Mental health needs to be part of the conversation about long-term care

This story was originally published in The Fulcrum | Photo credit: Georg Arthur Pflueger,

Long-term care is one of the sectors hardest hit by the pandemic. The high death toll in long-term care homes, lack of proper action from many of these places, and—as was the case west of Montreal—the literal abandonment of long-term care residents supports the case.

Amid the chaos is a second tragedy that few have talked about so far: residents’ mental health. As Canada re-opens, this issue should not be left behind.

For a long time, it has been an open secret that loneliness, social isolation, depression, and anxiety are common among older adults in long-term care homes.

In a report done by the Canadian Institute for Health Information in 2010, 44 per cent of the sampled 50,000 seniors who lived in long-term care had a diagnosis or reported symptoms of depression. The reality is, if you are in long-term care, you may be more at risk of psychological distress. And there are some driving factors that can put certain older adults more at risk than others. 

One such factor is disabilities. Many people are admitted to long-term care when they are physically or mentally unable to take care of themselves. This loss of independence, depending on their ability to cope, can lead to depression. 

Another is change in environment. When a person transitions to long-term care, they might be stressed or anxious about what the future holds for them. This is not helped by the fact that many long-term care homes resemble hospitals more than actual homes—which can lead to further feelings of alienation and discomfort among residents. 

And yet another factor, and perhaps the most tragic, is the notion of grief at the loss of loved ones. Grief is already enough to put a person’s mental health at risk. But combined with disability and living in an unfamiliar environment, it can further set the stage for anxiety and depression.

In May of this year, long-term care residents made up 81 per cent of all COVID-19 related deaths. It is therefore not hard to imagine that rates of depression and anxiety would increase among the survivors. 

Surviving residents bore witness to the death of their friends and neighbours, all while coping with their own feelings of isolation and uncertainty related to the virus. Going forward we might expect them to be consumed by a new level of grief and trauma.

On the bright side, there are many things we have done to stay connected to residents during the pandemic. Children have organized letter-writing campaigns, volunteers are teaching residents to do video calls, families visit and have play music outside of residents’ windows.

These efforts are good, but they should only be a start. There remains a dire need to address the mental health of long-term care residents, especially as the trauma of the pandemic sets in.

As Canada re-opens, long-term care must stay on the agenda and mental health needs to be part of the conversation. 

We have all been shocked by the pandemic, some more than others. 

When it comes to mental health, it is one thing to survive, but it is another thing entirely to feel alive.

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