MD, MBA, President of CareMore

More than 40 percent of seniors experience loneliness on a regular basis, according to a recent University of California, San Francisco study. This feeling of separation and disconnection with society, community and family impacts emotional and physical health, so much that we believe it should be addressed by physicians, nurses, and other clinicians as a treatable medical condition.

Research shows that a lack of social connection and the feeling of loneliness and isolation is as damaging to one’s health as smoking 15 cigarettes a day. Loneliness is also a risk factor for cognitive decline, the potential progression of Alzheimer’s disease, stroke and obesity. It’s even a factor for something as simple as the common cold. A recent study in Health Psychology showed people who were lonely complained of 38.5 percent more severe symptoms than those who were less lonely.

Beyond the human impact, loneliness also has a financial toll on our health care system. One AARP study showed those who are very socially isolated influence about $130 per month more in Medicare spending than their non- or less-isolated counterparts.

Loneliness is complex and its symptoms are often masked, so it is not only rarely diagnosed—it’s rarely discussed. It is nonetheless incumbent upon our health care leaders—myself included—to deliver common-sense solutions to meet the holistic needs of patients.

Addressing senior loneliness in clinical practice requires just a little common sense and focus on the issue—both as a symptom of other illnesses, as well as a potential cause of a patient’s deterioration. If we as health care professionals are going to truly understand and support a patient’s health needs, we have to ask the types of questions that can help spot a lonely patient, and determine what the medical, psychological and personal health implications of this may be. We strongly believe that listening and understanding a patient’s needs—as well as paying close attention for signs of social isolation—is at the core of providing the best care.


It is critical for us as clinicians to see the warning signs that may be staring us in the face, and engage in conversations that will unmask and destigmatize the issue for our patients. What if loneliness following the death of a spouse begins to progress into depression? Could we avert the patient’s developing full-blown major depressive disorder by unmasking the issue and suggesting resources to help? We believe it’s possible for the health care system to prescribe treatment strategies, just as it would for any other disease or chronic condition.

CareMore is a health plan and delivery system that focuses on better managing the needs of seniors and others with complex medical problems. We’re committed to doing what’s right for patients, beyond traditional care paradigms. That’s why we created the Togetherness Program, a first-of-its-kind clinical program designed to ensure loneliness is addressed in the clinical setting.

Led by the industry's first Chief Togetherness Officer, our program will focus initially on regular phone conversations with patients whom we have identified as at-risk for loneliness. The purpose of these calls is to build connections, provide consistent and positive engagement and support a patient’s individual health care needs. Based on what we learn from these calls, we can address loneliness from a holistic and direct patient care standpoint—whether that is connecting patients with community-based social programs operated out of our Care Centers; providing hearing aid support, since it may be hearing loss that’s driving the feeling of isolation; or something entirely different. Loneliness has many causes—and our job is to identify modifiable risk factors and address them.

It’s rewarding and encouraging to hear the spirits lift and the tones in voice shift during these early conversations with patients. It is our goal with this program to see improvement in quality of life and clinical outcomes (such as increased socialization and decreased depression), as well as to reduce hospital admission rates.

That recent University of California, San Francisco, study also found that people 60 years and older who reported feeling lonely faced a 45 percent increased risk of mortality. The Togetherness Program helps ensure we are treating the whole person. In addition to the clinical benefit, programs like this are responding to demands from seniors who want to receive more than just medicine from their health care providers. According to a recent survey we conducted of seniors nationwide, 27 percent of respondents said they would like their provider to offer programs to connect them to people or activities in their community to help them stay healthy.

For seniors, a major step towards responding to this need is making sure health care professionals ask questions to ensure that if patients are lonely, they are getting the attention and care they need and deserve. All it really takes is to keep our eyes and ears open, and recognize that our arsenal to treat loneliness is well within reach if we embrace it as a solvable problem.

 

Sachin H. Jain, MD, MBA is President of CareMore.