Professional Comment

Reading and Audiobooks May Reduce Loneliness in Care Homes

by Dr Deborah Lee, Dr Fox Online Pharmacy

Life in a care home can be very lonely. Even before COVID-19, 60% of care home residents had no regular visitors. Age UK had reported that 200,000 older people had not a conversation with friends or family for a month. When asked, 3.9 mil- lion older people, said the TV was their main companion.

Since lockdown in March 2020, in con- junction with expert advice from the British Geriatric Society, Care Homes were advised that the risks from having visitors outweighed the benefits, and all visits,

with very few exceptions, had to stop. Care home residents are now at risk of being lonelier than ever.

Loneliness has serious adverse effects on physical and mental health. For example, in one 2012 Swiss survey, those who described themselves as lonely were significantly more likely to have a variety of chronic diseases, including high cholesterol, diabetes, depression, and psychological dis- tress. Loneliness was also associated overall, with an increase in smoking, and alcohol consumption, and a decrease in levels of physical inactivity.

It’s a sad fact – lonely people are 50% more likely to die prematurely. Being lonely is bad for your health, as smoking 15 cigarettes per day.


Many ideas have been put forward to combat loneliness, including activ- ities clubs, befriending services, attending day centres, and lunch clubs. However, there are challenges in providing these services in the face of social distancing and the pandemic.

One alternative option exists. Have you considered helping elderly resi- dents to do more reading? Reading – or more correctly termed ‘bibliother- apy’ – is actually a recognised therapeutic technique for people suffering from stress, anxiety, depression and other medical conditions.

“Reading is to the mind, what physical exercise is to the body,” says Carla Greenwood from the World Literacy Foundation.


Whereas many elderly people may find reading a print book difficult – perhaps due to failing eyesight, difficulty with long periods of concentra- tion, or physical problems holding books and turning pages, there’s always the option of audiobooks. This may be an under-used resource.

When a person reads a fiction book, they become engaged in the story and undergo a specific cognitive process. This means the detach from their current environment and experience a range of emotions, they think more critically and engage in problem-solving. Reading enhances reasoning skills, vocabulary, self-expression, and improves concentration. It also improves empathy and influences emotional intelligence.

When you read – even if this is only 6 minutes per day! – this has been shown to lower blood pressure, slow the heart rate, reduce cortisol levels (stress hormone), and make you feel calmer and more relaxed.

A 2016 American study, the authors compared the long-term survival rates of people aged 50-90 years, with their reading habits. 3636 partici- pants (already enrolled as part of a Health and Retirement Study), were regularly interviewed over a 12-year period. The study investigators found that reading for an average of half an hour a day, resulted in a 20% decrease in mortality, compared to non-readers. Book reading means immersing yourself in another world, which is thought to be beneficial to maintain cognitive function.

Interestingly, these results only applied to reading fiction books – not to newspapers or magazines. 87% of the above study participants, who were regular readers, were reading fiction books.


What about a book club? There are currently around 50,000 book clubs in the UK. They are increasingly popular, and even in lockdown, meetings have been continuing, for example, on Zoom.

Even older people with medical conditions can benefit from a book club. In one 2019 study of 10 stroke patients with aphasia (language and communication difficulties), there were positive improvements in reading com- prehension from attendance at a progamme of 7 book club sessions. The authors noted the benefits from social engagement and commented these sessions could be incorporated into rehabilitation protocols.

In another 2017 study, 8 cancer patients completed a 24-week active book club which involved listening to an audiobook, walking with a pedometer and supervised book club meetings. Although the results were mixed, the authors concluded that audiobooks can bring a whole new meaning to going for a walk, but noted it was important to choose an appropriate type of literature and choice of story.

Participants found listening to a story being narrated was challenging, but they found it was mentally absorbing and that the experience was meaningful. They recognized the programme had also focused on listening skills, and that talking about the books, then focused on their speaking skills. This is the first published study to link audiobooks to physical activity and has shown overall positive benefits.

Perhaps care homes could consider what can be done to assist their res- idents to read, and improve their access to audiobooks, as a way of com- batting loneliness?


Listening Books – A charity, with over 8000 titles which can be sent through the post as CD’s, or downloaded directly to a computer/listening device. There is a small membership fee of £20 per year.

Royal National Institute for the Blind (RNIB) -Talking Book Service. You can choose to receive your book on a CD or a memory stick or to download it directly onto your own listening device.

Calibre Audio – A free audiobook service for anyone with a print disability – that is the inability to read a printed page, for example, a learning disability, a brain injury or a stroke, or a neurological condition such as multiple sclerosis or Parkinson’s Disease.