID-19 pandemic revealed gaps in infection control and emergency preparedness. Reports from Health Canada highlight the need for stronger standards, better staffing, and consistent oversight across provinces.

Key Risks in Elder Care & Home Safety

Safety challenges for seniors arise in both private homes and institutional settings. Some of these risks are predictable and preventable, while others require system-wide changes.

Falls and Mobility Injuries

Falls remain the leading cause of injury among older Canadians. According to Public Health Agency of Canada, between 20% and 30% of seniors living in the community experience at least one fall each year, and many of these occur at home. In long-term care, about half of residents fall annually, often resulting in fractures or hospitalization.

Common causes of falls include:

• Poor lighting and cluttered pathways
• Loose rugs or electrical cords
• Slippery bathroom floors
• Muscle weakness, balance issues, or dizziness from medications

A single fall can trigger a loss of independence, leading to long hospital stays or permanent relocation to care facilities.

Infections and Disease Transmission

Infections are a major safety concern in both long-term care homes and private residences. Seniors are more vulnerable because their immune systems weaken with age, and many live with chronic conditions.

In long-term care, outbreaks of influenza, COVID-19, and norovirus can spread quickly because residents live in close quarters and often share common areas. The Public Health Agency of Canada provides guidance on infection prevention, including the use of personal protective equipment, staff screening, and enhanced cleaning. These measures reduce the risk of healthcare-associated infections, which remain one of the most serious threats in elder care.

At home, infections are often overlooked. Something as common as a urinary tract infection can escalate into hospitalization if not detected early. Food safety, proper handwashing, and keeping vaccinations up to date are all simple but essential ways to lower the risk.

Medication Errors and Polypharmacy

Medication management is another critical area of elder care safety in Canada. Many seniors take multiple prescriptions daily, a situation known as polypharmacy. This increases the likelihood of missed doses, overdoses, or harmful drug interactions.

Errors can happen at several points: when medications are prescribed, dispensed by the pharmacy, or administered at home or in a facility. Even something as simple as confusing two pill bottles can have serious consequences.

To reduce risks:

• Use pill organizers and blister packs supplied by pharmacies
• Schedule regular medication reviews with doctors or pharmacists
• Monitor side effects and interactions, especially when new prescriptions are added

Transitions of care are especially high-risk moments. Moving from hospital to home or from home to a long-term care facility often results in medication changes. Without careful reconciliation, seniors may end up taking duplicate or conflicting prescriptions.

Staff Shortages, Training Gaps, and Human Factors

The safety of residents in long-term care homes depends heavily on staff. Across Canada, staffing shortages and high turnover have strained the system. When staff are overworked, the risk of mistakes rises—whether it’s a missed medication, inadequate infection control, or delayed response to an emergency.

Training is equally important. Personal support workers and nurses require regular updates on proper lifting techniques, infection prevention, and emergency protocols. According to a review by Healthcare Excellence Canada, consistent training and strong leadership are key to building a culture of safety in elder care.

Families should feel comfortable asking facilities about staffing levels, staff-to-resident ratios, and ongoing training. Transparency on these points is a good indicator of whether a home prioritizes safety.

Environmental and Structural Hazards

Beyond human factors, the physical environment itself can create risks. Older buildings may lack modern safety features such as sprinkler systems, automatic fire doors, or wheelchair-accessible layouts. Tragic events, such as the L’Isle-Verte nursing home fire in Quebec, highlighted the importance of proper fire safety measures in long-term care.

Common hazards include:

• Narrow hallways that make it difficult for staff to respond quickly
• Shared rooms with limited privacy and infection control challenges
• Poor ventilation or outdated heating and cooling systems

Many provinces now require long-term care homes to retrofit sprinklers and meet updated building codes, but compliance varies. Families should tour facilities carefully and pay attention to physical details like lighting, flooring, and emergency exits.

Quick Reference: Common Elder Care Risks

Safety Measures and Best Practices in Long-Term Care Facilities

While risks in elder care homes cannot be eliminated entirely, strong safety systems can reduce harm and improve quality of life. Canadian long-term care facilities are increasingly adopting structured programs and physical improvements designed to protect residents.

Environmental and Engineering Controls

Creating a safe physical environment is the foundation of elder care home safety in Canada. Simple changes can prevent accidents:

• Grab bars in hallways and bathrooms support mobility.
• Non-slip flooring reduces the chance of falls.
• Adequate lighting in corridors and bedrooms helps residents navigate at night.
• Clear pathways and clutter-free rooms improve staff access in emergencies.

Bathrooms deserve special attention, as most falls occur there. Walk-in showers, raised toilet seats, and easy-to-reach storage all improve safety. Facility design that balances accessibility with resident comfort can make a significant difference.

Infection Prevention and Control (IPAC) Programs

Infection prevention is now a legal and professional requirement in long-term care. The Public Health Agency of Canada outlines national standards for hand hygiene, use of personal protective equipment, and outbreak response.

Many provinces require facilities to designate an infection control lead and maintain an active surveillance program. These programs track infections, flag outbreaks early, and implement containment measures. Families should ask facilities about their IPAC protocols, including vaccination policies, staff training, and visitor screening.

Staff Training, Protocols, and Auditing

Even the best policies are ineffective without properly trained staff. Ongoing professional development is critical. Training topics typically include safe lifting and transfer techniques, infection control, and emergency evacuation procedures.

Regular audits and drills ensure that staff are prepared for real-life scenarios. For example, mock fire evacuations or medication audits can reveal gaps before they become safety incidents. Facilities that conduct routine quality improvement cycles tend to report fewer safety issues.

Fire and Emergency Preparedness

Fire safety remains a priority in long-term care. Following tragic events in older facilities, most provinces now mandate sprinkler systems in every home. Evacuation plans must be clearly posted, and staff should participate in regular drills.

Emergency preparedness also extends to severe weather, power outages, or medical crises. Facilities are expected to have backup generators, accessible emergency exits, and clear communication systems for families. The Canadian Red Cross recommends that care homes update emergency plans annually and practice them regularly.

Technology and Innovation in Safety

Technology is playing an increasing role in elder care safety. Modern homes are introducing:

• Fall detection sensors that alert staff instantly
• Smart lighting systems that adjust to movement and time of day
• Wearable devices to monitor heart rate, oxygen levels, or activity
• Video monitoring tools (with consent) to improve oversight without reducing privacy

These innovations complement, rather than replace, human care. Their goal is to provide faster responses and reduce avoidable harm.

Resident-Centred Safety Culture

Beyond physical changes and technology, a strong culture of safety is essential. Facilities that involve residents in safety planning tend to see better results. For example, asking residents for feedback on hallway lighting or floor layouts can highlight hazards staff may miss.

Balancing safety with dignity is also important. Overly strict safety measures may restrict independence. The best homes adopt a person-centred approach that respects residents’ autonomy while keeping them secure.

Home Safety for Seniors: What Families and Caregivers Can Do

Not every older adult lives in a long-term care facility. Many Canadians age at home, supported by family members, community programs, or home care services. While familiar surroundings provide comfort, the home environment can also present hidden dangers if not adapted properly.

Home Risk Assessment and Modifications

The first step in keeping seniors safe at home is a thorough risk assessment. Families can walk through each room to identify hazards such as poor lighting, loose rugs, or cluttered hallways.

Simple modifications include:

• Installing grab bars in bathrooms
• Securing loose cords and removing area rugs
• Adding brighter lighting, especially at entrances and staircases
• Installing ramps or stairlifts for mobility access

The Safe Living Guide from Health Canada provides a practical checklist that families can use to assess risks in every part of the home.

Behaviour and Routine Adjustments

Beyond physical modifications, daily routines can reduce risks. Seniors should be encouraged to:

• Wear supportive, non-slip footwear indoors
• Use canes or walkers when needed
• Avoid rushing, especially at night or when moving between rooms
• Schedule regular vision and hearing checks to catch sensory changes early

Strength and balance exercises, such as tai chi or physiotherapy programs, can also lower fall risk. Community centres often run free or low-cost senior fitness classes that target these needs.

Medication Management at Home

Managing multiple medications is just as challenging at home as in long-term care. Families can reduce errors by using:

• Weekly pill organizers or blister packs from pharmacies
• Reminder apps or alarms for dosing times
• Regular medication reviews with a pharmacist to check for side effects or interactions

The Canadian Pharmacists Association encourages seniors and caregivers to keep an up-to-date medication list and bring it to every doctor’s appointment.

Infection Prevention at Home

Basic hygiene practices remain essential. Seniors and caregivers should wash hands regularly, clean shared surfaces, and follow safe food handling practices. Vaccinations against influenza, pneumonia, and COVID-19 provide an additional layer of protection.

Families should also be alert for early signs of infection, such as confusion, sudden weakness, or loss of appetite. Prompt medical attention can prevent minor issues from escalating into emergencies.

Emergency Preparedness

Every senior household should have a clear plan for emergencies. This includes posting emergency numbers by the phone, keeping a charged cell phone nearby, and preparing for power outages with flashlights and backup batteries.

Caregivers can also prepare a “go bag” with essential items—medications, medical records, identification, and spare clothing—so the senior can leave quickly in case of fire or evacuation.

Support and Oversight

Even with modifications and precautions, seniors living at home benefit from regular check-ins. Families can schedule daily phone calls or visits, or arrange professional home care services for additional support.

Community resources, such as local senior safety programs or health unit initiatives, can provide fall prevention workshops, equipment loans, and caregiver training. These services help families manage the balance between independence and safety.

Regulation, Standards, and Oversight in Canada

Safety in elder care is not only about good practices inside homes and facilities—it is also about the rules that govern them. In Canada, regulation is shared between the federal government, which sets broad expectations, and provinces and territories, which handle licensing, inspections, and enforcement.

National Standards and the Safe Long-Term Care Act

The federal government has supported the development of national long-term care standards, led by the Canadian Standards Association (CSA Group) and Health Standards Organization (HSO). These standards address everything from infection prevention to staff training and emergency preparedness.

Health Canada has also consulted Canadians on the proposed Safe Long-Term Care Act, which aims to improve safety, consistency, and accountability across provinces. While the act has not yet been fully implemented, it signals stronger federal involvement in protecting seniors nationwide. More details are available on the Government of Canada’s health policy page.

Provincial and Territorial Oversight

Each province and territory regulates long-term care facilities differently. For example, Ontario has detailed legislation covering staffing, infection control, and resident rights, while other regions use broader frameworks.

Inspections are carried out at the provincial level, with varying frequency and enforcement powers. Some provinces require unannounced inspections, while others rely heavily on complaints to trigger reviews. These differences can affect the consistency of safety standards across the country.

Accountability, Reporting, and Transparency

Public reporting is an essential part of elder care home safety in Canada. Many provinces publish inspection results, allowing families to compare facilities. Complaints processes are also in place, though they can be complex and intimidating for families.

Independent bodies, such as provincial ombudsmen or commissions, provide additional oversight. Ontario’s Long-Term Care COVID-19 Commission, for instance, highlighted gaps in staffing and infection control and pushed for reforms. Transparency helps ensure that problems are not hidden but addressed quickly.

Challenges and Gaps

Despite efforts to improve oversight, challenges remain:

• Staffing shortages continue to strain care quality.
• Aging infrastructure leaves many homes without modern safety systems.
• Uneven enforcement across provinces creates disparities in resident safety.
• Limited funding makes it difficult for facilities to keep up with evolving standards.

Advocates argue that without stronger national enforcement, some seniors will remain at greater risk depending on where they live. The Canadian Institute for Health Information has repeatedly called for more consistent data and national benchmarks to guide reforms.

Moving Toward Reform

Recent years have brought a stronger focus on regulation. Calls for dedicated federal funding, minimum staffing standards, and mandatory reporting of safety outcomes are gaining ground. While implementation will take time, the momentum suggests that Canada’s long-term care system is moving toward greater accountability.

Programs, Innovations, and Case Studies

While challenges remain, many programs and innovations across Canada are improving elder care safety.

Promising Programs

Several provinces have introduced fall prevention initiatives that combine exercise classes, home safety assessments, and education for caregivers. These programs reduce hospital admissions and help seniors stay independent longer. Technology-based supports, such as remote monitoring and fall detection systems, are also expanding through pilot projects in Ontario and British Columbia.

Lessons from COVID-19

The pandemic highlighted vulnerabilities in long-term care. In response, many homes now limit staff from working in multiple facilities, strengthen outbreak protocols, and improve ventilation systems. The Office of the Chief Science Advisor emphasized that these changes must continue beyond COVID-19 to protect residents from future infectious threats.

How Families and Caregivers Can Take Action

Families play a vital role in elder care home safety in Canada. Being proactive can prevent risks before they escalate.

Advocating with Facilities

Families should feel comfortable asking direct questions:

• What infection control measures are in place?
• How often are safety drills performed?
• What is the staff-to-resident ratio during day and night shifts?

Requesting inspection reports and participating in resident councils are additional ways to hold facilities accountable.

Oversight at Home

For seniors aging in place, families can schedule periodic safety reviews. Using home safety checklists, keeping emergency contacts visible, and ensuring that mobility aids are in good condition can make a meaningful difference.

Respite and Self-Care

Caregivers themselves also need protection from burnout. Local health authorities often offer respite care, support groups, or caregiver training sessions. Taking advantage of these resources ensures caregivers can continue providing safe and attentive support.

Conclusion

Elder care home safety in Canada is a shared responsibility between families, caregivers, facilities, and governments. From preventing falls and managing medications to enforcing stronger regulations, every measure contributes to safer living for older adults.

While risks cannot be eliminated, they can be reduced with thoughtful planning, oversight, and innovation. Families should stay informed, ask questions, and use available resources to create the safest environment possible—whether at home or in a care facility.

For practical next steps, explore resources from your provincial health authority, review the Safe Living Guide for Seniors, or connect with community organizations offering support. By working together, Canadians can ensure that aging with dignity and safety is not just a goal, but a reality.

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