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Our study found that many of these individuals are low-income, living on limited government-provided pensions. Even though they are living in long-term care facilities where they have food and shelter, few can afford basic personal care items, such as clothing, lotions or denture adhesive. Similarly, uninsured services, such as dental, hearing and eye and foot care services are beyond their financial means.

Even those who can afford these basics frequently go without them because they have no one to purchase these items on their behalf or arrange for appointments.

Our study found that overworked care aides in long-term care facilities, who themselves often make a basic wage, frequently purchase supplies out of their own pocket to help the “unbefriended.” One care aide reported buying dental adhesive out of her own money so the residents in her care could put in their dentures. Another reported seeing “unbefriended” seniors in worn and threadbare clothing so scouted out second-hand clothes for them.

We also found that “unbefriended” individuals have limited social interaction, especially if they exhibit challenging behaviours due to mental illness or dementia. Little social interaction contributes to a lower quality of life. Those with more financial means could hire a companion for social interaction, but most are unable to afford this luxury or are unable to facilitate hiring someone.

In Canada, “unbefriended” seniors are assigned a government-appointed public guardian to take over decision-making responsibilities on their behalf, such as for their health-care and living arrangements. But public guardians are not care-providers nor family members. They do not spend much time with their clients who live in long-term care facilities because they are deemed safe and housed. Many public guardians carry large caseloads of well over 50 clients. While they are supposed to visit their clients four times a year, they often struggle to meet this goal.