How to better foster community among long-term care residents

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Eleanor Feldman Barbera, Ph.D.
Eleanor Feldman Barbera, Ph.D.

Mr. Cooper was staring out the window when I came by to see him for his weekly psychotherapy session. “There's no one here to talk to except you,” he said despondently.

“You're the fourth resident who told me that this week, Mr. Cooper!” I replied. “We need to get all of you together so you can talk to each other!”

Our strength is community

Many, if not most, of the services offered in the nursing home can be provided through home-based care. What sets nursing homes and other long-term care sites apart is the opportunity for residents to socialize with each other with ease.

The community atmosphere can be one of our most appealing aspects and biggest selling points to potential residents. Savvy facilities will make the most of this through developing and promoting their recreation programs and facilitating connections among residents and their families.

Benefits of social connections

According to Anna Miller in her January 2014 article in the American Psychological Association Monitor, having strong social connections has been “linked with such benefits as a greater pain tolerance, a stronger immune system, and a lower risk of depression and early death … [Loneliness causes] physiological processes to activate that are directly bad for your health.” This suggests we can actually improve the physical health of our residents by increasing their involvement in meaningful social activities.

Creating a stronger sense of community

Here are some suggestions to help develop positive connections between residents in long-term care:

1.     Facilitate interactions between residents upon their admission.

As I wrote in The Critical Period, the arrival in LTC is a time when new behaviors — such as attending activities — are easiest to establish. Don't wait until a resident is in the habit of staying alone in his or her room all day; instead, send a welcoming committee to engage the resident immediately. Find out new residents' interests and connect them to others in the facility who share their passion for gardening or baseball, for instance.

2.     Create opportunities to share secrets.

Research shows that “gradually increasing the depth of questions and answers between strangers can spawn friendships in just 45 minutes.” Our residents may need more time and some assistance in overcoming the challenges of low voices and hearing impairments, but an aware staff member can bridge the gap. Create group activities that encourage residents to share personal details they're comfortable with revealing, such as their hobbies or their favorite type of music. Help residents get to know each other as people and offer socially acceptable ways to let them “brag” about their past accomplishments. For more on facilitating activities that encourage bonds between residents, visit My Better Nursing Home for the free report (scroll down the page), Leadership Strategies for Maximum Socialization.

3.     Breed familiarity.

According to Miller's article, researchers find that, contrary to the old saw about contempt, “familiarity breeds attraction.” After discovering in a secret-revealing group that two residents share a love for art, for example, have your recreation staff seat them next to each other at the next art class and again the week after that. Assign two residents from the same hometown to the same dinner table. Assist residents in wheelchairs to sit near their friends because they're often unable to maneuver the chair themselves in a crowded environment. Seat companions next to a resident's “good ear” so they can be part of the conversation.

4.     Work together toward a common good.

Many residents yearn for the opportunity to be of service to the larger community. They want to be taking care of something rather to be continually taken care of. Couple this urge with the opportunity to work with peers on a joint project. It could be raising money through a bake sale to benefit a local charity of the residents' choosing or putting together a musical that the whole facility can enjoy. Long ago, I ran a group with a recreation therapist in which one of our projects was writing letters to residents (identified by group members) who didn't leave their rooms, inviting them to join our activity. A blind woman had help from an illiterate man about where to set her pen on the paper and the group voted on what to say — an empowering pro-social collaboration.

Facilitating positive connections between residents not only benefits them —  it also creates a more hopeful and positive environment in general. Residents who are busy with their friends are less likely to be anxious and demanding of staff time.

Everyone on the floor is cheered observing elders sharing a laugh. Family members feel better leaving their loved ones in your care, and admissions tours take on a more optimistic tone when visitors observe engaged residents enjoying their days.

Eleanor Feldman Barbera, PhD, author of The Savvy Resident's Guide, is an accomplished speaker and consultant with over 17 years of experience as a psychologist in long-term care. This blog complements her award-winning website,, which has more on how to create long-term care where EVERYBODY thrives.


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