During the COVID-19 pandemic, the media provided daily coverage of this unprecedented crisis in the history of the 21st century. Some topics, such as how the virus affected older adults, were widely covered. The way in which COVID-19 was documented evoked a ‘tragedy’ narrative through consistent reporting about the suffering it was causing and the deleterious consequences it had on specific populations, including residents of long-term care homes (LTC). This article explores how reports on COVID-19 in LTC homes in a national newspaper (The Globe and Mail) fuelled a tragedy discourse that modulated the value of life of older adults living in those environments. We used critical discourse analysis and analysed 74 articles focusing on older persons residing in LTC homes in two Canadian provinces (Quebec and Ontario) during COVID-19. This article offers a brief overview of the notion of tragedy and how the discourse of tragedy is intertwined with humanitarian crises, life and death, and the value of life. Our findings revealed the construction of three types of tragedies that shape our societal values around life and death in LTC: the tragedy of the threat to life, the tragedy of the unfortunate (old, vulnerable and lacking in agency) and, finally, the tragedy of historical neglect and abandonment. Our findings suggest that the nature of reporting on life and death in LTC homes during the COVID-19 pandemic provoked a sense of fear and pity for a passive other. Re-thinking what gets reported in the media, including whose voice is represented/missing and how tragedy narratives are balanced with contesting stories, could elicit more sentiments of solidarity and action rather than reinforce pity, distancing and immobilisation.

The literature on ethics in health care that explores the moral concerns of care providers typically focuses on registered health professionals and ethical dilemmas in acute and primary care. Far less attention has been paid to the long-term care (LTC) environment and non-registered, direct care workers. To address this gap, this research examined the moral concerns of personal support workers (PSWs) who provide direct care to residents. Data were collected during a 5-year participatory action research project to formalize palliative care programs in LTC homes. Eleven focus groups explored PSWs’ experiences providing palliative care in LTC homes, their challenges and learning needs (n = 45). In-depth secondary analysis of these focus groups found that PSWs experienced moral dilemmas. Two main moral dilemmas were ensuring that residents don’t die alone; and providing the appropriate care based on residents’ wishes. Their organizational constraints coalesced around policies, hierarchy, time, and balancing residents’ needs.

Growing demand for beds in government-subsidized long-term care (LTC) homes in Ontario is causing long waitlists, which must be absorbed by other residential alternatives, including unsubsidized retirement homes. This study compares Ontario’s LTC homes and retirement homes for care services provided, funding regimes, and implications of differential funding for seniors. Descriptive data for both types of homes were collected from public and proprietary sources regarding service offerings, availability, costs, and funding. Overlaps exist in the services of both LTC and retirement homes, particularly at higher levels of care. Although both sectors charge residents for accommodation, most care costs in LTC homes are publicly funded, whereas residents in retirement homes generally cover these expenses personally. Given waitlists in Ontario’s LTC homes, many seniors must find residential care elsewhere, including in retirement homes. Several policy alternatives exist that may serve to improve equity of access to seniors’ residential care.

Quality of life (QoL) of long-term care (LTC) facility residents is an important outcome of care. This cross-sectional, descriptive study examined the self-reported QoL of LTC facility residents in Canada using the interRAI Self-Report Nursing Home Quality of Life Survey instrument. A secondary purpose was to test the instrument’s psychometric properties. Psychometric testing of the instrument supported its reliability and its convergent and content validity for assessing the residents’ QoL. Findings showed that residents rated positively several aspects of their life, such as having privacy during visits (76.9%) and staff’s being honest with them (73.6%). Residents gave lower ratings to other aspects such as autonomy, staff-resident bonding, and personal relationships. The findings point to gaps between facility philosophies of care and their translation into a care environment where care is truly resident-directed. Moreover, the findings have potential implications for resident care planning, facility programming, social policy development, and future research.

Background: The IPA Taskforce on Mental Health Issues in Long-Term Care Homes seeks to improve mental health care in long-term care (LTC) homes. The aim of this paper is to provide recommendations on comprehensive assessment of depression and behavioral problems in order to further stimulate countries and professionals to enhance their quality of care.

Methods: Existing guidelines on comprehensive assessment of depression or behavioral problems in nursing home (NH) patients or patients residing in LTC homes were collected and a literature review was carried out to search for recent evidence.

Results: Five guidelines from several countries all over the world and two additional papers were included in this paper as a starting point for the recommendations. Comprehensive assessment of depression in LTC homes consists of a two-step screening procedure: an investigation to identify factors that influence the symptoms, followed by a formal diagnosis of depression according to DSM-IV-TR or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease in cases of dementia. Comprehensive assessment of behavioral problems encompasses three steps: description and clarification of the behavior, additional investigation, and assessment of probable causes of the behavior. The procedure starts in the case of moderate behavioral problems.

Conclusion: The recommendations given in this paper provide a useful guide to professional workers in the LTC sector, but clinical judgment and the consideration of the unique aspects of individual residents and their situations is necessary for an optimal assessment of depression and behavioral problems. The recommendations should not be rigidly applied and implementation will differ from country to country.