Social
Who is lonelier: in-home or long-term residential care? Rosanne Freak-Poli* Rosanne Freak-Poli Barbara Barbosa Neves Chilot Agegnehu Pei-Chun Ko
Background
Surgeon General Murthy has declared that America has an “epidemic” of loneliness and has likened its public health risks to smoking. People in later life and people with ill health are particularly vulnerable to loneliness.
Aim
To compare loneliness, social isolation, and social support by living situation among Australia’s most health-vulnerable older adults.
Methods
495 Australians receiving the highest care tier under the government subsidy system were recruited. Surveys were conducted online and in-person between October 2023 and July 2024.
Results
Participants in long-term residential care (n=279) were older (mean±SD 85.81±7.83 vs. 82.34±7.28 years, p<0.001), more likely to be born in Australia (67% vs. 58%, p=0.01), speak English as their first language (90% vs. 80%, p=0.03), and report having never had a partner (19% vs. 6%, p=0.001) compared to those receiving in-home care (n=216). No significant differences were observed for gender, sexual orientation, Aboriginal or Torres Strait Islander status, or education level.
The prevalence rates are disheartening. Across multiple measurements, at least 30% are lonely, 40% have low social support, and around half are socially isolated (Figure). Long-term residential care participants tended to be less lonely and have more social support, but be more socially isolated than in-home care recipients (Figure).
Conclusion
This study represents the largest research sample of high-tier recipients. We found that individuals receiving in-home care experience more loneliness and lower social support, despite having lower social isolation compared to those in long-term residential care. Given the known benefits of social interaction for health and well-being, these findings have critical implications for policies that assist people to remain at home in later life. However, the disheartening prevalence rates highlight the need for strategies to enhance social connection among older adults in both settings
