Abstract
BACKGROUND: Approximately one-quarter of the Canadian population will die in long-term care (LTC) homes, highlighting the importance of improving end-of-life (EOL) care in these settings. There is a growing recognition of the need to integrate palliative approach to care in these settings. Central to this approach is compassionate care, which supports the emotional, psychological, and spiritual needs of residents and their families at EOL. Compassion is fundamental to person-centered care and plays a critical role in shaping how staff and families experience dying, death and bereavement. Compassion in LTC settings fosters connection, meaning and dignity at the EOL. This study explored the perceptions of nurses and bereaved family members regarding their experiences with EOL and bereavement practices, and how enacting compassionate care supported residents dying in LTC homes across Canada. METHODS: This qualitative study was conducted across four LTC homes in Ontario, Manitoba, Saskatchewan, and Alberta. Using an interpretive qualitative design, we conducted semi-structured interviews with LTC nurses and bereaved family caregivers to examine how compassionate care is practiced in LTC settings. The analysis focused on how acts of compassion support both staff and family caregivers during the EOL process and contribute to the experience of a “good death” for residents. RESULTS: A total of 26 family members and 13 LTC staff were interviewed. Three major themes emerged: (1) nurturing compassionate care within relationships, (2) integrating family as a team member to promote compassionate care, and (3) sustaining compassionate care practices in LTC. Several subthemes further elaborated on these core findings. CONCLUSION: Compassionate care is an essential and highly valued component of EOL care in LTC settings. Findings highlight the importance of supporting compassionate care as an integral part of a palliative approach to care, emphasizing the need for system wide initiatives to sustain and enhance such practices in LTC settings. CLINICAL TRIAL: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-026-02040-0.