Understanding the relationship between social connection and mental health for resident of long-term care

by Cathleen Edwards, Education Manager

I am excited to be celebrating my 1-year work anniversary with FCO, and what a year it has been! I had just settled into my new routine and started to develop a work plan for 2020 when COVID-19 was declared a Global Pandemic in March 2019. I recall my frustration as I recognized the analysis of data from the Needs Assessment was most likely outdated. I shared in the FCO team’s sadness of the sudden restrictions on visitation for family members. Within the first three months of my role as Education Manager, I experienced a roller-coaster of emotions.

One of the silver linings of 2020 was the opportunity for collaboration. Being new to the organization, it would ordinarily have taken me years to connect with the people and organizations that I have had the pleasure of meeting over the course of 2020. One such opportunity was an invitation by Dr. Jennifer Bethell from the KITE Research Institute at the Toronto Rehabilitation Institute/University Health Network for Family Councils Ontario to participate in a Canadian Institutes of Health Research (CIHR) Knowledge Synthesis Grant focused on COVID-19 in Mental Health and Substance Abuse. I am excited to share a summary of this project as well as some of the resources created by the project team, composed of various stakeholders in the Long-term care sector including Behavioral Supports Ontario (BSO), Ontario Associations of Residents’ Councils (OARC), the KITE Research Institute/University Health Network, as well as a Family Council member representing the voices of family members.

The focus of this project was to examine the impact of social connectedness on the mental health of residents in long-term care home. Through a systematic review of existing research, the team sought to identify the strategies to support social connection for residents, more specifically which strategies are used to promote social connection for residents in the context of outbreaks like COVID-19.

What do we mean by social connections?

There are for key terms associated with social connections:

  • Social Networks: The web of social relationships that surround an individual and the characteristics of those ties. Examples of people in our social network includes our family, friends, and team members who work in the home.
  • Social Support: Emotional, physical, and other help provided by and to others, typically by those in our social network.
  • Social Connectedness: Feelings of caring and belonging, the opposite of loneliness.
  • Social Engagement: Taking part in activities with others, typically with those who are in our social network. Examples include having lunch or going for a walk together.

Analysis of existing research suggests that social connection is associated with better physical and mental health in residents of long-term care. In a systematic review of existing research conducted by the team, we identified 12 strategies that may be used to help residents build and maintain social connections:

  • managing pain,
  • addressing sensory losses (hearing/vision),
  • sleep patterns,
  • activities promoting creative expression,
  • physical activity,
  • religious and cultural practices,
  • gardening,
  • visiting with animals,
  • using technology to communicate with others,
  • laughter/humor,
  • reminiscence, and
  • addressing communication impairments through non-verbal communication.

While we acknowledge that certain strategies represent aspects of resident care, others will not apply to all long-term care homes or residents.

What are the implications of this project?

  • Infection control measures that are put into action to protect residents in long-term care from COVID-19 such as restricting family and other visitors as well as interactions with other residents and staff in the home likely had a negative impact on residents’ mental health.
  • Research evidence suggests strategies that residents, families and staff can use to help build and maintain social connections as outlined in the resources generated by the project team. Unfortunately, each of the strategies outlined relies on a healthy, sustained workforce in long-term care.
  • There is a need for more research to understand the health impacts of social connection for residents of long-term care homes as well as the strategies used to address social connection both during and outside of outbreaks.

If you would like to learn more about the relationship between social connection and mental health for residents of long-term care the project team created several resources, available in both English or French to share what learned in this project including:


Project report:

Journal Article:

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

Despite the many challenges of 2020, it’s amazing to see what I got to experience over the last year. This project alone created an infographic, a report, a journal article, and there are also conference presentations. I think the resources will be welcomed by Family Councils and a good start when it comes to helping them build a case in support of their role in their homes. I’m looking forward to building more relationships and developing new tools to support families and Family Councils. Here’s to a better 2021!

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