Pandemic brings new level of isolation, loneliness to nursing home patients, UB study finds

A new study by researchers from the School of Nursing has found that the COVID-19 pandemic brought a new level of isolation and loneliness to nursing home residents, leaving them with a palpable sense of anxiety that permeated the facility.

According to results of the study conducted in two Central New York nursing home facilities in 2020-21, the COVID-19 virus forced nursing homes to restrict family visits, intensifying feelings of isolation and despair among the elderly residents.

“It was like a big, sad feeling of being alone came over our residents. They were separated from their families, their routines disrupted,” says lead author Audrieanna Raciti, a nurse practitioner and PhD student in the School of Nursing. The study, “Nursing Home Residents’ Experiences During the COVID-19 Pandemic,” was published in the Journal of Gerontological Nursing.

“It wasn’t just about the physical care, but also about addressing their emotional needs,” says Raciti, who has spent half a decade immersed in long-term care settings. “And that was a lot harder.

“The interviews with the residents,” she says, “were incredibly enlightening, although emotional.”

Led by Yu-Ping Chang, professor and associate dean for research in the School of Nursing, the research team’s results addressed several topics:

• Technology’s limited impact: While nursing homes tried to use technology to bridge the gap, it was no substitute for human contact. “There is a need for real-life interaction, far beyond what technology can offer, Raciti says.

For many residents, the challenges posed by technology furthered their feelings of seclusion. “The experience was far from ideal,” she adds. “A lot of the residents just weren’t good with technology. Many couldn’t see or hear properly, and this only added to their feelings of isolation.”

The study found that interventions like phone calls, pet robotics, laughter therapy and horticultural therapy worked more effectively to ease loneliness than video calls.

• Importance of transparency: Many residents also reported feeling “kept in the dark” about the situation within the facility during the COVID outbreak, exacerbating their feelings of isolation and fear. “They felt cut-off, not just physically but emotionally, too,” Raciti says.

The investigators say the research showed the significance of transparent communication in addressing these situations, and that residents should be updated about illnesses within the facility to feel included. Raciti says she personally practices transparency with her patients and families, informing them about patient conditions and involving them in decision-making whenever possible.

“Transparency and communication are crucial in such settings,” she notes. “I really try to get the family involved, be super-transparent about everything.”

• A surge in the use of antidepressants: Raciti also observed a notable increase in depression among the residents, with almost every patient taking some form of antidepressant medication. “It’s been disheartening to see the increased severity of psychiatric conditions in these patients,” she says.

Raciti emphasizes that residents have a strong desire for social connection and support, and suggests that facilities and families proactively address this need. She has also observed a disturbing trend of families growing distant and neglecting their elderly loved ones. The situation, she says, is dire and needs immediate attention.

“A lot of them don’t come in,” Raciti says of the families. “Probably of all the patients that I have, close to 100 here, maybe I see five to 10 whose families are actually attending to their loved ones." 

Raciti is also concerned about the declining mental health of residents, an issue she believes has been exacerbated by the pandemic. She advocates more social interaction and encourages health care providers to show kindness and compassion toward residents.

“Many of these residents have no one,” she says. “We have become their family. It is our responsibility to care for them as such. They truly appreciate being surrounded by people who genuinely care about them.”

Chang agrees that loneliness and social isolation are critical concerns for long-term care residents.

“Interventions are urgently needed to address these issues,” she says. “Although technology can play a role in solving problems related to mental health, it needs to be designed in a way that is intuitively understandable and meaningful, as well as meeting the needs of this vulnerable population.”