Restrictions in visiting and isolation policies to control the COVID pandemic in care homes have increased the burden of loneliness and social isolation among residents, while creating an enormous challenge for care professionals trying to address their social needs. In this emergency context, several initiatives, from stand-alone actions to programmes, have been implemented to alleviate older people's loneliness and social isolation. We aim to synthesise knowledge about the ways in which loneliness and social isolation could be alleviated among older people living in care homes during the COVID pandemic. Specifically, we aim to understand ways in which loneliness and social isolation could be alleviated and the mechanisms that were expected to (or were found to) lead to these improvements among older people living in care homes. Our research question is: which practices aimed at increasing social connection or preventing or alleviating social isolation or loneliness, have worked on any health and wellbeing outcome for older people living in care homes and their families; and in which circumstances during the COVID pandemic?
We are conducting a scoping review using the principles of realist synthesis. We search for articles published 2020 and 2021 conducted in care homes targeting older residents and we include any study describing or evaluating a programme or initiative that sought to alleviate loneliness or social isolation among care home residents.
Data are extracted and analysed narratively and use the dimensions of intervention components, context, mechanisms, and outcomes for the synthesis of the data. Any outcome reported quantitatively or qualitatively including adverse effects is extracted.
Our preliminary findings, based on 45 articles, show that some initiatives promoted the communication between residents and their families with alternative or adapted visit approaches and remote contact (video and phone visits, window visits and outdoor in-person visits). Other interventions fostered the communication and relationship with professionals, peers or volunteers (e.g. medical students). Some interventions were specific programmes targeting social wellbeing, while others were embedded in programmes focused on health care. Some intervention strategies involved technology (robots, tablets, smart phones) and the virtualization of previous activities such as befriending or pets. Some of those interventions have achieved positive (self-reported) outcomes in loneliness, support, mental health, social wellbeing and satisfaction. Adverse events have been also reported among residents related with the technological gap and with the difficulties in communication in persons living with dementia, visual or hearing impairments. Moreover, adverse events among families have been also described such as uncertainty and delay in meeting expectations, unsatisfaction, guilt and frustration.
These results will help to build on learnings from the response to the pandemic and support the recovery of the care and social wellbeing in care home settings.