3 areas home-based strategies can help

The Bottom Line

  • Loneliness and social isolation, heart disease, and dementia affect millions of Canadians.
  • A variety of strategies delivered in the privacy of a person’s home may help enhance social connectedness in older adults, can be comparable to centre-based rehabilitation in people living with heart disease, and can improve everyday functioning in people living with mild-to-moderate dementia.  
  • Interested in trying a home-based strategy? Speak with your healthcare team about what options are available and well-suited for you.     

A home can house many things: people, pets, keepsakes, and memories. Beyond that, it can also be a place we leverage to improve our health and well-being. How, you ask? Well, through the implementation of home-based strategies. These strategies, which can be delivered face-face-to-face and/or virtually, help to remove barriers that reduce access to health care services and impact adherence to treatments or healthy behaviours. Over the years, researchers have investigated how we can engage in different strategies right from the comfort of our own homes and if they're effective. Home-based strategies targeted at folks experiencing loneliness and social isolation, as well as those living with heart disease, dementia, and Parkinson’s have been studied (1-3). Click on the links below to learn more.


1. Loneliness and social isolation

A large percentage of Canadian’s aged 50 or over experience social isolation (41%) and varying levels of loneliness (57%) (4). Psychological therapies, befriending programs, skill development activities, and the provision of support by health and social care professionals are examples of home-based strategies that aim to tackle these issues. Research shows that compared to usual care or placebo, home-based strategies may enhance social connectedness in older adults through large increases in social engagement and moderate increases in social support. Additionally, they may result in small or very small reductions in loneliness and depressive symptoms. More research is needed to further support these findings and shed light on how best to deliver these strategies (1).


2. Heart disease

In Canada, 2.6 million adults aged 20 or over live with a diagnosis of heart disease (5). One strategy geared towards this population is cardiac rehabilitation, which combines education, emotional support, exercise training and promotion, and risk management in a personalized way. Research shows home-based cardiac rehabilitation and supervised centre-based cardiac rehabilitation can be comparable when it comes to improving exercise capacity, number of deaths, and health-related quality of life. More research is needed on how cardiac rehabilitation at home vs. a centre stack up in the long term (2).


3. Dementia

More than 733,000 people in Canada live with dementia, and this number is growing (6). For people living with dementia, cognitive rehabilitation—a collaborative and tailored strategy that involves developing and implementing a plan to improve activities of daily living that an individual has identified as important to them—is one available support. Cognitive rehabilitation is generally delivered at home. Research shows that compared to usual care, cognitive rehabilitation can produce large improvements in everyday functioning. These benefits are specific to people living with mild‐to‐moderate dementia and can last up to 3 to 12 months. More research is needed to increase certainty in the findings (3).  


Curious about what healthcare services and health-related programming you can access at home? Consult your healthcare team to learn more about your options, specially what’s available, feasible, and appropriate for you and your health needs.


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References

  1. Chua CMS, Chua JYX, Shorey S. Effectiveness of home-based interventions in improving loneliness and social connectedness among older adults: A systematic review and meta-analysis. Aging Ment Health. 28(1):1-10. doi: 10.1080/13607863.2023.2237919. 
  2. McDonagh STJ, Dalal H, Moore S, et al. Home‐based versus centre‐based cardiac rehabilitation. Cochrane Database Syst Rev. 2023; 10:CD007130. doi: 10.1002/14651858.CD007130.pub5.
  3. Kudlicka A, Martyr A, Bahar-Fuchs A, et al. Cognitive rehabilitation for people with mild to moderate dementia. Cochrane Database Syst Rev. 2023; 6:CD013388. doi: 10.1002/14651858.CD013388.pub2. 
  4. Iciaszczyk N, Neuman K, Brierley A, et al. Perspectives on growing older in Canada: The 2023 NIA ageing in Canada survey. Toronto, ON: National Institute on Ageing (2023), Toronto Metropolitan University. 
  5. Government of Canada. Heart disease in Canada. [Internet] 2022. [cited September 2024]. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html 
  6. Alzheimer Society. Dementia numbers in Canada. [Internet] 2024. [cited July 2024]. Available from: https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada

    DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

    Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.