TABLE 1.

Theme development

Themes	Categories	Codes	Examples of original quotations within this theme
‘The outside world is just gone’ Residents suffered from social isolation and missed their family and friends	1. Feeling alone 2. Lacking meaningful relationships 3. Missing social connection	Trapped in their room No one to talk to Always on their own Cut‐off from world No meaningful friendships Alienated from family and friends Missing loved ones Wanting to leave LTC home	‘What I found was once you come here the outside world is just gone. I've been so isolated here it's unbelievable’. (resident) ‘They were seeking social connection. They would be out in the hallway looking for someone to talk to someone to say hello to and we'd have to keep saying please go back to your room’. (staff member)
‘Straight down the hallway they all passed away … it's like a nightmare’ Residents felt hopeless and grieved for lives lost	1. Grief 2. Feeling hopeless	Shocked by deaths Mourning Loss of friends and peers Feeling upset Losing hope Lack of control over situation	‘Straight down the hallway they all passed away … it was a wave of shock … it's like a nightmare’. (resident) ‘Residents had an opportunity to share their grief, because some of the people who had passed away with their friends or roommate or the person that they used to sit with at the table’. (staff member)
‘Number one is people you know, connection with people’ Social support reduced resident loneliness	1. Meaningful social connection 2. Acknowledgment 3. Safe social support	Virtual connection Companionship with other residents Empathy Relationship with staff members Validation Acts of kindness	‘Number one is people you know, connection with people’. (resident) ‘just holding their hand makes a difference … telling them they haven't been forgotten by their family’. (staff)
‘I have to live positive’ Creating opportunities for recreation and promoting positivity reduced loneliness	1. Positive atmosphere 2. Self‐fulfilment 3. Recreation	Engagement Enthusiasm Solo hobbies Keep themselves busy Pleasant physical atmosphere Staff meeting resident's needs Positivity Modifying recreation	‘I want to learn so I can keep up with the world … I have to live positive’. (resident) ‘they will put on these different game shows … the residents they came alive, they loved it’. (staff member)

Note: Each theme encompasses two or more categories. Examples of codes that were grouped to form categories within each theme are listed.