The COVID-19 pandemic had devastating consequences for long-term care facilities (LTCFs), particularly in Quebec where mortality rates were especially high during the early waves. Although the psychological toll on frontline healthcare workers has been more frequently documented, less is known about the experiences of managers and of residents and relatives, especially in the context of end-of-life care across the course of the pandemic. This study aimed to integrate multiple stakeholder perspectives to provide a more comprehensive understanding of the psychological effects of the pandemic within Quebec’s public LTCFs over all seven pandemic waves. Methods. A mixed-methods design was employed. In the quantitative phase, an online survey was conducted with managers of public LTCFs across six regional health and social service centres in Quebec (Canada). Measures included the Peritraumatic Distress Inventory related to the pandemic effects, sociodemographics, as well as organizational and COVID-19 related data. In the qualitative phase, semi-structured interviews were conducted with healthcare workers and relatives of deceased residents to explore their experiences of the pandemic and their perspectives on communication and care. We used descriptive and bivariate analyses for survey data and a conceptual categorization approach for qualitative narratives. Results. Seventy-seven managers completed the survey (57% response rate). Nearly half (48.6%) scored above the clinical threshold for peritraumatic distress, indicating substantial risk of post-traumatic stress disorder. No significant differences were found for gender, age, or working experience, although trends suggested higher stress among women and those aged ≤ 50 years. Qualitative findings reinforced and enriched these results: healthcare workers identified the first waves as the most critical period, marked by uncertainty, high mortality, and restricted visitation. They also reported exhaustion, moral distress, and professional grief, while relatives described helplessness and constrained grieving amid organizational instability. Conclusions. This study demonstrates the profound psychological and organizational toll of the pandemic on Quebec’s LTCFs. Findings highlight the need for systemic recognition of persistent psychological effects, accessible mental health and grief supports, and leadership training that equips managers to support frontline teams. Psychosocial support must be treated as a core component of emergency preparedness in LTCFs, not as an afterthought once crises unfold.