How peer mentoring affects depression, loneliness, and social engagement within long-term care settings

Theurer, K. A., Stone, R. I., Suto, M. J., Timonen, V., Brown, S. G., & Mortenson, W. B. (2020). The Impact of Peer Mentoring on Loneliness, Depression, and Social Engagement in Long-Term Care. Journal of Applied Gerontology, 0733464820910939. 

https://doi.org/10.1177/0733464820910939

Summarized by Ariel Ervin

Notes of Interest:

• There are limited opportunities for the elderly population, who are living in long-term care settings (i.e. assisted living, retirement homes, & nursing homes), to engage in meaningful social interactions  
• Peer mentoring can help boost the social citizenship of the elderly population
• This current study examines the influence that mentoring has on mentee’s depression, loneliness, and social engagement; it also looks at how mentees perceive peer mentoring relationships
• Quantitative surveys and qualitative interviews were conducted
• Findings suggest that mentoring can potentially encourage individuals to become more involved, especially for those that usually don’t engage much in social activities
• Rates of depression and loneliness decreased as the peer mentorship progressed
• More research needs to be conducted to assess how effective peer mentoring is in providing social and emotional support within long-term care settings 

Introduction (Reprinted from the Abstract)

Loneliness, depression, and social isolation are common among people living in long-term care homes, despite the activities provided. We examined the impact of a new peer mentoring program called Java Mentorship on mentees’ loneliness, depression, and social engagement, and described their perceptions of the visits. We conducted a mixed-methods approach in 10 homes in Ontario, Canada, and enrolled residents as mentees (n = 74). We used quantitative surveys and qualitative interviews to understand their experience. After 6 months, mentees (n = 43) showed a 30% reduction in depression (p = .02, d = .76), a 12% reduction in loneliness (p = .02, d = .76), and a 60% increase in the number of monthly programs attended (p = .01, d = .37), with small-to-medium effect sizes. The analysis of mentee’s interviews revealed positive perceptions. This program offers an innovative, nonpharmacological alternative to the treatment of loneliness and depression.

Implications (Reprinted from the Discussion)

In this article, we explored mentorship as a potential program for reducing loneliness and depression and increasing social engagement among residents who are isolated within long-term care homes. Although the study design does not permit causal inferences to be made, the findings suggest that mentoring may be a useful approach for engaging residents who are typically not involved. The findings are buttressed by the congruence between the quantitative and qualitative findings and the fact that quantitative data demonstrated both subjective (psychological) and objective (program attendance) changes. The decrease in loneliness observed is remarkable given the many failures of loneliness interventions noted previously in the literature (de Jong-Gierveld et al., 2018). Prior research indicates that the consequences of loneliness are not adequately addressed in many existing programs and that there is a lack of evidence on how to improve the outcomes (Cohen-Mansfield, 2014). The mentorship program is different as it is based on a theoretical foundation and has a structure that is built on weekly team meetings, education for the mentors, and visiting in pairs to enhance social engagement among socially isolated residents. This result resonates with prior research that indicates the importance of relationships and reciprocity in social support (Brownie & Horstmanshof, 2011). Cohen-Mansfield and Parpura-Gill (2007) proposed that psychosocial factors have the strongest influence on loneliness and that preventive programs that include multiple opportunities for engagement will have the greatest effect. The program’s structure enabled mentors to use a variety of approaches during visits and to visit throughout the week as their schedules allowed. For instance, one mentee described that her loneliness was most intense in the evenings and that she valued a chance to talk at that time of day. Consequently, having flexible times for the mentors’ visits was useful and may have contributed to the decrease in loneliness scores overall.

Our finding of reduced depressive symptoms is also notable. Given the recalcitrant nature of depression in these settings (Conn & Snowden, 2010), it is important to highlight that the toll depression takes on the health of older adults, which includes increased cognitive decline and dementia, and reduced functioning and quality of life (Hawkley & Capitanio, 2015). This decrease in depressive symptoms is consistent with an earlier study that found peer mentoring as a promising model of depression care delivery for older adults (Joo et al., 2016). Long-term care residents often have fewer friends and family contacts (Meeks & Looney, 2011), so relationships with peers may help residents cope with the many losses they experience. As over a third of the mentees had GDS-SF scores suggestive of depression, the importance of these connections with their peers and the pleasure they derived from these connections is noteworthy. If this intervention proves to be effective in future experimental studies, it might help address an overwhelming need.

Our finding of increased engagement among mentees in other programs is also significant. This finding suggests a potentially significant impact of residents helping their peers to connect socially and emotionally in their communities. Program attendance might drive decreases in loneliness and reductions in depression. However, the quality of those programs and residents’ engagement in them are also likely to be important (Theurer et al., 2015). Another possibility is that the reduced feeling of loneliness encourages participation, thereby creating a positive feedback loop.

 

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