Long Term Care Context

Importance of Relational Care

Older persons comprise about one-quarter of the Canadian population, and are the group hardest hit by COVID-19. This is especially the case for older persons residing in long-term care homes (LTCH), which comprise of most deaths from COVID-19. Healthcare providers in LTCH settings are also increasingly being affected by the virus, further straining the workforce and compromising the care and well-being of both groups. 


Relational care refers to care that is built on the importance of human connectedness for health and well-being, and the understanding that people need compassionate relationships for meaningful contact and for growth.  In the LTCH context, relational caring fosters interpersonal bonding,  dialogue, and collective decision-making among older persons, their families, and HCPs, and is built on reciprocity, respect for multiple and divergent viewpoints, and trust and consensus. As long-term care homes struggle to meet the basic physical needs of older adults during the pandemic, relational caring approaches have been severely compromised despite being critical to quality of life. The prioritization of infection control during the COVID-19 pandemic has placed relational caring at risk. Ontario has been directed to isolate older persons from their families and communities, and group activities and social programs have also been significantly reduced. Additionally, the physical barriers needed to control infection (plexiglass, screens, masks, and gloves) can exacerbate sensory deficits, distort recognition and communication, and increase isolation, anxiety, and agitation. Despite these barriers, there are reports that families and HCPs have developed creative means to promote relational care throughout the pandemic. 

Our research project goals

This research aims to understand the impacts of the pandemic and document strategies used to sustain relational caring and critical to improving the response to the pandemic situation in LTCHs. Due to the suspension of research activities in clinical settings, this study will target HCPs and family members, who have access to required technology for data collection.


How you can participate

Flexible options for participation will be provided where participants will be provided with two options to participate: an on-line open-ended questionnaire, OR a semi-structured telephone or virtual interview. Those wishing to participate using the questionnaire can access to the study site via a secure link in our recruitment materials. 

The questionnaire and interview guide are designed to capture challenges brought about by COVID-19 and the details of a critical incident, when/where it occurred, who was involved, their role, how the incident affected older persons/Health Care Providers/family members and relational caring practices, and factors that supported or threatened relational caring during the pandemic, including innovative and creative strategies developed to sustain relational caring. Participants will also complete demographic profiles. 

The questionnaires will also explore specific challenges brought about by COVID-19: how these have affected capacity to deliver relational care, as well as any innovative solutions that were developed to mitigate these challenges. Completion of the questionnaire will be considered to indicate consent to participation. Recognizing the financial insecurities resulting from the pandemic, each participant will be provided with a small honorarium valued at $50.00 to compensate for their time.

This study has been reviewed by and received ethics clearance from the Research Ethics Board of Ryerson University (REB#2020-553) and University of Waterloo (REB#42321).

Who is eligible to participate?

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Administrators, Advanced Practice Nurses, Chaplains, Dieticians, Family members of older persons in long-term care homes in Ontario, Managers, Nurse Educators, Occupational Therapists, Personal Support Workers, Pharmacists, Physicians, Registered Nurses, Registered Practical Nurses, Recreational Therapists, Social Workers, Spiritual Care Practitioners. 

You are eligible to participate if you are:

  • 18 years of age or over

  • A family member who has cared for an older family member (65 years old and above) who is or has been a resident of a long-term care home in Ontario during the COVID-19 pandemic

  • A healthcare provider who has worked as a healthcare provider in a long-term care home in Ontario during the COVID-19 pandemic. Note: if you participated in the previous ARC-MCU study (Fall 2020), you are still welcome to participate in this study.


Previous ARC-MCU Study
(Participation Closed December 2020)

Aging Relational Care Study Context

It is critical to understand how best to support older persons and their care during the pandemic in a variety of care settings, not exclusive to long-term care. It is also important to understand how to support the health and wellbeing of healthcare providers who are caring for older persons during this crisis.

The purpose of this study is to understand, how best to support relational care of older people in pandemic times across a variety of care settings. We are also interested in understanding from the perspectives of healthcare providers in a range of practice settings, how the relational care of older persons has changed during the pandemic and how these changes are affecting healthcare providers' mental health and wellbeing, and what innovative strategies they have developed to overcome these changes.


A qualitative, critical incident method that focuses on generating practical solutions to real problems will be used to guide data collection and analysis. A total of 200 healthcare providers including nurses, practical nurses, personal support workers and other healthcare workers that provide direct care to older persons, will be recruited.


They will be provided a link to an online critical incident questionnaire (Opinio platform) where they will type responses. Demographic data will be analyzed using descriptive statistics. The typed responses will be analyzed using thematic analysis. Findings will provide critical information that Ontario urgently needs to improve the care for older persons during the pandemic crisis while protecting the health and wellbeing of HCPs caring for older persons. We expect that the creative and innovative strategies for relational care and other lessons learned will be of immediate value and use to HCPs, clinical educators and administrators across health-care sectors, but in long-term care settings, in particular.