Sustaining the Long-Term Care Workforce: An Appreciative Inquiry into the Relational and Generative Factors Driving Staff Retention.

Abstract

Literature often explores turnover, burnout, and inadequate support of long-term care (LTC) workforces, and their negative impact on staff retention and care delivery. However, current evidence on positive core elements that retain staff is limited and does not adequately capture multidisciplinary staff perspectives. This study uses the appreciative inquiry approach with multidisciplinary staff in an urban LTC home in Canada to examine positive drivers of staff retention. Reflexive thematic analysis identified three retention drivers: (1) being valued as a whole person rather than solely as a worker, (2) experiencing relational belonging through team cohesion and family-like connections with residents and colleagues, and (3) working within a supportive organizational environment that fosters flexibility, autonomy, and career development. These findings reveal that workforce sustainability extends beyond wages and workload to include relational, cultural, and identity-affirming dimensions of work. We propose the C.A.R.E. model based on our findings: Cultivate community, Amplify the positive core, ensure Resources for growth and Inclusivity, and Empower LTC workforce by supporting equity and diverse voices. The path to a sustainable LTC system is to nurture an environment that inspires staff to stay; we call for more research on how to achieve this with LTC communities.