Emotional Wellness Among Older Adults in Long-Term Care

Takeaways

• Emotional wellness is critical, but often overlooked, for older adults in long-term care.
• Approaches that do not involve medications (e.g., gardening, reminiscence therapy, social activities, and technology) show promise in improving emotional well-being.
• Families can also play a vital role in supporting residents' emotional health through visits, advocacy, and promoting autonomy.

Mental and emotional health affect every stage of life — especially older adulthood. For millions of older Americans, especially those living in long-term care settings such as nursing homes, assisted living communities, or memory care facilities, emotional wellness is vitally important, yet often overlooked.

The Growing Challenge

Older adults in long-term care face notable emotional health challenges. According to data from 2022, depression affects more than 25 percent of residential care community recipients. A 2024 study found that up to 56 percent of residents in long-term care report loneliness.

These conditions often go unrecognized or untreated for reasons that can be complex. For one, many long-term care facilities don’t have systemic screening protocols for depression. Staff in these settings may also lack mental health training. Symptoms that could signal depression may be mistaken for “normal” aging.

The COVID-19 pandemic amplified these challenges. Many residents spent months isolated from loved ones and with communal activities restricted. Rebuilding connection and community has since become a central focus for many facilities.

What Can Help

A growing body of research points to approaches that support mental wellness without relying solely on medication. A recent study found that therapies such as gardening and exercise reduced depressive symptoms in long-term care residents.

Gardening in particular has proven effective. This may include having residents tend to small indoor plants, help maintain a garden, or simply spend time outdoors. Forms of therapy that encourage older adults to share life stories, photos, or music from their past, can also rekindle meaning and connection.

Social connections are also essential. Facilities that combine group-based and leisure activities delivered face-to-face may be especially effective at reducing loneliness. Activities such as group exercise classes or art projects may help residents reconnect with others and strengthen community bonds.

Emerging Innovative Approaches in U.S. Senior Communities

Across the country, long-term care providers are rethinking how to make emotional wellness a core part of daily life. Some facilities are piloting “small household” models, like the Green House Project. In these settings, about a dozen residents live together in a home-like environment with consistent staff, shared meals, and flexible daily routines. These models have been linked to higher satisfaction and lower depression rates compared with traditional institutional settings.

Health care settings are also using technology creatively. Virtual reality experiences, for example, let residents “travel” to destinations from their past or explore calming natural settings. Some facilities use robotic pets or sensor-based music therapy to soothe agitation in residents with dementia. While these tools are still emerging, early results suggest they can supplement, though not replace, human connection.

Other programs integrate emotional wellness directly into daily life through mindfulness workshops, stress management sessions, and peer support groups. Such initiatives reflect a growing understanding that mental wellness is not a luxury — it’s necessary for healthy aging.

The Family’s Role in Emotional Health

Families remain a cornerstone of emotional wellness for residents in long-term care. In the U.S., family caregivers for older adults rose from about 18 million in 2011 to over 24 million in 2022. Many continue to visit, advocate for, and emotionally support their loved ones even after a transition to residential care.

Regular visits, meaningful conversations, and shared activities have profound benefits. Bringing photo albums, familiar music, or mementos can spark memories and conversation. For some residents, a 10-minute chat about old times can lift spirits more effectively than any medication.

Families can also play an active advocacy role to help ensure that emotional wellness remains a care priority. They may ask facility staff how they monitor depression and loneliness or suggest therapies like gardening. Supporting a loved one’s sense of autonomy is also important. For example, older adults should be able to make choices about their daily routine, meals, or activities whenever possible.

At the same time, families must care for themselves. Caregiver stress and burnout are widespread. Support groups, counseling, and respite services can help family members maintain their own mental health while remaining engaged advocates.

Barriers and Opportunities

Despite progress, challenges remain. Many long-term care facilities still face staffing shortages, and caregivers often lack formal training in geriatric mental health. Other disparities also persist. For example, Black and Latino long-term residents often have less access to quality resources.

Addressing these issues may be possible through several strategies:

• Expanding routine mental health screening in long-term care facilities
• Increasing reimbursement for therapies that don’t involve medication
• Investing in staff education on how to recognize and respond to depression and loneliness
• Advocating for lawmakers to view emotional well-being as an important measure of quality in long-term care

The Path Forward

Emotional wellness in older adults is not just about preventing depression. It also involves helping them feel connected, valued, and alive. For long-term care residents, even small steps can make a significant difference. These might include a garden walk, a shared story, a visit from family, or a moment of laughter in a group activity.

As the U.S. population ages, emotional wellness must be seen as a central pillar of quality care. The goal is not simply to sustain life but to enrich it by ensuring that older Americans in long-term care have opportunities to feel purpose, joy, and belonging each day.

Additional Reading

For additional reading on topics related to emotional wellness, check out the following articles:

• Make New Friends and Keep the Old: It’s Good for Your Health
• The Loneliness Epidemic: Helping Seniors Stay Connected
• How Mental Health Apps Can Help Older Adults