Social Connection in Long-Term Care Homes: A Scoping Review of Published Research on the Mental Health Impacts and Potential Strategies During COVID-19.
Jennifer Bethell, Katelynn Aelick, Jessica Babineau and 8 others
PMID 33347846WHAT IT FOUND
Across long-term care home studies, better social connection was commonly linked with less depression, better mood and fewer responsive behaviors, but evidence was uneven and mostly observational.
Twelve low-cost strategies were identified, not proven.
Key findings
01In 35 studies testing depression, 28 found better social connection associated with less depression, while 5 found no statistically significant association and 1 found social support associated with more depression among new residents.
02Nine studies tested responsive behaviors; six linked social connection with fewer behaviors, but one found high social interaction associated with more agitation and one found benefit only among residents without dementia.
03The review identified 12 potentially quick and low-cost strategies for social connection, but most intervention studies were not randomized and often excluded residents with cognitive impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
No formal quality assessment was done, so the strength of the evidence is not graded. Most association studies were cross-sectional, so social connection and mental health cannot be ordered in time, and bidirectional effects are likely. Many intervention studies were small, not randomized, and often excluded residents with cognitive impairment. The review used a broad definition of social connection and excluded some social communication behaviors, which may have missed people with advanced dementia. No included studies were conducted during infectious disease outbreaks, so applicability to pandemic isolation is uncertain. The review did not include intervention studies that used social connection as a means to address another outcome, such as responsive behaviors.
The easy way to misread this
Do not read the 12 strategies as proven ways to improve social connection or mental health. The review found limited evidence, most studies were cross-sectional or nonrandomized, and no studies were conducted during infectious disease outbreaks.