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Where are the risks? Safety versus isolation: closed cultures caused by Coronavirus

Loneliness and isolation are not only terribly sad to see, but very harmful to health.

Unfortunately, due to the pandemic there has been a surge in loneliness across all age ranges. Nowhere is it more evident than amongst those living in care homes and other long stay settings. I think many care home staff have managed a hugely difficult situation very well, there are pictures of innovative ways to maintain contact popping up across social media all the time. Loneliness isn't restricted to care home residents; let's remember people can be frightened and lonely in an accident and emergency department, on maternity leave at home or shielding in the community.

Maybe, in some ways, it is no bad thing that my own mother is past the point on her life's journey where she can feel loneliness. Sadly, her ability to interact with the world was severely curtailed by a serious stroke nearly two ago. Her cognitive abilities are reduced to an awareness of pain, fear and hunger. Her responses are often restricted to overtly distressed behaviours; the care staff in her nursing home manage the challenges her situation presents very well. I trust them to be compassionate, to provide for the basic needs she has. I know they use the power of a kindly touch to reduce her anxieties and stress. That feels very reassuring for me, as a family member who cannot visit at this time.

How should we manage the risk of transmitting a deadly virus to a very vulnerable group against the risks of loneliness and isolation? I guess its easy to see if someone is becoming physically unwell from a known cause, isn't it? We can see they are struggling to breath or have a raised temperature. We focus on acute illness because we know how to respond; we feel better when we do something to alleviate discomfort.

How well do we understand the impact of loneliness and isolation? Do we recognise that when our need for social relationships is not met, we fall apart mentally and even physically? What are those risks? Is it more than feeling sad?

Well yes, it is. Loneliness has a significant impact on us and can cause raised blood pressure; it undermines the regulation of the circulatory system and causes increased levels of stress hormones.

It destroys the quality and quantity of sleep such that sleep loses it's restorative powers. Tragically, it increases the risk of suicide.

The Royal College of Nursing suggests that, "The effect of loneliness and isolation can be as harmful to health as obesity or smoking 15 cigarettes a day.

Lonely individuals are at higher risk of the onset of disability and loneliness puts individuals at greater risk of cognitive decline."

If health and social care professionals want to provide the very best care, if they are committed to seeing the whole person and responding to individual needs, they need to consider whether loneliness is an unmet need for the people they are serving. If it is, they need to look at ways to reduce the risks and help people develop social contact and coping mechanisms. People are social creatures; they need company, activity, fun, touch, laughter and to be supported to maintain contact with those they love.

A huge ask for staff at this time but one well worth investing in. A team willing to think 'outside the box' to adapt their own ideas and those of others to work out solutions rather than barriers to success will pay dividends.

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