JustCare

Tag: Social isolation

  • Why social health is as important as physical and mental health

    Why social health is as important as physical and mental health

    I’ve written a bunch about the value of a buddy or buddies to your overall health, as well as the health costs of social isolation. A new piece by Kasley Killam in The Guardian lays out why “social health” is worth paying attention to. In a few words, it is as important as food and water.

    Curiously social health remains underappreciated in the US. We tend to focus on exercise, eating right, avoiding alcohol and tobacco and getting a good night’s sleep as the best ways to stay healthy. No question that these activities all improve physical and mental health.

    But, social interactions take physical and mental health to a whole other level. We all need people to support us, whether in an emergency or when we’re having a bad day. We need time alone. and we need time with family and friends.

    Relationships–both friendships and romantic relationships–as well as simply hanging out with others can lengthen our lives and stave off chronic conditions. When we build relationships with others, we improve our social health. We enhance our self-worth.

    There’s been a bunch written of late on the health risks of loneliness. The US Surgeon General called it a public health emergency in 2017. But, there has been less written on the health benefits of relationships. And, the data suggest that Americans are increasingly less healthy socially.

    Since the mid-90’s, for example, 2o percent fewer Americans enjoy a cadre of 10 or more close friends. And in the last ten years, 20 percent fewer Americans participate in communities. No question that we are further isolated in the wake of Covid-19.

    One national survey found that around 50 percent of Americans felt that they had no close friends or family who understood them.

    While the data suggests that Americans are not doing well from a social health perspective, people in other countries are also not doing well on the social health front. One Gallup poll found that, all told, 330 million adults don’t speak with friends or family for weeks at a time. One in five adults around the world say they have no one to connect with if they need help.

    Without social connections, the data show that people’s likelihood of stroke increases by 32 percent, dementia likelihood is up 50 percent and premature death by 29 percent. But, 80 percent of people in the US and UK, who lack social relationships do not appreciate the severity of their situation for their health and well-being.

    Everyone needs connection and community, whether lonely or not. So, nourish your relationships, don’t ignore them or put them aside. For your health!!!

    Here’s more from Just Care:

  • Let postal workers help care for older Americans

    Let postal workers help care for older Americans

    Elisabeth Rosenthal writes for Kaiser Health News on how postal workers could help care for older Americans. They have the time and they reach millions of homes a day.

    Postal workers have less mail to deliver nowadays since so much correspondence is electronic. They could raise additional revenue for the USPS if they were paid to spend time doing home visits and basic health checks of isolated older adults. It sounds like a crazy idea. What skills do they have for this work?

    Believe it or not, other countries are using postal workers to perform this work. These countries understand the dangers of social isolation. In response, they have successfully enlisted postal workers to check on vulnerable citizens. France and Japan both do so. It’s one way to address the shortage of home care workers and would help the US Postal Service earn needed revenue.

    Today, literally tens of millions of elderly Americans are aging in place. They are living at home, but need help in order to remain in their communities. But, there is not enough help to go around.

    Many older Americans with mental and physical conditions are forced to fend for themselves, even though they do not have the means to do so properly. For sure, they are not taking their medicines as they should and likely not eating properly either.

    Rosenthal argues that the US Postal Service could make time for home visits by ending daily mail service and, instead, delivering mail three times a week. They would then have three off days to take on some of the home care services people need. They do not need a health care certificate to take a few minutes to speak to homebound elderly and make sure they have the food and prescription drugs they need. If trained, they could check blood pressure and blood sugar levels for diabetics.

    The US Postal Service is losing money and at risk. Rosenthal argues that we should not lose our postal service because people are not mailing as many letters as they used to. We should make use of the postal workers in ways that help them and isolated adults living at home. There is a critical need.

    To be sure, postal workers cannot cover the $160 billion US Postal Service budget gap through home visits to isolated older adults. But, Congress could take this first step of relieving postal workers of the requirement of delivering mail six days a week and allowing them to offer “nonpostal” services.

    Here’s more from Just Care:

  • Is medication an appropriate treatment for loneliness?

    Is medication an appropriate treatment for loneliness?

    Judith Garber writes for the Lown Institute about the overmedication of isolated older adults. Loneliness can have severe health consequences. But, treating loneliness with too many medicines has adverse effects and unclear benefits.

    Isolated older adults are more likely to suffer physical impairments. They are more likely to die prematurely. They are also more prone to overtreatment.

    Some isolated older adults experience depression. Others experience pain. Both of these conditions can lead doctors to prescribe them medicines even though evidence is scarce that the medicines treat their loneliness. And, these medicines can have harmful side effects.

    One recent study in JAMA Internal Medicine found that doctors tend to prescribe benzodiazepines to older adults who feel lonely twice as often as they do to older adults who do not report being lonely, 11 percent v. 5 percent.

    Doctors also prescribe sedatives twice as often to people who report being lonely than to people who are not lonely, 20 percent v. 9 percent. And, doctors prescribe antidepressants nearly twice as often to people who are lonely than people who are not lonely, 27 percent v. 14 percent.

    Doctors are more likely to prescribe older adults who are moderately or highly lonely pain relievers, sedatives and antidepressants. They are also more likely to prescribe them multiple prescription drugs. The dangerous side effects of these prescription drugs can actually make it harder for older adults to be socially engaged.

    Older adults on benzodiazepines and antidepressants are more likely to experience cognitive impairments. They also face a greater likelihood of falling. If they take too much aspirin or ibuprofen, they face a greater likelihood of kidney and heart failure, ulcers and bleeding.

    The best way to improve your health is to have a buddy or buddies. Doctors should be arranging for patients who are lonely to be more socially active. “Social prescribing” would take a bit more time than writing a prescription. It could involve difficult discussions between patients and doctors. But, isn’t that the doctor’s role?

    Here’s more from Just Care:

  • Coronavirus: Where to live as you age?

    Coronavirus: Where to live as you age?

    The novel coronavirus has in no small way taken over all of our lives. It is also leading us to reconsider where to live as we age. Judith Graham reports for Kaiser Health News on new thinking among older adults about housing.

    Given the inability of so many nursing homes to contain the virus, many more people now recognize the dangers of ending up in a nursing home. As of now, the latest data show that 70,000 nursing home and assisted living residents and staff have died of COVID-19. Indeed, all group housing options need a rethink. Independent living is seeming far more attractive than ever before.

    At least in the confines of your home, you can control your environment. Other people are not in charge of your day-to-day activities, who you see and who can visit. You can protect yourself.

    Graham reports that some older adults are thinking ahead about a living environment where they can get assistance when they need it. Others are thinking about how best to age in a way that minimizes social isolation. In both cases that could mean owning or renting a bigger home, where there is adequate space for multiple people.

    Some older adults are waiting the pandemic out before they make a decision. At this point, no one has a good sense how long the pandemic will last or whether it will ever fully go away. But, they think they are more likely to avoid exposure to COVID-19 if they are in their own homes.

    Of course, getting care if needed is the challenge for anyone choosing to remain in their homes as they age. It can be expensive. And, good care can be difficult to find.

    Living on your own presents other challenges. Being able to engage with others might not be easy. In a group environment, it’s far easier to be around other people. And, then there’s the question of getting supplies, including masks and other protective equipment.

    All of these decisions turn in part on what’s affordable. For a growing number of older adults, eight million, living in a group facility, be it independently or with assistance, is not affordable. That’s in addition to the more than seven million older adults who live in poverty, with annual incomes under $12,000.

    If you or some you love is considering moving, here are some questions to consider:

    • What is the facility saying to its residents and their families about COVID-19?
    • Has there been a COVID-19 outbreak at the facility and, if so, is it letting people know about infections and death rates
    • How is the facility keeping its residents safe?
    • What is the facility’s plan and supplies in the case of a hurricane or other natural disaster?
    • How does the facility provide social engagement for its residents?
    • What is the financial situation of the facility? Can it withstand a drop in occupancy?

    Here’s more from Just Care:

  • Coronavirus: Coping with dementia

    Coronavirus: Coping with dementia

    It’s hard enough for people in great mental health to sleep at night or to cope from one day to the next during this pandemic. Imagine the toll the novel coronavirus is taking on the nearly six million older people with Alzheimer’s disease and other types of dementia. Heidi de Marco reports for Kaiser Health News on the difficulties they and their loved ones are facing.

    If you are looking for assistance with caregiving for a loved one with dementia or other care needs, EngAGED is a national resource center that might be of help. It offers information on programs that provide telephone reassurance and wellness checks, help for people with dementia and other resources for older adults.

    More than four million people with dementia still live in their homes, alone or with family. During this pandemic, they are living a very different life. Their daily routines have changed as has the world around them. It can be challenging for them to understand why their family and friends are not visiting and why they can’t go to the supermarket or the bank. They might find it difficult to understand why people around them are wearing face masks and why they must as well when they are out in public. All of this threatens their health and well-being further.

    When home, reading the news can be downright chilling. Combine that with social isolation, and many older adults are facing serious stress and anxiety. Life becomes more emotionally challenging and all the harder for older people. And, caring for them becomes all the more difficult for the 16 million family caregivers in the nation.

    Old ways of providing personal support through social interactions are no longer available. Support systems for people with dementia, to the extent they are available, are online. Many older adults are not capable of interacting with others virtually. And, those people who can go online do not get the same benefits online as they would in person.

    Again, for guidance on resources to help the older people you love through this pandemic, check out EngAGED.

    Here’s more from Just Care:

  • Coronavirus: Many older adults at risk because they are unable to navigate in a digital world

    Coronavirus: Many older adults at risk because they are unable to navigate in a digital world

    Older adults who are not tech savvy and cannot navigate in a digital world are particularly at risk right now. If you don’t know how to access Zoom or FaceTime or buy groceries and medicines online, it’s far harder to stay healthy and safe from COVID-19. Social isolation takes a toll.

    Our health care system is enormously complex as it is. Layer in a pandemic, and it is all the more difficult to stay safe and healthy. Judith Graham writes for Kaiser Health News that if you’re demented, unable to hear or see well, have a low literacy level, or simply do not know how to use a computer, you cannot rely on online resources, putting you at great risk. Yet, a large number of older adults fall into one of these categories. As many as one in three do not have the ability to have a telehealth visit with their doctors.

    In addition, older adults might not have the means to own a computer or internet services. Without internet access, older adults are more likely to be lonely and isolated, to go without needed care and other essential items and services. Indeed many nursing homes, assisted living facilities and other congregate homes for older adults lack wi-fi services.

    COVID-19 aside, studies show that if you have a chronic condition, you are far more likely to face social isolation than if you are healthy. You might struggle to find other people who can relate to your condition. And, you probably will end up feeling worse and becoming mentally and physically less healthy. Not surprisingly, health care costs for older adults who are socially isolated are higher than for those who are socially engaged.

    Here’s more from Just Care:

  • Coronavirus: How to keep an eye on your loved ones remotely

    Coronavirus: How to keep an eye on your loved ones remotely

    Many older adults are staying in their homes during this novel coronavirus pandemic, removed from their children and other loved ones. Their isolation keeps them safe from the novel coronavirus, but how can they be properly cared for? Without being able to visit in person, many caregivers and family members rely on virtual tools to keep an eye on their loved ones. Susan Garland reports for the New York Times on how technology can ensure older adults living alone are doing ok. 

    Some technology platforms allow older adults to chat with their family members remotely. They also might have motion sensors. And, sometimes they can monitor an older adult’s vital signs. These technologies allow older adults to give the people they love the ability to check in on them and know they are safe. For example, are they sleeping at night?

    While in-person medical visits are down substantially, some technology helps health care providers monitor isolated older adults remotely. They can check a person’s weight, the amount of oxygen in their blood and other vital signs.

    Some technology is designed to notify loved ones by text if anything is off. For example, a motion detector will let a caregiver know if a loved one has not made it into the kitchen by a designated time in the morning. You can also make sure your loved one gets a reminder to take his or her medications.

    Of course, some technology is easier to install and use than others. It’s helpful if the company providing the technology has good customer support.

    Virtually all monitoring tools require an internet connection and some rely on GPS tracking to let you know exactly where your loved one is. With some devices, the older adults can press an emergency call button and get help if needed. And, some devices automatically contact a call center if the older adult falls or has a large change in heart rate.

    In some cases, Medicare will pay for a health care provider to monitor patients remotely through telehealth services.

    Amazon Echo and Google Home technologies offer ways to combat the emotional and psychological toll of social isolation. Because they are voice-activated, older adults can rely on them to call family members and friends, turn lights on, set alarms, and provide information on any subject they choose.

    Here’s more from Just Care:

  • Coronavirus: Minimizing the health risks of isolation

    Coronavirus: Minimizing the health risks of isolation

    Paula Span reports for The New York Times on efforts to minimize the risks of isolation for older adults during this coronavirus pandemic. It’s not normal for most people to spend so much time apart from other people. For older adults, in particular, social isolation can take a huge toll.

    As the National Academies of Sciences has reported, social isolation and loneliness are large public health risks, promoting heart disease, stroke and dementia and other poor health outcomes.The National Academies found that about one in three older adults experienced social isolation before the novel coronavirus pandemic. A study published in JAMA in 2012 found that more than four in ten older adults experienced loneliness. Since the pandemic, it’s likely that a far higher proportion of older people are experiencing social isolation and loneliness.

    It’s important to stay active however makes you happy, while keeping safe. Some older adults living at home are cooking for the first time in decades. And, many older adults who are getting Meals on Wheels benefit from a regular relationship with the person delivering the food, from a distance.

    Senior centers, YMCA’s and other organizations serving older populations are offering stay-at-home activities for their older adult members. Among other things, staff reach out to older members by phone on a regular basis. For members who use the computer, some offer concerts and lectures and classes on Zoom, as well as group conference calls.

    Two PACE programs–programs that provide all-inclusive care for the elderly–are loaning tablets to their members so that they can do email and video chats.

    Unfortunately, according to Pew Research, one-third of older adults are not able to use computer technology on their own. Many also do not have internet access.

    Whatever you do, move around as much as possible during the day. Don’t sit for too long if you can avoid it. Keep active. If you have access to stairs, climb them. Physical activity benefits your mind and body.

    Here’s more from Just Care:

  • Well Connected provides companionship to older adults by phone

    Well Connected provides companionship to older adults by phone

    Well Connected, a free program launched by Covia, a nonprofit organization that promotes positive aging, offers phone and online companionship to older adults. It aims to address social isolation and improve people’s physical and mental health.

    The data suggest that having people to talk to and engaging in social activities improves your health and extends your life. Buddies can provide mental, physical, emotional, social and psychological support that many older adults, particularly those living alone, are lacking. Indeed, even casual buddies, people you may not know well, but with whom you are in regular contact, can improve your health.

    Through Well Connected, people can participate in group conversations on a wide range of topics seven days a week. Topics include everything from advocacy to religion, just plain conversation, books, health and wellness. There are more than 20 pages of options listed in the Well Connected catalogue.

    Group discussions are usually no larger than 12 people. And, there’s always a facilitator. People from all backgrounds and all parts of the country come together on the call. The goal is to provide a venue for mutual support, where participants can learn from and support one another.

    Calls are free of charge–there’s a toll-free number–and last 30 minutes to an hour. If you enjoy the program and want to participate on multiple calls, you can join as many sessions as you’d like.

    Today, more than 1,500 older adults from 41 states enjoy the benefits of Well Connected. If you’re interested in learning more about the program, you can contact Covia at 877.797.7299, or [email protected]

    Here’s more from Just Care:

  • More than any other generation, baby boomers aging alone and lonely

    More than any other generation, baby boomers aging alone and lonely

    Whatever your age, having a buddy or buddies does wonders for your social, emotional and physical health. The older you are, the more important it can be to have buddies, though it is often harder to have even a single buddy. The Wall Street Journal reports that older baby boomers are, more than ever before, aging alone and lonely.

    Not only does social isolation and loneliness take a toll on individuals, making people’s retirement challenging, it is a threat to the public health. Today, more than 25 percent of boomers never married or are divorced. About 8 million Americans, 9 percent of people 50 and older, are without a partner or child. And, that number is only expected to increase.

    The physical toll loneliness takes on older adults is equivalent to smoking as many as 15 cigarettes a day or drinking six cocktails, beers or glasses of wine a day. Loneliness shortens people’s lifespans. It is worse for your health than being overweight or not exercising.

    Loneliness in older adults imposes a large cost on the federal government. It costs Medicare nearly $7 billion a year, according to a 2017 AARP study, in partnership with Harvard and Stanford. Loneliness leads to more time hospitalized and in nursing homes.

    To address loneliness, study authors propose the need for a tool to screen older adults for social isolation and the testing of interventions that recognize cultural, socio-economic, mental and functional differences among people. They recommend that, once developed, the tool be used in Welcome to Medicare and Medicare annual wellness visits.

    Recognizing the challenges of social isolation, Great Britain recently appointed a minister of loneliness. The Trump Administration is focused on expanding faith-based partnerships.

    Here’s more from Just Care: