Loneliness and Social Disconnection Common During COVID-19 Pandemic
More than one-third of Medicare beneficiaries said they were more socially disconnected, and nearly one in four reported they were lonelier during the COVID-19 pandemic, according to the results of a recent survey.1
“There was some overlap, but not total overlap,” says Louisa Holaday, MD, MHS, lead study author and instructor in the division of general internal medicine at Icahn School of Medicine at Mount Sinai in New York City. “One thing that comes up in the literature is that asking people directly about loneliness [can be a problem] because it’s stigmatized. But asking them questions like, ‘Are you feeling less socially connected?’ is a way to get the same answer without it seeming stigmatized.”
Internet Access Is No Help
From a case management perspective, any questions designed to screen patients for loneliness also should avoid the word “lonely,” Holaday notes.
“It’s important when people ask, they ask in these indirect ways, saying, ‘Do you see friends, neighbors, and family? Do you feel like you have someone you can talk to? Do you have someone you can connect with?’” she suggests.
Researchers also explored how access to the internet affected the older population’s feelings of loneliness. Their findings were surprising, Holaday says.
“We found that people who had access to the internet were more likely to say they felt lonely,” she says. “The people who lived alone and who had internet access were the most lonely, and we don’t know why.”
This is a topic that researchers should investigate. “It would be interesting to know what is going on with older adults who are on the internet,” Holaday says. “What are the things that are negative for their mental health, and how do we mitigate that?”
It suggests case managers could recommend patients stay connected with family and friends through regular phone calls, rather than through social media posts.
“There are some studies suggesting that the internet can’t replace the phone call connection, and it can’t replace contact in-person,” Holaday says. “People do better with phone calls.”
Access to the internet and online healthcare information has benefits, but it is not the answer to social isolation. “Asking, ‘Is there someone who can call you regularly?’ might be more meaningful,” Holaday says.
Holaday offers these additional suggestions for how case managers can help patients reduce loneliness and social isolation:
• Ensure patients have a primary care provider. “People who had access to a regular doctor for check-ups were also less likely to report feeling lonely,” Holaday says. “It might be their doctor was asking these questions and encouraging them to stay connected with others.”
• Ask patients if they have any friends, counselors, or other trusted individuals they can talk to when they need support. “We know this is important because for older adults, feelings of isolation and loneliness can lead to bad health outcomes later on,” Holaday says.
• Ask patients if they feel lonely, but do this indirectly. “Do not ask them the direct question of, ‘Do you feel lonely?’” Holaday suggests. “But, say, ‘Do you have someone you can talk with? Do you feel like you have companionship?’”
Those questions will help a case manager discover the patient’s underlying concerns and issues, without having them answer a potentially stigmatizing question.
• Look for organizations that can provide connections and social support to older patients. For example, some communities offer doula programs that link older adults with community volunteers, who will call them regularly. Meals on Wheels visits, phone calls from church members, and other outreach also helps alleviate loneliness.
The COVID-19 pandemic has contributed to more people feeling lonely and disconnected.
“Health systems should ask people when they’re being discharged or coming in for primary care, ‘Do you have someone you can connect with? Are you feeling socially isolated?’” Holaday suggests. “It’s important for your health that you talk with someone regularly. Right now, we’re all going through this pandemic, where we feel fewer connections than we did before. We’re all a little more isolated and are doing our best to stay safe and keep others safe.”
- Holaday LW, Oladele CR, Miller SM, et al. Loneliness, sadness, and feelings of social disconnection in older adults during the COVID-19 pandemic. J Am Geriatr Soc 2021;Nov 30. doi: 10.1111/jgs.17599. [Online ahead of print].
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