Background and objective: Chronic and emergent care challenges have led to diminished quality of care in many long-term care (LTC) facilities during the COVID-19 pandemic and beyond. Healthcare aides (HCAs) occupy a strategically important role in achieving improved resident care outcomes yet continue to experience disempowerment through authoritarian working conditions. The aim of this study was to develop a robust description of HCA perceptions of how organizational structures empower them and the desired dream state for such structures. Approach: This study used a qualitative descriptive research design informed by Kanter’s theory of structural empowerment within an appreciative inquiry (AI) framework. AI was chosen for its optimistic egalitarian approach towards organization change; it provided a platform for HCA voices to be heard, protected, and valued. Sampling used volunteer participants and involved convenience and snowball sampling. Ten HCA participants were recruited from four Winnipeg LTC sites. Semi-structured virtual interviews were used to gather rich descriptive data, allowing for an understanding of participant perspectives. Findings: Two main themes emerged from the data: i) What is Important to Healthcare Aides; and ii) Challenges. These participants care about their residents, their job satisfaction and team functioning but experience numerous challenges in their work. They lack access to opportunities for education, resources (i.e., staffing and time), and support from managers and organizations; they also endure difficult, stressful, and dangerous working conditions and retention is inadequately prioritized by the LTC sector. Modifiable organizational structures have the potential to improve resident care by empowering healthcare aides and may to be mediated by the functionality of teams and the use of regular healthcare aides. Conclusion: Empowering healthcare aides is a means to improve the well-being and satisfaction of these essential workers and represents a strategy for ensuring these workers have what they need to provide quality care to residents.