Individuals who lack decision-making capacity and have no family or friends to act as their surrogate decision-maker are unbefriended. Unbefriended individuals are unsupported by family and friends, and often require a public guardian to help make personal decisions. In long term care, these individuals can be socially isolated, which may have negative social and health impacts, making this group of residents a highly vulnerable population.

As part of her doctoral research, our PhD student Stephanie Chamberlain, reviewed literature on unbefriended individuals in long term care to find out what other researchers have written about the topic. Stephanie conducted a type of literature review called a scoping review, which assess a large body of scientific literature, to see what information was available on this population in Canada and the US. She was interested in finding out who individuals under public guardianship are--what are their demographics, how many individuals are there, and what type of facilities they reside in.

The results of Stephanie’s review were recently published in the Canadian Journal on Aging. She found no Canadian studies or reports on unbefriended individuals. Studies from the US indicated that these individuals were more likely to have age-related dementia, have multiple chronic conditions, have issues with functional impairments, and in many cases have limited financial resources, compared to those who have a family member guardian. Unbefriended adults are also more likely to be single, childless, and have fewer siblings, substantiating the idea that they have fewer social networks from which to draw on for social support.

Stephanie says that she was surprised by the lack of Canadian research on the topic, and this signals a troubling gap in our understanding of the prevalence this issue and characteristics of these individuals in Canada. She has recently completed a survey to assess prevalence and interviews with long term care staff and public guardians to identify unmet needs. The results of this research are forthcoming.