COVID-19 has had an unprecedented impact on social isolation. Care homes across the U.K have had to restrict visitors in line with recommended visiting regulations  based on individual risk assessments, and shared decision-making from all stakeholders. As part of recommended practice , when face-to-face communication is not possible, it is suggested that care homes facilitate communication by using tools such as a telephone or a smart device.

Our research team, at both Northumbria and Swansea Universities, recently carried out a study, funded by the British Academy/Leverhulme Trust, exploring older adults’ experiences of using technology (including social media) to connect with others. The first phase of this two-phase study involved interviews with 20 older adults (65+ years old) from across the UK, all of whom regularly used digital devices and social media. These findings highlighted the importance of technology and social media for social relationships, specifically visual communication tools. Although this study was carried out before the onset of COVID-19, and with older adults living independently, there are some translatable outcomes for the adoption of technology for social connection in care homes.

The findings show that prior to COVID-19, individuals primarily chose to use technology to keep in touch with family and friends whom they could not see in person. Participants described the benefits of technology, including video calling, WhatsApp messaging, and social media, as increasing the regularity of communication with friends and family.

“[My children and I don’t] communicate too often, but with a WhatsApp family page we throw things at each other. We’ve been hearing about my daughter’s holiday. My son is abroad at the moment, we’ve been hearing about him. He works abroad quite a lot, so he keeps in touch that way”

This way of communicating with friends and family could be useful to care homes, particularly now with the new restrictions. Whilst the telephone is an accessible form of communication, the participants in our study spoke of the importance of seeing each other, they felt like they were ‘really’ getting a sense of how someone was feeling, connecting on a deeper level.

“I mean it’s the visual. If you’re having a conversation with someone and you can see their face and see the response and the smiles and the rest, it just adds something, doesn’t it? […] And the same with the telephone you can find out that you have an argument starting that wouldn’t be there if you could see the twinkle in the eye”

On the whole, participants described the benefits of online communication, specifically visual communication, as a way of connecting with family and friends and maintain relationships.

But what about those who do not have these technologies to use, or don’t have the skills to do so? The participants in this study, who used multiple devices and apps regularly, still experienced barriers to using it as a tool to connect with others:

1. Low self-confidence
2. Fear
3. Problems with physical functioning
4. Culture and communication
5. Lack of social capital (i.e. social network to support use)

The barriers experienced by individuals living independently can also be experienced by those living in care homes, however, additional factors need to be considered. As a researcher with a particular interest in the health and well-being of older adults, I have visited a number of care homes in recent years and something identified as problematic is poor internet connection. Care homes often have complex layouts with internet connection only accessible in certain parts of the building. During the pandemic, care home residents may rely exclusively on technology to connect with family and friends so this can be act as an additional barrier.

A study describing the implementation of a ‘Skype on Wheels’ intervention, highlighted various facilitators and barriers to using video-calling technology in a care home. In addition to individual barriers, staff attitudes, staff risk averseness and staff turnover often acted as barriers. In our study, an individual’s social network was highly influential. Often, without this existing social network, individuals would not have received the digital device, have gotten started with it, or have the support to keep using it. Although staff and other residents could support individuals, this was dependent upon their own digital knowledge and skills.

What can care homes do to promote digital inclusivity?

1. Set up time to support use of technology – a 5-minute tutorial on how to make a video call. This could be supported by care staff or peer-support from another resident. Having someone available to help can help boost confidence.
2. Encourage residents to experiment with video calling friends and family.
3. Consider the care home environment itself. Identify areas with poor internet connection. Speak to the internet provider about upgrading the service.

Why should care homes be promoting digital inclusivity?

Reducing isolation and loneliness in care homes extends further than residents simply feeling less lonely. Research shows that loneliness increases the risk of developing high blood pressure, coronary heart disease and stroke. In addition to this, a number of mental health issues are connected to loneliness such as, cognitive decline, dementia and depression.

Encouraging residents to stay connected to friends and family, in whatever way possible, should be thought of as a preventative health measure. Educating people on the benefits of using technology to stay connected can promote improved health and well-being.

Final thoughts

The overall message from this study was that technology was a useful tool for social connection, but not a replacement for face to face communication. However, restrictions during COVID-19 mean it may be the only way in which residents can communicate visually with friends and family. However, equally, reliance on technology during the COVID-19 pandemic will bring the “digital divide” to the fore as many will not have access or the ability to use this technology. For care home residents, this can additionally be mediated by their environment. It’s vital that those who struggle to use technology or get online aren’t left behind.

The research team: Dr Gemma Wilson (Northumbria University), Mrs Jessica Gates (Northumbria University), Dr Santosh Vijaykumar (Northumbria University), and Dr Deborah Morgan (Swansea University).

 The podcast “Ageing in a Digital World” accompanying this study is available to listen/download on the following platforms:

Soundcloud:                  https://soundcloud.com/user-589740502/ageing-in-a-digital-world

Spotify:                            https://open.spotify.com/show/3YaugSTw5wTNCujhTZSTug

iTunes:                             https://podcasts.apple.com/gb/podcast/ageing-in-a-digital world/id1506615062?i=1000470663608