Video calls became a lifeline for many people during the restrictions of the early COVID-19 pandemic, allowing families to catch up, employees to work and patients to meet their doctors, all without ever leaving home.
But those calls weren't always accessible to those who needed them most: people living with dementia in care homes. Now, just as Zoom meetings at work have outlasted pandemic restrictions, a new program aims to make facilitated video calls a standard part of the care for people living with dementia in long-term care, with the goal of improving their quality of life and combating loneliness.
"Connecting Today" is a facilitated virtual visiting program developed by Hannah O'Rourke, assistant professor in the Faculty of Nursing, that trains care home staff to facilitate up to 60 minutes per week of calls between care home residents and their family members. There's a manual for the facilitator including technical tips and prompts to engage both the resident and the visitor. They may just talk or listen to music together and look at photos — non-verbal interactions that continue to matter to people living with even the most severe dementia.
It may seem like a common-sense solution, but using care staff to facilitate virtual calls to connect residents to the people they care about is not offered in every care home. There is limited research exploring whether the facilitation approaches are feasible and engaging for people with moderate or severe dementia, says O'Rourke, and such programs have never been tested for effectiveness.
"The irony of the care home is that residents are surrounded by people, but are those interactions meaningful? Do they have an opportunity to connect with the people who have mattered to them throughout their life?" asks O'Rourke.
O'Rourke has just completed a three-year feasibility study of the program with funding from the Alzheimer Society of Canada and is continuing with a new grant of $100,000 from the Canadian Institutes of Health Research. Next she plans to test the program through a multi-province clinical trial.
"We wanted a program that would support people across all stages of dementia, regardless of their ability to communicate verbally, so they can have meaningful interactions with their family and friends, and potentially expand their network a bit, because oftentimes in care homes they see the same visitor over and over, putting pressure on a single family carer, or they may not receive many visits at all," O'Rourke explains.
A human right to social connection
There's no cure for dementia, which is marked by progressive memory loss and other cognitive decline, but that shouldn't mean people who live with it can't live satisfying lives, says O'Rourke. In a scoping review of previous studies involving interviews with people living with dementia, O'Rourke found four factors that individuals identified as most important to their quality of life: a sense of wellness, a sense of purpose, a sense of place and a sense of togetherness.
All of those are highly modifiable factors according to O'Rourke, unlike cognitive impairment, and she set up her research program with a focus on improving social connection.
"Social connectedness is just a human need and people living with dementia are no different," O'Rourke insists. "I believe it's a human right to have social connection and quality of life. People living with dementia in care homes therefore require accessible programs that will promote social connection."
In a soon-to-be-published paper, O'Rourke worked with 21 residents over a period of six weeks and she reports that 92 per cent demonstrated alertness and pleasure during the video calls. In previously published results, residents' family contacts rated Connecting Today as a logical, effective and low-risk approach to increasing social connection for their loved ones in care homes.
