Resilient leadership in long-term care: A thematic analysis of how leaders navigate hardships

Background: Post-Acute and Long-Term Care (PALTC) administrators led frontline responses during the COVID-19 pandemic, navigating rapid regulatory changes, resource shortages, and emotional strain. While traditional leadership models offered partial guidance, the crisis exposed the need for adaptive, resilient leadership approaches. Research on resilience in PALTC settings remains limited. Objective: To explore the leadership behaviors, decision-making styles, and lessons learned by PALTC administrators during the pandemic, with a focus on identifying features of resilient leadership. Methods: This qualitative study used thematic analysis of semi-structured interviews with 20 purposefully selected PALTC administrators. Interviews explored leadership experiences during the pandemic. Data were coded inductively to identify themes related to leadership style and organizational resilience. Results: Administrators reported using transformational, servant, and authentic leadership styles. However, prolonged crisis conditions also led to the emergence of a distinct leadership approach, conceptualized as resilient leadership. This style was defined by adaptability, emotional intelligence, transparent communication, and the capacity to lead through sustained disruption. Participants emphasized that both personal and organizational resilience were crucial for maintaining operations, staff morale, and delivering quality care. Conclusion: This study introduces a novel conceptualization of resilient leadership in long-term care, grounded in the lived experiences of PALTC administrators during COVID-19. Findings underscore the importance of integrating resilience, adaptability, and emotional competence into leadership development and training. These insights have implications for strengthening crisis preparedness, regulatory policy, and workforce sustainability in the PALTC sector.