COVID-19 and Social Isolation Puts Elderly at Risk for Loneliness

COVID-19 and Social Isolation Puts Elderly at Risk for Loneliness

By Gary Call, MD

To protect our elderly and chronically ill from COVID-19, we’ve asked this population to isolate at home. This is the best way to keep them safe. But how do we protect this population, already at high risk for loneliness, from the health risks that come with isolation?

Loneliness and social isolation have been associated with increased risk for several chronic conditions, including dementia (64 percent increase), stroke (32 percent increase), and coronary artery disease (29 percent increase). Social isolation has also been linked to increases in emergency department visits, hospitalizations, and nursing home placements.

Among Medicare beneficiaries, social isolation is the cause of $6.7 billion in additional healthcare costs each year, according to Health Affairs. This higher spending is driven by increased hospitalization and institutionalization. Researchers have also found that socially isolated seniors face higher mortality rates.

In times of public health emergencies or natural disasters, the physical safety of our patients is always top of mind. The healthcare system mobilizes to assist individuals with crisis-related injuries, as well as people dealing with chronic medical conditions. During times of crisis, behavioral health also cannot be overlooked.

To protect vulnerable patients, healthcare entities—including payers, providers, and government organizations—must incorporate behavioral health into their crisis communication activities. This begins with communicating about the resources that are available to assist patients with their needs.

During the COVID-19 outbreak, proactive information sharing can help elderly patients cope with social isolation and the accompanying sense of grief, anxiety, and stress. Outreach and links to helpful resources can reduce feelings of loneliness and replace them with a sense of inclusion. This time of crisis has resulted in healthcare systems that are overwhelmed by patient demand for services. It is critical to use available technology as a force multiplier to increase the reach of our human outreach capabilities.

To keep our elderly patients calm, optimistic, and safe, we must engage with them and let them know that the community cares. Here are some ideas for reaching the right people at the right time with the right message.

Use Analytics to Predict Loneliness and Social Isolation Risk

The first step is to identify those most at risk of social isolation during an emergency. Healthcare organizations can turn to analytics and predictive models to quantify groups that are currently at risk of loneliness and social isolation, as well as those who may be at risk in the future.

Humana, for example, has developed a loneliness predictive model that targets at-risk members with interventions, such as connecting seniors to college-age companions and fitness classes. Even though our elderly population must self-isolate in the face of COVID-19, having these connections—even virtually—can make a big difference.

Crucial Components of Patient Engagement Communication Strategies

When circumstances are changing rapidly, planning and careful execution are the key to communicating effectively with elderly patients. Outreach messaging must prioritize safety. Components of the outreach may often include the kind of check-ins that a friend or family member might do, such as obtaining access to healthcare, medications, food, and water, and performing personal care services. In addition, communications must be timely, personalized, and relevant. This builds trust and confidence. Outreach messages may include efforts to engage patients in healthy behavior change and it is important to have messaging crafted by experts in that area.

Healthcare entities also should engage with elderly patients via their preferred channels of communication and include multiple touchpoints. To predict the communication channels that are most likely to generate a response, providers must understand the demographics and psychographics of their patients. For instance, data shows that Medicaid populations respond most frequently to both text messages and phone calls. A feedback loop on modalities and contact times that are most successful can increase the reach rate and engagement of future outreach attempts to each individual.

When developing rapid response communications, it’s important to convey forward-looking information. This will help elderly patients look beyond current events and towards next steps in the future.

Four Emergency Communications Objectives

To ensure effective outreach, healthcare organizations and even employers should consider forming partnerships with technology vendors to accomplish four emergency communications objectives:

  1. Specifically target elderly patients with timely, relevant, and factual messaging that avoids unnecessary disruption. Use behavior-change experts to craft messaging when indicated.
  2. Prepare responses for common post-crisis questions, such as inquiries regarding emergency updates and access to healthcare, food and water, and other essential services.
  3. Use multiple channels to increase engagement, time permitting.
  4. Think of crisis communications as one part of a larger, more comprehensive engagement program. Experience has shown that patients who received messaging in the past are more likely to engage in the future.

The United States and other countries across the globe are now in the beginning stages of managing the response to COVID-19. Healthcare organizations need to use this time to create and evaluate outreach plans to ensure that high-risk patient needs are addressed.

Engagement solutions that incorporate behavioral health insights are an effective way to reach elderly patients. Empathetic communications are also needed to provide the comfort and support that will get them through this crisis.

Despite our highly connected world, too many Americans are suffering in silence from social isolation and loneliness. Healthcare entities have a role to play in addressing this widespread and costly problem. Analytics can predict the risk of social isolation and loneliness, while new communication approaches and partnerships with community-based organizations have the potential to combat these issues like never before.


Gary Call is chief medical officer for HMS. He is board certified by the American Board of Family Medicine.

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