For Loved Ones in Long-term Care, Phoning Speaks Volumes

Isolated, lonely and fearful, many older Americans living in long-term care facilities have struggled during the coronavirus pandemic — especially when in-person visits from loved ones are not allowed.

A Yale School of Public Health study suggests regular phone calls could boost spirits and reduce loneliness.

The study, which was recently published in the American Journal of Geriatric Psychiatry, surveyed more than 160 Americans who have at least one close relationship with someone in a long-term care facility. The findings were not surprising in some ways, but surprising in others: Phone calls and e-mails were associated with fewer negative emotions and more positive emotions for family members, friends, and residents. However, written letters were associated with more negative emotions.

First author and Associate Professor Joan Monin, Ph.D., said the study provides key lessons for the future. As the pandemic still rages, she explained, phone calls could be a great way to keep in touch with those in long-term care facilities.

“It's an easy way for people to communicate and it doesn't have as much burden on staff to help facilitate as some of the other methods like video chat or window visits,” Monin said.

Monin’s team of researchers solicited responses from people across the country — and on Amazon’s task-fulfillment center Mechanical Turk — between March and April. After adjusting for key variables, their survey data shows that older Americans used a variety of methods to communicate with loved ones at that time, from phone calls and physically distanced visits through facility windows to letters and dropping off comfort items, but only some helped.

Many respondents reported having phone conversations with loved ones at least once per week. A smaller group texted with similar frequency. Those who tried phone calls while communicating through a window said they did so on average of about once per week.

Some of these methods were associated with emotional experiences; whereas others were not. There was no evidence that video conference calls had a greater benefit than just talking on the phone or email exchanges. In all, the research suggests that when in-person meetings are not possible, phone calls are most effective.

Still, it remains unclear why video conversations did not provide added benefit. Monin suspects that older adults are more familiar with using the phone to communicate with family members than using video chat, which may lead to greater comfort during communication. “However, as more people become familiar with using video chat, this may change,” she said.

“Also, synchronous communication, like using the phone, is preferable to getting letters in the mail, probably because you're able to talk back and forth and get real-time information about how they are feeling,” said Monin.

These findings have pushed Monin to figure out ways to facilitate more safe methods of communication between those in long-term care facilities and the outside world while also keeping staff burden down.

“I'm excited to take this work further to understand how to best support staff at long-term care facilities and help older residents stay in touch with their family members and friends,” she said. “We're just starting that work, but we want to make sure that we are asking staff to help in ways that don’t add to their burden but make everyone’s lives happier.”