Understanding Emotion-Based Care

The implementation of an emotion-based approach to organizing and delivering care is the revolutionary change needed in LTC. Small home-like environments provide eight to sixteen residents with the ‘stuff of life’. A life of meaningful activities surrounded by staff who interact with them and care for them with empathy and kindness.

An emotion-based approach to care looks like:

  • A warm, caring environment that feels like home.
  • Staff truly know their residents, their families, and understand their lived experiences.
  • Schedules and routines match residents’ preferences and needs.
  • Meaningful activities that engage residents according to their abilities and what brings them joy.
  • Relationships thrive between and amongst staff, volunteers, residents, and their families.

An emotion-based approach to care means:

Using a relationship-based approach to care where residents, staff and families feel part of a community and are treated with dignity and respect.
Setting up small home-like environments of 8-16 residents/unit with shared living spaces such as a living room or kitchen.
Leadership committed to a relationship-based approach to care.
Employing full time, well-paid staff, who are trained in empathy and who understand the culture change required in these facilities.
Hiring staff based on emotional intelligence.
Recognizing families and caregivers as integral members of the team.
Engaging volunteers who are trained in empathy and culture change.

These changes can happen in our LTC homes if the following are addressed:

Staff and Volunteers
Working Conditions
Value, support, recognize and respect all staff and volunteers for their work.
Provide fair compensation with fitting salaries and benefits including sick leave.
Ensure staff positions are full-time wherever possible with staff dedicated to working only in one long-term care home and with realistic workloads.
Provide more hours for direct care.
Recruitment and Retention
Recruit staff and volunteers who exhibit emotional intelligence, empathy, compassion, have a willingness and ability to learn new approaches, and work as a team.
Actively involve staff and volunteers in decision-making that is integral to better resident care.
Education / Training
Educate staff and volunteers on relationship-based approaches.
Strengthen staff and volunteer skills in empathy, social interaction and team work.
Provide timely, on-the-job continuing education for staff and volunteers that is responsive to changing residents’ needs.


Many LTC homes in Ontario are old and outdated with some residents living four to a room and sharing one bathroom.
Support shift from institutional to home-like environments.
Require facilities (existing and new) to create an environment that supports a culture of person-centred care, shared living spaces, and private bedrooms.
Shorten provincial timelines for requirement of homes to meet most recent standards for LTC building design.


Use cumulative reports of LTC home inspections and data to guide timely improvements in Ontario’s provincial LTC system. Engage family councils, residents, families and front-line staff in this process.
Evolve the role of LTC inspectors to that of compliance advisors or resource persons who foster a partnership between government funders and providers of care.


Value, support, recognize and respect families and caregivers as part of the community in the home.
Activate timely and up-to-date communication protocols between families and LTC homes when a crisis occurs.
Support and help maintain family-resident relationships when a crisis occurs.

Innovative models

There are several innovative models of care that have embraced effective change and that already exist in other countries, with a few in Canada and even Ontario. These are The Butterfly Model, The Eden Alternative, The Hogewey Villages, and the Green House Project. These models have shown better outcomes than our traditional homes by decreasing aggressive incidents, decreasing the use of antipsychotic drugs, decreasing the number of staff sick days (in one case up to 75%), and an increase in social interaction. Although these homes have their own unique features, they all subscribe to an emotion-based model of care. In Ontario there are a growing number of homes that have, or are in the process of, developing a unit/units which are following the Butterfly model.

The CARP Ottawa Chapter, with the support of CARP Chapters across Ontario and nationally have been championing the needs of LTC residents and the importance of Transforming the delivery of care models in long-term care homes. You can find out more about their advocacy and the different models of care on their campaign page.  www.changeltcnow.com

Click here to read, print, share our Transform Long Term Care, PDF

Please take a moment to watch this video and witness what an emotion-based transformation looks like, in Mississauga, Ontario today.