Review: Competing crises: COVID-19 countermeasures and social isolation among older adults in long term care

This article was published on July 9th, 2020 by the Journal of Advanced Nursing (JAN). It examines social distancing guidelines in long term care (LTC) facilities in Canada and the difficulties it creates as a by-product to the mental and physical health of older residents in these facilities.


  • Older adults living in LTC facilities have the highest rate of mortality and comprise 79% of the COVID-19 deaths in Canada. Isolation has been implemented to limit spread, but it has had unintended consequences to the mental and physical health of residents.
  • Recently LTC visitation policies allowed family members to visit, but with a time limitation, a negative COVID-19 test, and PPE requirements, many families have found visiting to be impracticable and restrictive.

Social isolation is a health risk, too

  • Before the COVID-19 pandemic, around ½ of Canadians over 80 years had feelings of loneliness.
  • Isolation increases the risk of cardiovascular disease, obesity, stroke, and is correlated with mental health problems and cognitive decline.

Partial solutions and room for innovation

  • Teleconferencing applications, phone calls, and written letter campaigns are some options which loved ones have used to remind older adults of their support network.
  • Benefits have been seen with these communication devices, but there have been some setbacks such as a lack access and proficiency of technology, and a lack of dexterity to hold a tablet. There is a need for innovation in creating easier to use technology for older adults and their family.

Current approaches are the antithesis of person-centered care

  • Autonomy and individual acceptance of risk are two theories which have received little attention during the pandemic. Reports have detailed increased suicide rates and residents preferring death over isolation in their rooms.
  • Throughout the pandemic, nurses have been advocating for more staffing and having appropriate resources. Nurses can prepare for future outbreaks by advocating for reform, so LTC facilities can respond to outbreaks while meeting the physical and psychological needs of residents.

Chu CH, Donato‐Woodger S, Dainton CJ. Competing Crises: COVID-19 Countermeasures and Social Isolation among Older Adults in Long Term Care. Journal of Advanced Nursing. n/a(n/a). doi:10.1111/jan.14467

This review was posted on behalf of Spencer Hofschulte-Beck, medical student at Marian University, and approved by Dr. Kathleen Unroe, IU School of Medicine Associate Professor, geriatrician, and IU Center for Aging Research Scientist.

|2020-08-07T11:52:25-04:00August 7th, 2020|COVID-19 Literature|Comments Off on Review: Competing crises: COVID-19 countermeasures and social isolation among older adults in long term care

About the Author: James Dudley

James Dudley

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