The Resident Engagement Toolkit shows long-term care leadership how to work with residents to shape homes that work for everyone, said Dr. Jennifer Bethell.
KITE Scientist Dr. Jennifer Bethell partnered with the Ontario Association of Residents’ Councils to develop the Resident Engagement Toolkit for long-term care homes.
Resident engagement in long-term care often means surveys or suggestion boxes. But at Cassellholme, a home in North Bay, Ont., residents are engaging on a much deeper level. When the home was being redesigned, they provided feedback on room designs after viewing model simulations, watched construction progress through livestream footage, and received answers to questions at Residents’ Council meetings and through an online FAQ page.
This is the kind of engagement at the heart of a new toolkit co-developed by KITE Scientist Dr. Jennifer Bethell and the Ontario Association of Residents’ Councils (OARC). “Everything About Residents Involves Residents: A Co-Designed Toolkit Inspiring Resident Engagement in Long-Term Care Homes," contains practical examples, assessments, guiding questions, and other ways to increase engagement with residents living in long-term care homes (LTCs).
Dr. Bethell, an epidemiologist and health services researcher, says including the unique insights of residents can help foster a true sense of home and belonging. She hopes that this will have a positive impact on the many Canadians living in long-term care. “If people are living in a long-term care home, it's their home, so they should get to be involved in how it runs and operates,” Dr. Bethell said. “Our home is so important to our well-being. Feeling comfortable and happy in your home is important for all of us.”
Changing how long-term care homes look at resident engagement
In 2025, there were more than 600 LTCs in Ontario and just over 77,000 spots for residents, according to the Ontario Long Term Care Association. While all LTCs in Ontario have Residents’ Councils, the levels of resident involvement can differ widely. “Every home has engagement on some level, but how they do it and how they think about it, or think about possibilities, is going to vary from home to home,” says Dr. Bethell. “This toolkit is meant to help them engage residents in new, meaningful ways.”
The toolkit includes guidelines for developing strong relationships with residents, engagement methods, and areas where residents can be included in the decision-making process—from simple approaches like bulletin boards that keep residents informed to supporting resident-led initiatives and collaborative committees that give residents a place at the tables where decisions are made. It describes strong relationships between leadership and residents as key enablers for effective engagement. And it shares residents’ desires to have staff be visible, listen actively, and try to get to know each resident.
In addition to research-backed guidance, the toolkit highlights real examples of deep engagement in LTCs. One is from Kenora, Ont., where residents of the Wiigwas Elder and Senior Care participated in meetings along with staff and community members to help design a new home that reflects their Indigenous culture. This feedback will be used to inform the selection of building materials, layout and furnishings - such as bathing spaces that will resemble traditional log houses.
The power of partnership
Bethell says her partnership with the Ontario Association of Residents’ Councils was instrumental in designing a toolkit relevant to all LTCs. “The OARC is so plugged in: They’re already in homes, and they were already very connected to residents, and they have a wonderful network. Plus, we had many shared values. Every group involved used their strengths, and it worked out really beautifully,” she says. The OARC is leading activities to support LTC homes in implementing the toolkit by organizing and participating in in-person events and webinars after its release.
This research partnership adds credibility and trust to the toolkit,” says Melissa McVie, Acting Executive Director of the OARC. “Working with researchers such as Jennifer Bethell helped OARC grow our confidence and capacity in grant-writing, research, data collection, and evaluation, and ensured this resource was informed by evidence rather than assumptions.”
Residents were also involved in creating the toolkit, and two resident members were co-applicants on the grant. Jim Gilhuly, Resident Leader and Research Team Member, says the toolkit’s fundamental message is for LTCs to listen to their residents and to respect them. “It’s basically engaging people as people. Knowing that there is an intelligence there. There is a humanity there. There is life there. Life that should be lived fully, and it’s your job to help them live that life fully.”
Evidence-informed development
A number of literature reviews formed the foundation of this toolkit, says Bethell. The toolkit, which was supported by research funding from the Canadian Frailty Network, Perley Health, and the Canadian Institutes of Health Research (CIHR), was developed through a three-stage research process that included a scoping review, interviews, and final design.
The scoping reviews identified areas of the home where residents can be involved in the governance and organizational design, including food, physical space, human resources, and finances. Findings from the scoping reviews were published in the Canadian Journal of Aging in 2025 and BMJ Open in 2024.
They found that the existing body of work did not suggest many effective strategies or evaluation methods for resident engagement, and recognized that the LTC homes needed more support to address barriers to resident engagement. This toolkit was developed to address these gaps with practical, evidence-informed guidance for engaging residents more meaningfully.
Gale Ramsden, Resident Leader and Research Team Member, says the most exciting part of the resident engagement toolkit is that it shows what can be achieved when you work together with the residents, the true experts in LTC. “If the goal is to create a home environment that allows residents to live their best life, the most effective way to achieve this is to collaborate with residents on every aspect of the running of their home. There is no one better equipped to speak about what’s important and what it’s like to live in LTC.”