Your senior loved one may be dealing with multiple issues: hearing loss,
limited mobility, inability to manage household chores, etc. And it makes
sense that as you work to arrange care, managing straightforward tasks is
top of mind: hearing aid, walker, help with dishes—check, check, check.
These are essential tasks to handle.
many older people suffer from loneliness and depression, too. That’s a problem not as easily solved, and unfortunately,
loneliness has been shown to precipitate declining health and even
death. It can inhibit independence and mobility. And loneliness can even be an
issue for seniors who are not living alone. As you approach care options,
there are multiple paths—primarily, task-centered care vs. person-centered
professional caregiving—and it’s essential to consider the strengths,
weaknesses and outcomes of each in choosing a route for your loved one.
1. What is Task-Centered (or Task Management) Care?
Task-centered care is a social work practice, frequently used in hospitals,
nursing homes and assisted-living facilities, aimed at quickly
accomplishing measurable, specific goals. A target condition is identified by a medical professional, along with
steps to get there. In a hospital, for instance, the target might be
discharge, and the steps would be the checklist to get there. A goal is
accomplished, and the project is over.
A problem with task-centered care is that the person affected is
often not even involved. A
of the effects of person-centered care notes the many problems with the
task-centered model. Care Is “primarily granted and delivered based on
physical and functional needs, while psychosocial needs and quality of life
needs (quality of life) have been given less priority [leading to a] gap
between needs and services, between expectations and experiences, which may
lead to expressions of dissatisfaction.”
Furthermore, the study cites other studies that have demonstrated how much
“a trusting relationship between the older person and professional staff is
described as essential to enable shared decision making to facilitate the
older person’s autonomy and sense of being respected.”
The study also finds basis in another major issue with task-centered care,
particularly in nursing homes: keeping good staff. Citing many previous
the authors note that
“when it comes to age care staff in home care services, a growing crisis
has been described with high turnover rates and challenges in recruiting
and retaining skilled care professionals. Staff has reported experiences of
dissatisfaction and frustration with work, concerning a stressful and
hectic work situation, increasing demands for efficiency, not having
sufficient time to converse, provide the “little extras” and provide care
in the psychosocial domain.”
But it doesn’t have to be this way, the authors say, and person-centered
care is the solution:
“Other studies in aged care have shown positive results from
implementing a person-centered approach. For example, a study that
implemented person-centered care in rehabilitation care resulted in
functional improvements and higher satisfaction with care. Also, […]
increased involvement in care resulted in lower costs, higher physical
function, and shorter stays in hospital after hip fractures [and]
person-centered care of older people with dementia can prevent and
reduce agitation and depression.”
2. The Importance of an Interpersonal Connection
While task-centered care can provide the absolute bare minimum of care your
loved one needs, a professional caregiver offers that interpersonal
connection that supplements task-centered care in an essential and
exponential way. A professional caregiver offers more holistic care, to
ensure the emotional and social needs of your loved one—needs that may not
fall under task-centered care—are also met.
While the above study demonstrates the danger of isolation, it can be
helpful to consider real anecdotes, too. For example: In the aftermath of a
stroke, an 86-year-old Florida woman, who lived most of the year alone,
began receiving regular visits from a physical therapist and a nurse to aid
in her recovery. Her family—nearby, and closely involved in her care—found
peace of mind in having their experience on-hand, and were thankful for
While her family anticipated a boost in her physical health, they didn’t
expect what ended up being the greatest benefit: her absolute joy in having
these people regularly come to visit and the resulting immediate
improvement in her mental health. The aging Florida woman relished the
conversations she’d have during the visits, what they worked on, a funny
thing about so-and-so. It was a social side of her that her family hadn’t
seen in years. And—despite family members having tried everything to get
her to do simple exercises—she eagerly performed these tasks for the
visitors. She wanted to do her best for these new people in her life, in
the way that one puts forth even extra energy and effort in the beginning
of a friendship or relationship.
She was happy to be forging new connections, and not to feel so isolated.
Within weeks, she was walking with energy around the house and completing
tasks she hadn't handled by herself in years.
Not every instance will play out the same way, of course. That stroke was a
wake-up call and her expeditious treatment allowed for such a full
recovery. But this is far from the only example of professional caregivers
making a drastic difference in the lives of those they visit. The
regularity of a visitor, the conversation, the company to anticipate, the
“new friend”—these things can defeat loneliness and boost the quality (and
length) of one’s life.
In fact, the
National Institutes of Health cites several studies
demonstrating the adverse effects of social isolation in older adults—and
not just mentally or emotionally. Per the NIH:
“Social relationships are consistently associated with biomarkers of
health. Positive indicators of social well-being may be associated with
lower levels of interleukin-6 in otherwise healthy people.
Interleukin-6 is an inflammatory factor implicated in age-related
disorders such as Alzheimer’s disease, osteoporosis, rheumatoid
arthritis, cardiovascular disease and some forms of cancer. Social
isolation constitutes a major risk factor for morbidity and mortality,
especially in older adults” and “People who are lonely frequently have
elevated systolic blood pressure.”
3. What Can a Professional Caregiver Do Differently?
Many older individuals are adamant about staying in their own homes. But as
their health declines and the number of tasks they can no longer manage
grows, the situation can become challenging. Which is why many families
turn to professional caregivers, who can come help with grooming, household
chores, exercise, taking medication, etc.
But a professional caregiver can assist in a much more universal way,
helping keep loneliness and depression at bay and providing bright spots in
what tend to be otherwise long and empty days that stretch into weeks and
months. Your loved one can find a caregiver they connect with, who they
look forward to seeing, who gives them energy, on top of the benefits
inherent in being in their own home, which lets them maintain essential
self-respect and a sense of agency in being involved in their care plan. In
a nursing home or assisted living facility, task management care is what’s
available; it’s about checklists, the dedicated interpersonal aspect that
seniors need is almost always missing.
A professional caregiver goes beyond a measurable task. They are not
shuffled room to room marking charts and moving right along. Their presence
is consistent and long-term; they become a reliable conversation partner,
as well as an aid in health, well-being, and day-to-day needs.
Loneliness is a serious health issue, and the companionship of a
professional caregiver—someone who is focused on the person, not another
list of tasks—can help stave off the isolation that leads to loneliness and
depression. For more information on isolation in seniors,