Misconceptions vs. Reality: Reframing Conversations About Long-Term Care
By: Jess Downer
As a McMaster student, this past summer, I had the opportunity to work in a long-term care home and got to work alongside the most lovely, dedicated colleagues. I had the pleasure of connecting and building relationships with various residents within the home and developed bonds. As this job came to an end, I realized that a lot of my own thoughts and ideas about long-term care were thoroughly challenged throughout the summer.
Through this experience I not only learned a lot about skilled nursing facilities for older adults, but also about myself and what I want in my future. It is no secret that most people want to age in place, typically in their own home and on their own terms. It’s also just as important to understand what long-term care really looks like (and what it doesn’t), even if we have no intention of going there or hope not to need it.
What comes to mind when you hear “long-term care”? I can imagine when thinking of long-term care, ideas such as institutional settings (something hospital-like), lack of capacity, and loss of independence come to mind, but this is not always the case. These negative connotations are also impacted by overwhelming amounts of headlines during the COVID-19 pandemic, and thus, long-term care often is reduced to a last resort option. I hope to be able to convey a better understanding of what long-term care actually is (and is not), and to help you to plan better for the future. Although you may never need long-term care yourself, chances are someone close to you may, so it’s important to be prepared.
Below I will address common misconceptions, and how ongoing aging research can challenge these ideas:
Misconception 1: “Long-term care is ONLY for people at the end of their lives.”
In reality, long-term care offers an option for individuals with ongoing, reoccurring and/or complex needs, and is not merely for older adults. It has actually become increasingly more common for young and middle-aged adults with chronic conditions such as traumatic brain injury to live in long-term care settings due to the ‘around-the-clock’ nature of care. In Ontario specifically, the long-term care system, while addressing needs of older adults more often, also supports a broad range of needs for Ontarians. Most recently, in July 2025, the Government of Ontario announced The Local Priorities Fund (LPF), an allocation of approximately $35 million dollars to support long-term care residents’ complex needs, utilizing specialized and individual equipment, as well as new and innovative programs (Government of Ontario).
Misconception 2: “Once you enter care, you lose all independence,”
Increasingly, long-term care homes are starting to model a far more individualized focus called ‘person-centred care planning and providing’ . This means that based on the individual, a care plan is created and enforced, often meeting the person at their level of independence or need. Residents are given a variety of choices (e.g., food choices, events to attend, social routines) and continue to be independent in the capacity that they are able. An Ontario-wide initiative, called Ontario Association of Residents’ Councils (OARC), creates and provides tools to assist care homes in implementing resident councils and elements of collaborative design. In the long-term care home I had the pleasure of working in, the life-enrichment team provided reoccurring 1-on-1 visits with residents (in one instance, a resident was able to go golfing!), as well as a resident council, where a team of individuals living in the home had a say in fundraising and where funding was utilized, what meals were decided upon for the spring/summer menu, and various other decisions, allowing elements of co-design and compromise as well.
Misconception 3: “Long-term care is a nursing home.”
The care system occurs on a spectrum, or is a continuum of care, that ranges from supportive housing to institutional care. Some of the common systems include assisted living, home care, adult day programs, which all fall under what Ontario consider the care sector. According to OLTCA, in Ontario, only a little over 5% of all residents in long-term care could potentially be cared for in other healthcare settings (acute care settings, adult day programs, etc.), indicating that long-term care certainly integrates individualized care plans for their residents (OLTCA).
Misconception 4: “Staying healthy = Avoiding long-term care.”
While staying socially and physically active is important, and can help, long-term care is less about being sick or hurt, and more about providing support. Often admittance to long-term care can be a result of a rapid downward shift in health. For example, having a fall, caregiver burnout, accidents or sudden or life-changing diagnoses can all be reasons why an individual may need to transition to long term care. According to CIHI, between 40% to 50% of long-term care residents are admitted after a hospitalizing incident (CIHI).
In closing, understanding the reality of long-term care can provide clarity and create a space where individuals can openly talk, prepare, and advocate for themselves and others for person-centred care from day one.
Citations
https://news.ontario.ca/en/release/1006140/ontario-supporting-long-term-care-residents-with-complex-needs
https://www.cihi.ca/en/recent-staNing-and-quality-indicator-trends-in-canadian-long-term-care
https://www.ontario.ca/page/long-term-care-staNing-study
https://collaborative-aging.mcmaster.ca/events/collaborating-for-change-long-term-care/
https://www.oltca.com/about-long-term-care/the-data:
