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Article History

Received: 16 December 2025

Accepted: 13 April 2026

First Online: 18 April 2026

Declarations

:

: The research was conducted in accordance with the Declaration of Helsinki. Ethics approvals were obtained from the University of Alberta Health Research Ethics Board (Pro00117476), York University Office of Research Ethics (2022 − 240), University of Victoria Human Research Ethics board (H22-00783), University of Manitoba Health Research Ethics Board (HS25536 (H2022:191)), Mount Saint Vincent University University Research Ethics Board (2021 − 230), and St. Francis Xavier University Research Ethics Board (26675). Verbal informed consent was obtained from a key contact (director of care or NH administrator) for each participating home and from all participating care staff. The requirement for resident consent was waived by the ethics boards because researchers did not have access to resident names or other identifying details at any time.

: Not applicable.

: The authors declare no competing interests.