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Dementia and lockdown loneliness: problems and possibilities
Rates of loneliness and isolation have dramatically risen during the lockdown but what are the implications of this for people with dementia and for those who work with them?
The coronavirus has had a huge impact on the lives of older people. For as the Office for National Statistics has found, those aged over seventy make up more than four in five of those dying from the virus and are more likely to be advised to shield than other age groups. This has led to increasing levels of loneliness amongst older people both in care homes and in the community, with many being cut off from their usual support networks and activities. This loneliness has been found to be worse for health than smoking or obesity and can increase the incidence of dementia, heart disease, depression and even premature death. In view of these negative outcomes, some believe that our effort to avoid catching the virus is having a worse impact than the virus itself.
For older people with dementia the pandemic has given rise to particular challenges. For not only are they less likely than others to understand the need for social distancing and self-isolation but the impact of this isolation is likely to be especially severe, potentially serving to accelerate the incidence of cognitive decline. They are also less able to transcend the social barriers placed upon them during lockdown due, for example, to their common difficulties in using communication technologies such as Facetime, email and smart phones. Accompanying this digital exclusion is the more general and long standing social exclusion (1) of people with dementia. This is reflected and reinforced by stigmatising attitudes and by paternalistic and risk-averse professional cultures which focus on maintaining safety rather than on individual strengths and aspirations.
In response to the negative impact of loneliness and isolation, the government has launched a Loneliness Covid-19 Grant Fund aimed at providing targeted support for those most at risk. Health and social care workers can also play a role in tackling lockdown loneliness amongst people with dementia through measures that achieve a balance between protecting them from the virus while also acknowledging their right to live a fulfilling and meaningful life. Measures could include the incorporation within each person’s care plan a consideration of their need for social contact during lockdown and how this will be achieved, potentially permitting an acceptable level of risk in this achievement. These plans of care should also recognise that the extent and nature of this need for contact will vary and that isolation does not necessarily lead to loneliness which is, in itself, a subjective experience.
Appropriate activities and support to access them should also be made available. With this goal in mind, a number of innovative approaches have been developed during the pandemic to address the needs of older people. These include volunteer schemes (2) and virtual village halls (3) as well as advice on how to meet the specific needs of people with dementia. On a wider level, the Campaign to End Loneliness (4) gives detailed guidance on tackling loneliness in older age. It is also involved in campaigning on behalf of older people and their right to establish and maintain social connections. With no end to the pandemic in sight and with further lockdowns taking place, we should recognise that this social contact is not only key to individual wellbeing, it is also a basic human right both during this crisis and beyond.
(1) https://www.tandfonline.com/doi/full/10.1080/13607863.2016.1222351
(2) https://www.ageuk.org.uk/information-advice/coronavirus/
Elaine Argyle
Senior Research Fellow
The University of Nottingham
Elaine Argyle is a Senior Research Fellow at The University of Nottingham where she has worked since 2012. Prior to this, she worked as a postdoctoral researcher at Bradford Dementia Group after obtaining a PhD and an ESRC Postdoctoral Research Fellowship in Social Gerontology at the University of Sheffield. She is also a dually registered mental health professional (RMN, Dip SW) and has many years experience of working with people with dementia in these capacities.
