How to Effectively Engage with Lonely and Isolated Seniors

Negative impacts of loneliness and isolation are so significant that the U.S. Surgeon General wrote a formal advisory. Entitled “Our Epidemic of Loneliness and Isolation,” the advisory points to harmful consequences in our schools and workplaces. It even compared the mortality risk of lacking social connection to smoking up to 15 cigarettes a day.

As surprising as this information may be to some, the effects of social isolation are far from new. More than sixty years ago, the United States Congress was asked to address the issue of the “forgotten” population – seniors who had trouble providing for themselves and were isolated from society. In 1965, this effort culminated in the passage of a new social support program, Medicare. The program’s coverage of hospital services provided critical support to millions of patients, who otherwise had nowhere to turn to.

However, in the 1960s, people lived shorter lives and were more likely to live with family. Since then, life expectancy has increased by approximately 4 years and the proportion of seniors living alone has increased by roughly 50%. Today, the total number of seniors living alone is approximately 15 million, compared to about 3 million when Medicare was passed.

How to welcome the “forgotten patient” into our healthcare system

These social changes have led to a rising number of elderly patients who continue to be “forgotten.” Far from being places where relationships can be built, healthcare institutions have become increasingly transactional and impersonal. Healthcare in America works best for patients who can:

  • Understand basic healthcare
  • Speak English
  • Pay for supplemental services
  • Physically can get to the healthcare resource(s)

What if a patient cannot do one of the above or any of the above? By following four simple steps, we can make a world of difference in the lives of these “forgotten” patients.


1) Offer holistic treatments in the home or other accessible setting

Healthcare should not just be for those who are health literate, can speak English, afford supplemental services, and can physically get to healthcare facilities. We must meet the patients where they are, and we must provide them with services that they want and need. Services such as wellness programs, mental health counseling, and dental treatments top the list. In addition to improving physical health, these services can bring tangible hope to patients that may have lost it in the despair of pain, immobility, and depression.

2) Provide healthcare services using age and culturally specific content

Patients must feel wanted and understood by the clinical practitioner. All patients, and all people in general, need two things for happiness: health and companionship. Offering one without the other is inherently limited. Optimal patient engagement occurs when there is a healthcare service with proven value to the patient, performed by a clinician who can connect with them on a personal level. When quality healthcare is delivered in this way, patients will better understand clinical recommendations and how to best navigate our complex healthcare system.

3) Connect patients to integrated care delivery as part of the service

Most seniors have access to health insurance and medical providers, but many do not receive medically necessary care. The cause is multifactorial, but it generally comes down to a lack of holistic patient engagement. You remedy gaps in care by giving patients a reason to plug-in – a reason to engage. When you provide a service that allows them to have a better quality of life or pursue their passions, they are much more likely to take advantage of it. Therefore, we must innovate to bring those services to patients, with a focus on making them accessible, affordable, and integrated into broader healthcare delivery.

4) Proactively address those at highest risk with specialized care management programs

When patients experience even limited benefit from an initial service, they are much more likely to integrate into broader medical care delivery and their communities. It is a positive feedback loop which grants us the opportunity to assess patients who have specialized care needs and proactively intervene to improve their quality of life and prevent complications.

When we welcome the “forgotten patient,” the benefits accrue not just to the individual, but to their families, communities, and the healthcare system as a whole.

By following four simple steps, billions of dollars can be saved, but more importantly, seniors will be better cared for and communities will be strengthened.

Isn’t this the healthcare system you would want for our country, your family, and yourself?

About the Author

Marlow Hernandez, D.O., M.P.H., F.A.C.P.

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