For the past three years, Lucy DeFilippis has visited her 89-year-old mother several times a week at her long-term care home in Vaughan, Ontario.
Residents keep their doors open during the day, giving DeFilippis and her mother a look into the lives of more than 60 seniors who live on her floor.
They can’t help but notice there are some who seldom receive family visits.
“It’s sad,” said DeFilippis. “It’s almost like they stick them in a home and forget about them. Like out of sight, out of mind.”
Dr. Samir Sinha, director of health policy research at the National Institute on Ageing, says he regularly sees seniors who experience social isolation. Many seniors also admit they feel lonely.
“I see this all the time,” said Sinha. “As a geriatrician who specializes in caring for older adults… you can imagine I see higher rates of these issues.”
‘Nobody ever asks’
Last May, the US Surgeon General published a report on the epidemic of loneliness and isolation, citing research showing the harmful effects of being socially disconnected are equal to smoking 15 cigarettes a day. By November, the World Health Organization had declared loneliness a pressing health threat.
Both social isolation and loneliness “are associated with a decrease in the health span and a decrease in the lifespan,” said Dr. Roger McIntyre, professor of psychiatry and pharmacology at the University of Toronto. “People with loneliness and social isolation are more susceptible to obesity, diabetes, heart disease, depression, anxiety, insomnia [and] cognitive impairment.”
Loneliness still remains an understudied and under-addressed issue in Canadian health care, a topic Canadian Affairs has covered.
In 2022, the National Institute of Ageing began including questions about loneliness in surveys of nearly 6,000 seniors. They found 41 per cent can be considered socially isolated and 58 per cent report experiencing loneliness.
These figures do not include input from residents of long-term care centres.
“The challenge is that in many health-care environments, nobody ever asks about social isolation or loneliness,” said Sinha.
It is also hard to accurately assess patients’ loneliness because most seniors in long-term care homes — as high as 90 per cent — have a cognitive impairment, says Sinha. But health experts could use simple screening tools such as questionnaires to understand if residents, even ones with dementia, feel lonely, he said.
‘They leave crying’
Families play a crucial role in helping their elders with dementia, said Carrie McAiney, associate professor in the School of Public Health Sciences at the University of Waterloo and Schlegel research chair in dementia. But as a senior’s dementia progresses, families can find it difficult to adjust.
Many feel guilty for sending their parents to a long-term care home, said McAiney. People can also be confused over how to navigate the relationship with their parents at the facility. These feelings of guilt and confusion can make going to the long-term care home emotionally difficult.
“They might not know what to do with their relatives or what to say,” said McAiney. “It can be really painful to visit their relatives in long-term care.”
Visiting a family member with dementia feels like visiting a different person, said Connie Redmond, a recreational therapist who worked in long-term care centres for nearly 20 years.
She saw cases where parents “didn’t… recognize [their children] anymore,” said Redmond, who is now a life transitions consultant, advising families on senior care. Family members “would leave in tears.”
Some seniors “are forgotten,” said Redmond. But for the most part, “there is usually a reason behind” family members not visiting.
For some people who moved away for work or school, it may be unaffordable or hard to book the time off work to visit their parents regularly, says McAiney.
In other cases, the hustle of daily life — work, job, kids — can take priority over visiting with a parent, says Sharon MacKenzie, executive director of the i2i Intergenerational Society, a non-profit that organizes social connections between generations. Also, families may have complicated relationships that keep them from speaking to one another.
And caring for lonely seniors can be difficult to do in short-staffed, long-term care homes, said Redmond.
Using technology to enable seniors to connect can be helpful, she said. During Covid, many long-term staff helped seniors call or send virtual messages to their families.
But “computer literacy, internet literacy, social media literacy of the elderly clearly is not the same as someone who’s 16 years old,” said McIntyre. “They just cannot navigate that world as easily.”
Many seniors need help to make those calls. Fewer workers means personal support workers in the homes are scrambling to complete their tasks, and residents’ wishes to have more social contact is difficult to meet — even when both family members have a phone.
Heather Graham, who lives in a long-term care home, finds workers make an effort to encourage seniors to participate in the recreational activities.
“They do bingo, they do family feud, they do different games,” said Graham, who never married and has no children. “People aren’t left lonely.”
‘It’s worth it’
Stronger social connections can help different generations value one another, said MacKenzie. In her experience organizing activities for students and seniors, she has seen how both parties thrive from developing relationships.
“’I’m hoping that the kids that came through these intergenerational programs will make it a priority to go visit their parents or their grandparents,” said MacKenzie.
In one case, she witnessed a senior in a long-term care home who was reclusive after their son’s violent death. MacKenzie recommended a sixth-grade student, who was having trouble reading, partner with the senior to practise reading.
After months together, the student’s grades improved. The child’s grandmother called MacKenzie and said the boy’s improvement was thanks to the senior at the long-term care home.
“The bottom line was that he learned to read and… [the senior] became very engaged in the long-term care home because now she had a purpose,” said MacKenzie.
DeFilippis joined the family council at the long-term care home and helped to organize some activities with the help of the recreation team. During holidays, they make and deliver loot bags to all the seniors at the long-term care centre.
“This ensures that everyone is included even if family isn’t around. If it brings even an ounce of happiness, it’s worth it.”
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