Social Isolation and Nursing Leadership in Long-Term Care: Moving Forward After COVID-19.
Diana Lynn Woods, Adria E Navarro, Pamela LaBorde and 2 others
PMID 35659988WHAT IT FOUND
For long-term care residents with dementia, isolation is linked to worse mood, behavior, cognition and mortality risk.
The review describes keeping them connected through individualized activities, meals, music, family and cultural practices.
Key findings
01Social isolation in long-term care residents with dementia is linked to cognitive decline and increased behavioral symptoms.
02A consensus review identified staff training, environment adaptation, person-centered care and tailored activities as first-line non-drug approaches for dementia behavioral symptoms, with DICE and music therapy preferred.
03In the Nexus exemplar, 423 residents with MMSE scores of 15 or higher were included, and 91 completed measures at 6 months; those with the highest baseline MMSE maintained or increased cognition and ADLs over 2 years.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This is a narrative review without described search methods, so it is not a systematic summary of the evidence. Much of the content is advice about nursing leadership, staff education and workforce issues rather than tested patient care. The Nexus exemplar reports many concurrent components, including physical exercise, cognitive exercises, stress reduction, purposeful social activities, support groups, music, meals and environmental supports, so the effect of any single component cannot be separated. Attrition in the Nexus exemplar is reported: 423 residents were included, and 91 completed measures at 6 months, 68 at 12 months and 18 at 18 months. Some supporting data are unpublished or personal communication, and the 60% cognition improvement comes from a single LTC comparison rather than a controlled trial.
The easy way to misread this
Do not read the Nexus results as proof that social engagement alone works. Residents received physical exercise, cognitive exercises, stress reduction, purposeful social activities, support groups, music, meals as social activity, and environmental supports, and the paper does not separate these components.