Dr. Anna Azulai saw firsthand the issues of loneliness in long-term care when she was a practicing social worker. Since then, the assistant professor of social work at MacEwan University has focused on finding solutions.

“Living isn’t just about staying alive,” says the assistant professor in the School of Social Work. "Conversations about social isolation and extreme loneliness may have been new to the general public since the beginning of the pandemic, but for practitioners, this has been a longstanding issue for long-term care.” 

With 80 per cent of COVID-19 related deaths in Canada occurring in geriatric residential care facilities during the first wave of the pandemic, the focus was on survival. But as family visits abruptly stopped and facilities lost staff, loneliness and isolation become intolerable, says Dr. Azulai. 

“There was a lot of information proliferating about COVID-19 itself, but not much about how to cope with loneliness, social isolation and other determinants of health,” she says. 

But paying attention to the social and emotional needs of people in long-term care is essential. Today, people generally live independently for longer. Residents in the contemporary long-term care facilities in Canada are, usually, very sick and have complex, chronic medical and mental health needs. 

“The average stay in long-term care settings today is for about a year-and-a-half to two years,” says Dr. Azulai. “We are trying to protect them from dying, but realistically – survival is not necessarily the only concern. Quality of life and psycho-social wellbeing during their last months and years must also be considered.”

Thus the title of a new 18-month study, funded by the Social Sciences and Humanities Research Council, by Dr. Azulai and her colleague in MacEwan’s School of Social Work, Dr. Hongmei Tong and MacEwan Librarian Alison Pitcher: “It is not only about staying alive: A living systematic review of social care strategies for older adults in residential care facilities during COVID-19 pandemic.”

The study, underway now, looks at what is being done across Canada during the COVID-19 pandemic to address psycho-social wellbeing of residents in long-term care and other congregate-living facilities. 

The three researchers and their student research assistants, are beginning with a systemic literature review – a rigorous knowledge synthesis method in research projects. 

Combing through 85,000 research studies, Dr. Azulai and her colleagues will use the data-driven approach to map out social care strategies currently used across Canada – everything from family visits and engaging with volunteers to technology-focused initiatives used during the pandemic. They are also looking to identify gaps in addressing social determinants of health (non-medical factors that influence health outcomes, including income, disability, access to nutritious foods, access to healthcare, social inclusion education and more). 

Once they determine what is happening – and what isn’t – they can identify new recommended strategies, approaches and programs. They expect to have findings next spring, and ultimately, says Dr. Azulai, the goal is to share the knowledge they generate with social work, health and allied health practitioners, researchers and educators. 

“You don’t need to be alone to be lonely – when our immediate environment does not facilitate interest, engagement, presence, then loneliness can set in,” she says. “And even when people in long-term care have families who visit them quite often, they are still spending the majority of their time without their family members. That’s why finding ways to meet social and emotional needs is so important.”