The COVID-19 pandemic significantly changed how older adults and caregivers accessed care, social connection and daily activities. While many pandemic-specific restrictions have ended, some of the resulting changes to routines, supports and care environments can continue to increase the risk of Confinement Syndrome. Contributing factors may include:

• Disrupted social networks and support systems: Relationships and routines with family, essential caregivers, visitors and other sources of social connection may have changed, with some older adults continuing to experience reduced social engagement.
• Changes in access to health and social programming: Some programs and services shifted away from in-person delivery or changed their frequency, format or availability, which may have reduced opportunities for social interaction, assessment and meaningful activity.
• Reduced mobility and activity: Extended periods of isolation, inactivity and changes in routine during the pandemic may have contributed to deconditioning, loss of confidence with mobility and more sedentary routines that can persist after restrictions have ended.
• Changes in staffing and continuity of care: Workforce pressures and changes in care delivery during and following the pandemic may have affected continuity, making it more difficult for care providers to consistently know an older adult’s needs, preferences, routines and environment.
• Lasting changes to routines and environments: Older adults may have become accustomed to spending more time at home or in their room, with fewer opportunities or less confidence to resume previous activities and patterns of engagement.

It is important to find the right balance between supporting the safety and well-being of older adults and caregivers and reducing the ongoing risk of Confinement Syndrome. Assessment for the potential clinical and functional effects associated with prolonged isolation, reduced activity and disrupted routines should be incorporated into care planning and ongoing assessment.

Early identification of concerns and timely intervention can help support better outcomes for older adults and their caregivers, including maintaining mobility, function, social connection and quality of life. Addressing these concerns can also help reduce preventable health complications and support more effective use of health and community care resources.