Get­ting to the root of lone­li­ness

Modern Healthcare - - BEST PRACTICES - By Maria Castel­lucci

An es­ti­mated 43% of se­niors re­port feel­ing lonely on a reg­u­lar ba­sis. That sense of iso­la­tion can in­crease the like­li­hood of con­di­tions such as Alzheimer’s dis­ease, stroke and obe­sity. It can also lead to pre­ma­ture death.

Yet, it is a chal­lenge for health­care providers to ef­fec­tively ad­dress the prob­lem. It re­quires physi­cians, nurses and care­givers to ask the right, of­ten del­i­cate, ques­tions and gather the ap­pro­pri­ate, of­ten out-of-reach re­sources.

“Doc­tors don’t like to find prob­lems they can’t solve,” said Dr. Sachin Jain, pres­i­dent of CareMore, an An­them sub­sidiary that of­fers Medi­care Ad­van­tage plans and op­er­ates out­pa­tient cen­ters in seven states, in­clud­ing Ari­zona and California. “In the ab­sence of ther­apy, we don’t look for the dis­ease star­ing us in the face.”

Jain be­lieves lone­li­ness should be treated as a dis­ease since it can im­pact a pa­tient’s over­all health. Stud­ies show lonely pa­tients are more likely to be de­pressed, not fol­low their care plan and are vul­ner­a­ble to read­mis­sions. Also, be­cause lone­li­ness and other social de­ter­mi­nants of health can in­crease risks for other chronic dis­eases, health sys­tems are mo­ti­vated in this shift­ing re­im­burse­ment cli­mate to ad­dress these prob­lems.

To help providers ad­dress these is­sues, CareMore this week is launch­ing a clin­i­cal ef­fort fo­cused on get­ting lonely pa­tients the treat­ment they need.

So far, CareMore has flagged 1,100 pa­tients who could ben­e­fit. These pa­tients an­swered af­fir­ma­tively when asked whether they felt lonely in their com­pre­hen­sive health as­sess­ments, which about 80% of new mem­bers opt to com­plete. “We’ve been ask­ing our pa­tients this ques­tion for years, so we were able to quickly pull to­gether a reg­istry,” Jain said.

Pa­tients are called fre­quently to fol­low up. The calls are meant to gauge why pa­tients might be lonely and what activities they might be in­ter­ested in to in­crease so­cial­iza­tion.

Over­see­ing the phone calls and the ini­tia­tive is Robin Caruso, the sys­tem’s newly ap­pointed chief to­geth­er­ness of­fi­cer. Caruso has been a social worker for 28 years. Two other em­ploy­ees from the cus­tomer ser­vice depart­ment have also been brought on and trained to help con­nect with pa­tients.

All CareMore clin­i­cians have also been trained to ask pa­tients about their per­sonal lives. If pa­tients don’t ap­pear to have a strong social sup­port sys­tem, physi­cians and nurses are en­cour­aged to tell them about the social op­por­tu­ni­ties avail­able and pass along their in­for­ma­tion to Caruso’s team. “We are try­ing to en­cour­age con­scious­ness around the is­sue,” Jain said.

To eval­u­ate the pro­gram’s suc­cess, CareMore will rou­tinely mon­i­tor clin­i­cal out­comes such as de­pres­sion and read­mis­sion rates. Jain said he ex­pects pa­tients will be health­ier both phys­i­cally and men­tally as a re­sult of this ini­tia­tive.

CareMore has many op­tions avail­able to help mem­bers feel less lonely, Jain said. Most of CareMore’s 52 out­pa­tient cen­ters have an at­tached gym through its part­ner­ship with Nifty After Fifty, which en­cour­ages phys­i­cal fit­ness among se­niors.

The or­ga­ni­za­tion also has re­la­tion­ships with com­mu­nity-based or­ga­ni­za­tions so pa­tients can get in­volved or vol­un­teer. For ex­am­ple, vet­er­ans may want to join a vet­er­ans or­ga­ni­za­tion so they can share their stories with oth­ers.

“A lot of health­care in­no­va­tion is just about con­nect­ing dots for things that al­ready ex­ist,” Jain said.

Caruso said build­ing re­la­tion­ships with pa­tients will al­low them to un­der­stand their unique needs. For ex­am­ple, a pa­tient might not want to leave their home after their spouse dies, so a CareMore staffer will visit. “A part of this is un­der­stand­ing what are the bar­ri­ers to be­com­ing social again,” she said.

CareMore also ex­pects to hold social events for these pa­tients, such as lunches at CareMore cen­ters to al­low pa­tients to forge re­la­tion­ships, Caruso said. Jain hopes more health sys­tems will look to ad­dress lone­li­ness for their pa­tients, call­ing it a “prob­lem of our times.” Fam­i­lies have be­come much more nu­clear in re­cent decades and most se­niors aren’t as apt to use com­put­ers or social me­dia, iso­lat­ing them more from oth­ers, he said.

“We have to see our pa­tients in con­text of their broader lives,” Jain said. “That is the par­a­digm shift that needs to take place in Amer­i­can medicine.”

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.