Twenty-two-year-old Jade Waugh went into work as a care aide, scared that today was going to be the day that a resident she had grown close to would die. This elderly woman in the long-term care facility had contracted COVID-19 a few weeks before and had been getting progressively sicker as the days went on. Waugh picked up double shifts the entire week that her resident had been sick because the resident could have no family visit due to pandemic restrictions, and she knew that nobody deserved to die alone.
Waugh was working her very first job as a care aide in Kelowna, B.C. after she had moved there from Calgary. She had grown close with this resident throughout her time at the care facility as she was quite isolated and did not have a lot of visitors. She felt as if they were family because they had spent so much time together.
Waugh approached her resident’s room about halfway through the morning. She knew it was her time.
“Her breaths were slowing down, so I went and I sat with her on her bed. I can’t imagine that I was making her feel as comfortable as I could have if I’d been family, and had I not been covered in a big yellow gown with a huge mask over my face, wearing plastic gloves, trying to comfort her,” Waugh says. “And also treating her like she was a disease.”
One of the other employees brought in an iPad for the resident’s niece to say her goodbyes through a screen.
Waugh stayed with her for a little while after she died, holding her frail hand and explaining to her how loved she was. Likely through this interaction, Waugh contracted COVID-19 days later. However, in her mind, it was worth being there for someone who had no one.
Seniors at risk
While many seniors experienced increased loneliness during the isolation in long-term care, dying alone is an extreme form of it. The situation experienced by Waugh’s resident in Kelowna is one story of many. In fact, 30 per cent of seniors are at risk of becoming socially isolated according to the Government of Canada.
The pandemic has made the lives of seniors more difficult for not only health reasons, but it has also increased the feelings of loneliness among them. Since the population of seniors is rapidly growing in Calgary and Canada, it is important that Canadians find ways to combat this loneliness and get more seniors involved in the community due to the chance of an impending social recession. This term social recession is defined as the growing loneliness in a community which leads to increased isolation of the population.
Loneliness is an inevitable human condition, but to some can cause deep-rooted mental and physical health issues. It has been proven that loneliness can actually cause mortality, especially among the older populations who live alone.
Vida Valerie, a licensed practical nurse at Bethany Riverview long-term care facility who specializes in dementia care, says the pandemic has made existing problems worse.
“The number of residents that experienced loneliness has increased during this pandemic. And you could see their decline in general health even faster compared to pre-covid,” she says. “As one of the residents’ care aide, you can’t help but feel sympathy towards each resident because we somehow feel something similar.”
According to a study done by Statistics Canada, “Social isolation affects the psychological and cognitive health of seniors. It is associated with higher levels of depression and suicide. Seniors’ loneliness matters because this group is growing in our population, and their health needs will become more acute. According to the Institute for Research on Public Policy (IRPP), “In the next 20 years, Canada’s population of 75 and older is expected to double in size.”
In Calgary specifically, there are over 615,000 older adults 65 years and older. Calgary’s senior population is growing so much that by 2036, it’s estimated that nearly one in five Calgarians will be a senior.
Cindy Calderon, a nursing student from Mount Royal University who researched loneliness in older adults, asked on her website, How can you empower older adults during the COVID-19 pandemic within Calgary?
“As the older adult population increases, so does the risk for the said population to experience the implications of loneliness and social isolation,” Calderon states. “For these reasons, loneliness and social isolation experienced by older adults is a community issue affecting all Calgarians.”
Additionally, loneliness is a concern for other vulnerable groups as it has many mental health detriments. The loneliness epidemic is creating larger demands on the public health system as there are more and more seniors in need.
‘Loneliness is when we feel all alone’
Not many people on earth can say that they are a “loneliness expert,” and Ami Rokach is one of the few. He is also a psychologist and professor at York University.
Loneliness is a common human experience that almost everyone has gone through at one point in their lives.
“Loneliness is when we feel all alone,” he says. “And I say feel, which means we may be amongst people, however, there are some people who are surrounded by loving family and they still experience loneliness.”
Even though almost everyone in the world experiences loneliness, “seniors have had a tough two years,” says Sybil Chan, a psychology graduate and research assistant from York University. She has worked on multiple research papers with Rokach regarding the impacts of loneliness and social isolation.
She explains that older populations above 65 are already at a higher risk of developing mental health issues. They are in a very vulnerable state along with their physiology, which also makes them more of a threat to develop physical health problems.
“So when we put loneliness in that equation, it just becomes this terrible mix of things that will affect their day-to-day life,” Chan explains. “So I would believe that they would be at a higher risk of developing specifically depression and anxiety because of it.”
Taking care of lonely people affects caregivers as well. Jade Waugh’s friends would describe her as abundantly caring and kind-hearted, and these descriptions stick with her as she takes care of her residents at her daily job as a care aide.
“I love my job,” Waugh says. “My favourite part is creating emotional bonds with my residents and caring for them in ways that help their emotional and physical well-being.”
However, the pandemic has made this job difficult at times for her.
Seniors who live in care homes are often unable to leave their rooms because when there is a COVID-19 outbreak, the risk is too high. In particular, at the care home where Waugh works, the seniors had to stay in their rooms and only had social interaction with the employees and nurses.
“I’m sure that when they don’t have anyone visit, they probably feel quite stuck,” Waugh says. “I couldn’t imagine it being just me, myself and I and four walls.”
Waugh explains how some residents get frustrated with staying in their rooms for long periods of time.
“We had one man who’s very claustrophobic, he was getting very uncomfortable, anxious, frustrated, he kept coming out into the hallway and saying, ‘you can’t keep me in there,” she says.
Samir Boulazreg, a graduate student and researcher at Western University says the effects of loneliness could be considered more serious for the elderly.
“Research has shown that lonely elderly individuals are more likely to feel like life is no longer worth living, and in line with this finding, research has consistently shown that premature death rates for the elderly are significantly higher in comparison to non-lonely elderly,” he states. “In fact, the mortality risk of loneliness for the elderly has been compared to the equivalent of smoking 15 cigarettes a day, and premature deaths are 50% more likely.”
The pandemic has made social isolation inevitable for some seniors in Calgary according to Annastasia Stevens, the director of seniors social supports at Calgary Seniors.
“Extended periods of isolation, divisive politics, fear of contracting the virus and being hospitalized or dying – all of these have played a role in increasing not only loneliness, but in worsening mental and physical health in our older adult population,” Stevens says.
More time needed for emotional care
Long-term care homes or nursing homes provide a wide range of health and personal care services for older Canadians.
While there are employees that address the physical health needs of residents in these care homes, Waugh says there are very few staff that address the emotional connection that is needed to combat feelings of loneliness.
“More staff that can be one on one and provide some kind of emotional support would be so ideal,” she says. “You’re so burnt out by the fact that you’re picking up these understaffed shifts, that when it comes to your quality of care, not that it’s not good, but it’s hard to expect someone who has worked themselves to death to be able to provide someone else with emotional support when they’re struggling themselves.”
Paige Hutton, a former care aide at Colonel Belcher care home in Calgary and JB Wood Continuing Care in High Prairie also worked throughout the pandemic.
“What I found hardest was feeling like I couldn’t spend enough time just hanging out with the residents and talking,” she explains. “The residents’ faces always light up when you just sit down with no rush or specific reason and talk about whatever it is they love about the life they have had.”
Hutton says that her favourite part of her job was helping the female residents perform tasks such as painting their nails or doing their hair while talking to them about their life.
“This helped the ladies feel more like themselves,” she says.
Interactions with care aides and other care home staff like these ones are vital for the well-being of seniors at care homes, especially during the pandemic when family visitations are limited. However, the field is largely understaffed and underpaid.
A report done by the Royal Society of Canada in June 2020 indicated that 90 per cent of direct resident care is provided by care aides or other personal support workers who; receive low wages, receive minimal and variable education across the country, work part-time without benefits.
Additionally, these care aides are almost 90 per cent women, most of whom are older than 40, often from marginalized groups. The majority speak English as a second language, 25-30 per cent work more than one job, and two-thirds report having insufficient time to properly complete care tasks according to an article written by Sonya Norris.
This means that seniors in care homes are highly lacking in the emotional connection humans thrive on. Visiting or speaking with seniors when allowed is one of the most important ways to combat loneliness and social isolation. Ami Rokach explains that humans need to treat loneliness like a feeling that can be dealt with by connecting with others.
“It’s not a fate,” he says. “We need to remember that just like from time to time we feel hungry and we know what to do about it, from time to time we will end up feeling lonely.”
Personal connection is key
Debbie Olson, the coordinator for the Seniors Connection Program in Hillhurst Sunnyside, loves talking to seniors in the community and helping them with their everyday tasks from snow removal to helping them grocery shop.
“A lot of times I can tell from their voice that something’s wrong, or they’re not feeling good, or they’re upset about something,” she says as she explains what it is like connecting with seniors in the community on the phone. “And so I just find ways to get them to talk.”
During the pandemic, all of the services that Hillhurst offered went online instead of happening at their community center. This was a tough transition for their seniors, especially those who do not have the technology available to them.
“I’ve got quite a few seniors within the community itself who don’t have internet access, they don’t have the technology, so they can’t join the chair yoga online,” she says.
Due to seniors’ high health risk with the coronavirus, it makes it hard to resume their activities in person.
Technology, if utilized properly, would tremendously help the battle of loneliness among seniors in care homes. But many of them do not have access to technology that can keep them connected to others. This problem is due to its high cost and seniors’ limited comfort level with technology in general.
This is why Olson dedicates lots of her time to making phone calls to her seniors to check in on them and let them know that she is always there to talk to them.
Annastasia Stevens says that her organization, Calgary Seniors, provides social support by activating volunteers to increase the social inclusion and the quality of life of seniors at risk in the community.
“Our organization serves older persons, with particular emphasis on those who are socially isolated and/or experiencing other risk factors, such as being low income,” she says.
Some examples of some of the tasks that this organization does for seniors include; having volunteers drop off items to seniors who are homebound, check in frequently on isolated seniors by phone or in-person, and even deliver free daily meals prepared by the ATCO Blue Flame Kitchen to seniors who are in need.
“The very best way to help seniors experiencing loneliness is to volunteer,” Stevens explains. “Volunteering comes in many shapes and sizes. You don’t have to join an organization to help. We encourage people to think about the seniors in their lives – that might include family members, friends, neighbours, or strangers you bump into at the store. Small acts of kindness can mean a lot.”
Visits and check-ins make a difference
Jade Waugh explains how when a resident’s family comes to visit their loved one in the care home she works at, it makes a huge difference and boosts their emotional wellbeing.
“You want them to be happy, and you don’t want them to have feelings of loneliness,” she says. “When you see their family come in, it makes you feel love second-hand because you’re like, this person is not going to feel lonely anymore. But when you witness their family never coming in, it is so hard to witness.”
Valerie agrees with Waugh that it is hard to see a resident have no visitors when they are already so socially isolated.
“You can see a very noticeable difference in mood with the residents when they get to talk to and physically hang out with their families,” she says. “They are easier to cue with care, and they eat better. But during the pandemic, a lot of them have very little appetite.”
This is why it is so important to check in on seniors in the community and loved ones in care homes. It really does make a difference to even have a 10-minute phone call or drop by a senior’s home to ask if they need help with anything.