The Role of Long Term Care Homes in the Health Care System

By Dr. Mary-Lou Kelley, Lakehead University

The role of long term care homes in the health care system has changed drastically over the last 20 years. With advances in home and community care, peoplenow live at home much longer with a higher quality of life. If people move into long term care homes, they require care for complex, chronic, progressive and life limiting conditions, often including Alzheimer’s Disease. Most residents will live in their long term care home until they die and would benefit by receiving specialized palliative care in the last year of life to address their psychological, social and spiritual needs as well as manage pain and symptoms. Long term care staff is dedicated to supporting quality of life for residents to the end of their lives, however, the Quality Palliative Care in Long Term Care Alliance advocates new strategies to support long term care homes to develop and deliver formal palliative care programs. These are some examples:

  • Front line workers who provide the majority of direct care have developed specific competencies in palliative care and are included in creating and implementing guidelines and protocols for a palliative approach in long term care homes.
  • All direct care staff have access to education that is innovative and practical, such as high fidelity simulation labs to learn the best ways of communicating with residents and families about end of life issues. 
  • Routine interprofessional palliative care conferences or comfort care roundsare conductedthat include the resident, family and staff and facilitate care planning for quality of life at the end of life. 
  • Long term care homes formalize policyaboutproviding palliative care and provide grief and bereavement support to all staff, families and residents.
  • Community partners are actively engaged in supporting long term care staff to provide palliative care, for example hospice volunteer visitors, palliative pain and symptom management consultants or Alzheimer Societies who provide education and family support.

Long term care homes have become a major location of death in Ontario and the trends suggest that their role in providing end-of-life care will increase into the future. Palliative care programs have demonstrated they can increase client satisfaction and quality of life for people. For more information on palliative care in long term care or on the work of the Quality Palliative Care in Long Term Care Alliance please visit