Learn how social isolation and loneliness impact nursing home residents.

1. COVID – 19’s Impact on
Nursing Home Residents
Roseann Mulligan DDS, MS
Director of Geriatric Dentistry Online Master’s and Certificate
Programs
Herman Ostrow School of Dentistry of USC

2. Well-being of Nursing Home Residents
 Physical
 Care vigilance and protection
 Round the clock healthcare providers
 All ADLs provided including many IADLs
 Psychological
 Group activities
 Communal meals
 Opportunities for new friendships
 Visitations of family and friends
 Stimulation

3. https://www.euronews.com/2020/04/20/coronavirus-and-the-elderly-what-s-life-inside-a-
french-retirement-home-amid-covid-19-pand

4. COVID -19 Impact
 Decrease in meaningful socialization activities
 Decrease in stimulation
 Increase in mental health issues
 Depression
 Anxiety
 Worsening dementia
 Failure to thrive
 “Giving up”
 Increased death rates
Abbasi J. Social Isolation—the Other COVID-19 Threat in Nursing Homes. JAMA. Published online July 16,
2020. doi:10.1001/jama.2020.13484

5. Definitions of SI and Loneliness
Social isolation - objective lack of (or limited) social
contact with others.
Loneliness is the perception of social isolation or the
subjective feeling of being lonely.
Lonely – without companions; solitary
Blazer D. Social Isolation and Loneliness in Older Adults—A Mental Health/Public Health
Challenge. JAMA Psychiatry. Published online June 03, 2020.
doi:10.1001/jamapsychiatry.2020.1054

6. Social Isolation and Loneliness
 Is not the same as, but increases risk of
 Depression
risk of depression among those with loneliness nearly 50%
 Suicide
 Dementia
 Associated with
 elevated cardiovascular and neuroendocrine markers of stress
 impaired sleep
 proinflammatory physiological effects accelerating neurodegeneration

7. What Alternatives Are There?
 Family phone calls
 Family video chats
 Facilitated family visits under social distancing rules
 Therapeutic animals through windows
 Voice recordings of family members
 Family photo albums to review
 Closed circuit broadcasts to each room

8. What are Obstacles to Success
 Many new protocols now in place
 Staff daily screening
 Regular COVID-19 testing for staff and residents
 Need for many more staff
 Staff PPE contribute to
 patient stress
 inability to read clues
 further impedes communication
 New and disruptive behaviors
 More psychotropic medications being given

9. When There Are New Cases?
 Residents are confined to their rooms

10. Aren’t Window Visits Helping?

11. Engaging the Demented Patient
 Do window visits work?
 Lacking physical touch such as handholding and hugging
 Can be confusing to demented patients
 Lack of understanding?
 Leaving masks on
 Maintaining 6 feet of social distance separation

12. One Alternative:
Go Out of Doors!
OT and PT sessions
Live music and parades
Some meals
Outdoor walks with one on one aide
Outdoor family visits (after screening/testing)

13. https://marycrestculvercity.com/2020/drive-by-heroes/?utm_source=mailchimp-
F&utm_campaign=MMCovid0603