COVID-19 and Mental Health (CMH) Initiative: Research

The Relationship Between Social Connectedness and Mental Health for Residents of Long-term Care Homes: Knowledge Synthesis and Mobilization

Key Messages

  • Infection control measures put in place to protect residents of long-term care (LTC) homes from COVID-19 have had a major impact on their social connectedness.
  • Research evidence shows that, among people living in LTC homes, social connectedness is associated with mental health outcomes including depression, cognitive decline and responsive behaviours.
  • Research evidence suggests strategies that might help to build and maintain social connectedness for LTC residents, including some that might be adapted in the context of COVID-19.

Lay Summary

We found roughly 60 studies that tested the association between social connectedness and a mental outcome health and roughly 150 observational and intervention studies that assessed some measure of social connectedness as an outcome. These studies reported associations between social connectedness and depression, anxiety, cognitive decline, negative mood and affect, and responsive behaviours as well as other mental health outcomes. Observational and intervention studies suggest strategies that might build and maintain social connectedness among LTC residents, and our team highlighted 12 that could be adapted in the context of infectious disease outbreaks, namely: manage pain; address visual impairments; sleep at night, not during the day; find opportunities for creative expression like art, music and storytelling; exercise; maintain religious and cultural practices; garden, either indoors or outside; visit with pets; use technology to communicate; laugh together; reminisce about events, people and places; and, communicate non-verbally.


  • Long-term care homes
  • Nursing homes
  • Mental health
  • Social relationships
  • Social support
  • Social networks
  • Social engagement
  • Loneliness


  • Nominated Principal Applicant: Jennifer Bethell, KITE, Toronto Rehabilitation Institute, University Health Network
  • Bethell, Jennifer (KITE, Toronto Rehabilitation Institute, University Health Network)
  • Babineau, Jessica (KITE, Toronto Rehabilitation Institute, University Health Network)
  • Bretzlaff, Monica (Behavioural Supports Ontario)
  • Edwards, Cathleen (Family Councils Ontario)
  • Gibson, Josie-Lee (Ontario Association of Residents’ Councils)
  • Hewitt Colborne, Debbie (Behavioural Supports Ontario)
  • Iaboni, Andrea (KITE, Toronto Rehabilitation Institute, University Health Network)
  • Lender, Dee (Ontario Association of Residents’ Councils)
  • McGilton, Katherine (KITE, Toronto Rehabilitation Institute, University Health Network)
  • Schon, Denise (Lakeside LTC Family Council)
  • Viau Aelick, Katelynn (Behavioural Supports Ontario)

For more information, please contact: Jennifer Bethell,

Related Syntheses


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Chronic Disease and/or Mental Illness, Aging


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