Can I be treated at home for a serious illness?

If you get seriously ill, you may not be able to be treated at home, even if:

• it's what you want, and
• you're willing to take the risk.

If you have a communicable disease, the law gives medical officers of health the power to take steps to protect other people from being harmed.

Communicable diseases are diseases that can be spread from one person to another and cause many people to get sick. COVID-19 is one example of a communicable disease.

A medical officer of health can order you to go into the hospital for care. If you refuse, they can get a court order saying you must go. The court order will also say that if you refuse, paramedics and the police will take you.

There are public health units across Ontario. Each one is led by a medical officer of health.

Making medical decisions

If your illness becomes life threatening, you can still make decisions about your medical treatment, as long as you're mentally capable.

The health-care professional who's treating you decides whether or not you're mentally capable. If you're mentally incapable, this means that:

• you're not able to understand the information needed to make personal care decisions, or
• you're not able to appreciate what might happen when you make or refuse to make personal care decisions.

While you're mentally capable, you can refuse treatment or choose to get only palliative care, unless your decision puts other people's health seriously at risk.

Substitute decision-makers (SDMs)

If you're no longer mentally capable, a substitute decision-maker (SDM) will have to make decisions for you.

If you made a Power of Attorney for Personal Care, this could be the person you named as your attorney.

If you don't have a Power of Attorney for Personal Care, there are rules about who can be your SDM. Read more about these rules and what it means to be mentally capable in How do I make a Power of Attorney for Personal Care?

Choosing palliative care

Palliative care is special medical care for people living with a serious illness. It helps people get relief from the symptoms of their illness. This could include helping you with eating, bathing, and going to the toilet, or giving you oxygen or pain medication as your illness gets worse.

If you can't get enough palliative care from Ontario Health atHome or private agencies, friends or family members will have to help you.

Making difficult choices

Think about how choosing to stay at home will affect your caregivers. Ask yourself:

• Will they have to quit their job or ask for a leave to care for you?
• Will caring for you damage their health? For example, will they have to get up many times in the night to look after you?
• Do they also have young children to care for?

There are special risks if your illness is communicable and spreads easily. What will happen if your caregivers can't protect themselves, even if they use personal protective equipment, such as masks and gloves? What if they don't know how to care for you safely?

For example, your caregiver could be at risk of getting your illness if:

• your home only has one bathroom, or
• you cannot be isolated in a separate room

It's up to you or your SDM, not your doctor, to decide what medical treatments you get.

Talk to your doctor, your SDM, and your family members about why you want to stay at home, even if there are risks. This will help your caregivers understand and support the choices you make about your treatment.