Thank you for answering this survey. The survey should take about 10 minutes to complete.

Patient Ombudsman is interested in hearing about the experiences of long-term care home residents and their family members/caregivers during the COVID-19 pandemic even if there was no COVID-19 outbreak in your relative/friend’s home. We want to know about your experience since the beginning of the pandemic, March 2020 until now.

If you had more than one relative or friend living in a long-term care home at any time between March 2020 and now, please select one person and answer the survey questions based on that person. 

For at least some of the pandemic, visitation restrictions were in place and you may not have direct knowledge of all of the circumstances and conditions in the long-term care home. Please answer the questions based on the best of your knowledge or recollection.

If feasible, please also consider helping your relative or friend in long-term care to complete a resident survey about their own experience during COVID-19. 

All personal and other information collected for this survey will be handled confidentially and only for the purpose of Patient Ombudsman’s investigation

Question Title

* 1. What is your relationship to the person who was a long-term care home resident?

Question Title

* 2. What is the name of the Long-term care home where your relative/friend lived between March and June 2020 (Optional):

Question Title

* 3. In what city/town is the home located (Optional):

Question Title

* 4. If you know, please check the type of long-term care home:

Question Title

* 5. Were there one or more COVID-19 outbreaks in the home where your relative/friend lived between March 2020 and now?

Question Title

* 6. If there were one or more COVID-19 outbreaks, when did they begin? (Please check as many as apply)

Question Title

* 7. If there was a COVID-19 outbreak at the home where your relative/friend lived, who became ill? 

Question Title

* 8. Were there resident deaths because of COVID-19?

Question Title

* 9. Did your relative/friend become ill with COVID-19?

Question Title

* 10. What type of room did your relative/friend live in the spring of 2020?

Question Title

* 11. If there was an outbreak in the home, was your relative/friend moved to a different room to help prevent the spread of COVID-19?

Question Title

* 12. To the best of your knowledge, did your relative/friend experience a reduction in the level of support or quality of care provided in the long-term care home during the COVID-19 pandemic? Please check all that apply.

  Much better Better No change Worse Much worse
Help with meals and snacks
Help walking or moving around 
Help to get out of bed
Help putting on and taking off clothes
Washing/bathing
Daily oral care (mouth care, brushing teeth, denture care)
Foot and nail care
Nursing care
Medical care
Emotional support
Rehabilitation/therapy
Dental/denturist care
Activities and recreation
Maintenance/repairs for assistive medical devices (for example, walker, wheelchair, hearing aid)
Help with medications and drugs
Meal choice
Support for special diets
Quality or amount of food
Spiritual/religious support
Cleaning of resident’s room and common areas

Question Title

* 13. Did you have concerns about the level or quality of care your relative/friend received in the long-term care home before the COVID-19 pandemic?

Question Title

* 14. Was your relative/friend confined to their room to prevent the spread of COVID-19 or because staff were not available to help?

Question Title

* 15. Was your relative/friend left in bed all day because staff were not available to help?

Question Title

* 16. Was your relative/friend denied the ability to go outside to prevent the spread of COVID-19 or because staff were not available to help?

Question Title

* 17. Did you notice an overall decline in the health or well-being of your relative/friend living in a long-term care home between March 2020 and now related to COVID-19?

Question Title

* 18. If you answered ‘Yes’, what changed in your relative/friend’s health or well-being? Please check all that apply.

Question Title

* 19. What is the mother tongue of your relative/friend living in a long-term care home?

Question Title

* 20. Does your relative/friend normally receive services in their mother tongue in the long-term care home?

Question Title

* 21. If you answered yes to question 20, did the COVID-19 pandemic affect access to services in their mother tongue between March 2020 and now?

Question Title

* 22. Did you raise concerns with anyone about the level of support or quality of care your family member/friend received in the long-term care home between March 2020 and now?

Question Title

* 23. Who did you share your concerns with? Please check all of the people or organizations you shared your concerns with.

Question Title

* 24. What types of help or support did you routinely provide to your relative/friend in the home prior to the COVID-19 pandemic? Please check all examples of support you provided.

Question Title

* 25. How often did you visit and provide support before the COVID-19 pandemic?

Question Title

* 26. At the time when visitors were not allowed, were you able to communicate with your relative/friend living in a long-term care home?

Question Title

* 27. How were you able to communicate with your relative/friend? Please check all forms of communication available to you. 

Question Title

* 28. If communication wasn’t possible, what was the problem? Please check all concerns that you experienced.

Question Title

* 29. How often were you able to communicate with your relative/friend?

Question Title

* 30. Were you able to communicate often enough with your relative/friend?

Question Title

* 31. Were you able to get updates from staff at the long-term care home about your relative/friend’s health and condition? Please select all that apply to your experience.

Question Title

* 32. Were you able to get answers to your questions about your relative/friend’s condition or the situation in the long-term care home?

Question Title

* 33. Did the long-term care home contact you with information about the COVID-19 situation in the home and communicate how the home was responding?

Question Title

* 34. If you answered ‘Yes’ to question 33, what information did you receive? Please check all that apply to your experience.

Question Title

* 35. How was the information communicated? Please check all that apply.

Question Title

* 36. Did you experience any negative effects as a family member or caregiver? Please check all that apply to your experience.

Question Title

* 37. Did you ask to visit your relative/friend for compassionate reasons?

Question Title

* 38. If you answered ‘Yes’ to question 37, for what compassionate reason? Please check all reasons based on your experience.

Question Title

* 39. Was your request approved?

Question Title

* 40. If you were refused access, did you receive an explanation for the decision?

Question Title

* 41. What reason was given for refusing your request to visit?

Question Title

* 42. Were you able to visit your relative/friend when visits resumed?

Question Title

* 43. What problems, if any, did you experience when visits resumed? Please check a many as apply.

Question Title

* 44. Have you received the COVID-19 vaccine?

Question Title

* 45. If you chose to not get the vaccine, why not?

Question Title

* 46. Is there anything you want to add? (For example, concerns or issues the survey didn’t cover, suggestions for an improved experience in future outbreaks, compliments on how the staff or management of the home coped with the situation)

0 of 46 answered
 

T