Social Connection in Long-Term Care Homes: A Scoping Review of Published Research on the Mental Health Impacts and Potential Strategies During COVID-19

Abstract

Objectives: Good social connection is associated with better health and wellbeing. However, social connection has distinct considerations for people living in long-term care (LTC) homes. The objective of this scoping review was to summarize research literature linking social connection to mental health outcomes, specifically among LTC residents, as well as research to identify strategies to help build and maintain social connection in this population during COVID-19. Design: Scoping review. Settings and Participants: Residents of LTC homes, care homes, and nursing homes. Methods: We searched MEDLINE(R) ALL (Ovid), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Sociological Abstracts (ProQuest), Embase and Embase Classic (Ovid), Emcare Nursing (Ovid), and AgeLine (EBSCO) for research that quantified an aspect of social connection among LTC residents; we limited searches to English-language articles published from database inception to search date (July 2019). For the current analysis, we included studies that reported (1) the association between social connection and a mental health outcome, (2) the association between a modifiable risk factor and social connection, or (3) intervention studies with social connection as an outcome. From studies in (2) and (3), we identified strategies that could be implemented and adapted by LTC residents, families and staff during COVID-19 and included the articles that informed these strategies. Results: We included 133 studies in our review. We found 61 studies that tested the association between social connection and a mental health outcome. We highlighted 12 strategies, informed by 72 observational and intervention studies, that might help LTC residents, families, and staff build and maintain social connection for LTC residents. Conclusions and Implications: Published research conducted among LTC residents has linked good social connection to better mental health outcomes. Observational and intervention studies provide some evidence on approaches to address social connection in this population. Although further research is

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

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“…The proportion of COVID-19 deaths that occurred in nursing homes is high. In May 2020, it was estimated that about half of the COVID-19 deaths in France and Ireland were from nursing homes, with even higher proportions reported in the US and Canada [ 5 , 6 ], and high numbers of excess deaths in nursing homes reported in England and Wales [ 7 ].…”

Social Connection is Essential in Long-Term Care Homes: Considerations During COVID-19 and Beyond

“…Research studies conducted in LTC homes have demonstrated that social connection is linked to mental health outcomes including depression, cognitive decline, and behavioural symptoms of dementia. ( 8 ) Similarly, studies have also shown social connection is associated with physical health outcomes for LTC residents, including mortality ( 9 ) and self-rated health. ( 10 ) For residents of LTC homes, family and friends provide crucial social support, from hands-on assistance (e.g., during meals) to ensuring that staff understand who a resident is as a person and within a unique life history.…”

“…( 3 ) However, qualitative studies with older adults have found that maintaining contact with others (in person or by phone or other means) and engaging in (even solitary) purposeful activity are key strategies to prevent loneliness. ( 3 ) A recent scoping review of published observational and intervention research conducted in LTC homes that assessed social connection outcomes ( 8 ) highlighted 12 low-cost strategies that could be adapted for COVID-19 or other disease outbreaks. These strategies can be implemented right now to help build and maintain social connections with LTC residents:…”

Profile of Residents with Mental Disorders in Canadian Long-Term Care Facilities: A Cross-Sectional Study

“…Residents' cognitive impairment may also be a factor in their low level of social engagement and inability to enter into meaningful relationships with others. Good social connection has been associated with good mental health outcomes in LTC residents (Bethell et al, 2021). Meaningful social engagements are essential as they are associated with quality of life in LTC facility residents (Kehyayan et al, 2015;Morris et al, 2018).…”