From Patient Care to Human Connection: How Healthcare Practitioners Can Bridge the Loneliness Gap

Loneliness has emerged as a silent epidemic. Loneliness impacts the physical and mental well-being of Canadians across all age groups. While healthcare providers are focused on diagnosing and treating medical conditions, they are also positioned to recognize and address the underlying social and emotional aspects of their patients' lives. By addressing loneliness, they can play a pivotal role in fostering healing and improving patient health outcomes. There is also potential to prevent a myriad of health conditions.

Loneliness is more than just a fleeting emotion. It can be described as the feeling we get that our social relationships are lacking compared with what we want them to be. The profound impact of isolation and loneliness on the physical, mental, and emotional health of older adults cannot be overstated. Numerous studies have linked loneliness to an increased risk of depression, anxiety, cognitive decline, cardiovascular disease, hypertension, obesity, and even premature death. The increased risk of death from social isolation and loneliness is similar to smoking 15 cigarettes a day or having an alcohol use disorder, according to medical research.

At least as importantly, isolation and loneliness are known to erode an individual's sense of purpose, diminish self-esteem, and can reduce their ability of engaging in healthy lifestyle behaviors.

 

A recent commentary in the New England Journal of Medicine by Holt-Lunstad and Perissinotto noted that while social isolation and loneliness are rarely listed on death certificates, they may have contributed to the excess deaths from all causes observed during the pandemic. They suggest that clinicans require adequate training, resources, and support to integrate screening, interventions, and referrals into their existing responsibilities. They note that patient’s lives may hang in the balance.

 

Countries around the world are raising the alarm about loneliness in various ways. Based on reports of increasing numbers of lonely citizens, the British government appointed a federal Minister of Loneliness in 2018. This appointment built upon a 2011 national campaign to end loneliness. In 2022 the Minister of Loneliness commented on the pandemic’s exacerbating effect on loneliness and that the UK remained at ‘a critical stage’ of tackling loneliness. In early May 2023, the Surgeon General of the United States released a report entitled: Our Epidemic of Loneliness and Isolation, calling for a national strategy to advance social connection.  One of the six pillars of this strategy is to mobilize the health sector.

 

In response to these serious concerns the Canadian Coalition for Seniors’ Mental Health is currently completing clinical practice guidelines to encourage and support best practices related to social isolation and loneliness among older adults. These guidelines can be used by health and social service providers to support their patients and clients by help providers recognize, assess, and treat isolation and loneliness among older adults.

 

Social Isolation and feelings of loneliness are common across all age groups but older adults are particularly at risk due to some of the life circumstances and changes often more associated with aging including being retired, often living alone, being bereaved or living with physical limitations. Nearly one in five Canadians 65 years and older say they lack companionship. But loneliness is not an intrinsic aspect of growing older.

 

Addressing the health impacts of social isolation and loneliness among older adults requires a comprehensive approach that involves the older adults themselves, healthcare providers, community organizations, and policymakers. By recognizing and addressing the prevalence and impact of isolation and loneliness, targeted interventions can be put in place to address underlying physical or mental health conditions, promote social connections, and to improve the overall well-being of older adults in Canada.

Communication between older adults and their healthcare providers is vital in addressing loneliness. By discussing this issue, older adults can take the first steps towards finding solutions and clinicans can provide guidance, support, and access to resources that can help combat loneliness and improve the overall well-being of their patients.

Healthcare providers have a key role to play in the improvement of quality of life and the prevention of illness in later life. Addressing these issues can be complex and time-consuming but are well worth the effort.  If given the time and resources to embrace their role in preventative healthcare, healthcare practitioners can support older adults to make behavioural and life-style changes that could reduce or prevent isolation and feelings of loneliness subsequently reducing the likelihood of the development of a number of key illnesses in the future. Through early intervention, screenings, thorough assessments and collaboration they can empower older adults to work towards a healthier today and tomorrow.