Technology may exacerbate longstanding health issue of loneliness, writes Community Care Durham CEO
There is a sense of relief in the air. After the hardships of the pandemic, seeing family and friends gradually reunite during these summer months brings joy to our hearts. These social connections form a vital part of our health and wellness, bolstering our resilience to overcome many of life’s obstacles.
However, despite this optimism and with the threat of future waves due to COVID-19 looming, longstanding health and social issues remain exposed, threatening the same population that has suffered more than any other group — seniors. And it’s a condition that existed long before March 2020.
The World Health Organization long declared loneliness as a serious global health issue. Research has shown that loneliness increases the likelihood of hospitalization, loss of physical and mental function, higher rates of dementia, depression, anxiety and suicide. The risk factors of loneliness have been evenly compared to the risks of smoking.
For an aging population, these risks can also include the loss of a person’s ability to maintain their independence and ability to age at home. In its August 2020 survey, the Canadian Red Cross found that one-third of vulnerable older persons reported they did not have others that could help them or get them help right away if needed. Similar numbers reported feeling lonely frequently or every day. That is nearly three times the rate of healthier persons. As a result, only half of the respondents reported they felt good about themselves and their prospects for the future. Hope is the foundation of resilience.
The health system accelerated its virtual care solutions in response to public health restrictions on social gatherings and services during COVID. At Community Care Durham, virtual programs helped clients connect with our staff and volunteers and other members of the community. One client noted the positive social aspects of online exercise programs: “It gives me something to look forward to every day,” she said. “You get up and do your hair because you know you’re going to be seen.”
We and other agencies adapted to virtual delivery with our Adult Day Programs (ADP). In these programs, clients engage in activities that promote mental and physical stimulation, with opportunities for socialization and relief for their caregivers. Led by our local Seniors Care Network (seniorscarenetwork.ca), regional ADP providers evaluated the blending of in-person and virtual ADP services from July 2020 to March 2021. The evaluation found that a hybrid of in-person and virtual programs provided more significant opportunities for socialization, mental stimulation, physical activity and the maintenance of daily routines.
However, the evaluation also highlighted what we in the primary health care community knew: virtual programs are not a solution for everyone.
Virtual interactions cannot replace in-person interactions for many reasons, including the practical realities of the social-economic digital divide. Too many members of our society lack access to reliable, affordable technology. In-person programs are also better suited for most of our clients, many of whom have complex social, physical and cognitive challenges. These challenges create what I label as the cognitive-emotional digital divide.
Virtual interventions do not provide the same psychological benefit for everyone. Older persons with chronic health issues are more likely to have diminished perceptual, cognitive and psycho-social abilities. In-person programs provide a more tactile experience for people with dementia and mental health issues, such as anxiety and depression, and those with physical barriers such as deafness and blindness. These groups do not benefit from virtual interactions in the same way as a healthier, socially connected person.
If health systems and funders focus solely on virtual care solutions in this post-pandemic recovery, they may likely miss reaching the most at-risk people. While technology can be an inclusionary force by extending health services to distant or hard-to-reach populations, it may also risk alienating others who have neither the economic, social nor cognitive capacity to engage in it fully. In other words, technology may exacerbate rather than address the longstanding health issue of loneliness.
Virtual care is a valuable new tool in the health frontier. But its adoption must be done slowly and in conjunction with person-to-person interactions to cross the social-economic-emotional digital divide, rather than entrench it.