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VULNERABLE456 The average age of nursing home residents is 83,29 and most are female. The predominance of women in part reflects their greater longevity combined with more disabilities, and in part the pattern of women taking responsibility for the care of their male partners at home. Nevertheless, compared to the past, more are male. Men tend to be heavier and more prone to violence. More of the residents are under the age 65, and there is increasing diversity among both staff and residents. The majority of residents must be assisted to get out of bed, use the toilet, dress, bathe, and eat, all tasks that require attending to frailty, medical equipment, personal preferences, and resistance. The majority use incontinence products. Many spend most of their time in bed, and thus need to be constantly repositioned to prevent ulcers and to be bathed in bed. Many require specialized medical care, and not just assistance with activities of daily living, as this nurse explains: Anyone who tells you long-term care is easy is lying. Or they haven’t worked in long-term care. … I have a guy who’s having a heart attack over there, a stroke over there, this one’s got a pic line, this one’s got this … like all sorts of complex [care] … so I’m running my own blood work, X-rays and everything else … so I’m actually operating in a sense at a higher level than you would as a hospital nurse.30 All this work requires a high level of technical skill, as well as the social, psychological, and emotional skills that require familiarity with both residents and other staff. It also takes staff into direct and close contact with residents. That almost all the residents have some form of cognitive impairment complicates any intervention, especially if the care provider is not known to or recognized by the resident. Close, regular, personal contact is an essential part of this skilled work. Administering medications, for example, means knowing who can swallow the medication, how to convince them to take it, and who usually spits it out or is at risk of choking. This may involve touching the resident’s face and mouth to assist or ensure the resident swal- lows. Similarly, treating pressure ulcers requires technical skills that not only includes close personal contact but also working in close 29. Ibid. 30. Pat Armstrong et al, “RNs in Long-Term Care: A Portrait” (2019) at 12, online: Ontario Nurses Association <https://www.ona.org/carenow/>.