In the spring of 2023, Surgeon General Vivek Murthy released an advisory illuminating the dangers of loneliness. “It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity,” he wrote in his introduction. Jody Gan, faculty at American University wrote in a 2023 American University Press article, “Loneliness can increase the incidence of dementia by 50 percent”.
During the pandemic we kept our client’s “safe” by eliminating social contact that could expose them to Covid 19. For client’s living at home, we stopped the teams of multiple caregivers who were coming in throughout the week, canceled longtime housekeepers and many other services that were coming in to support our clients as well as the activities outside of their home that they enjoyed that provided social engagement and intellectual stimulation. We opted for one live in caregiver so that they were in their own “bubble” together, “safe.” Although we added technology such as elder friendly tablets with video access for families to stay in touch and be seen, what we did was terminate nearly all of our client’s social interaction. Although we kept our clients safe through those frightening days, we watched them decline mentally and physically in so many ways. Many of our clients with beginning stages of cognitive impairment progressed rapidly through Alzheimer’s and related dementias. These disorders are not reversable when progression occurs due to the changes that had occurred in their lives. As we reflect on those years, we know definitively that we must find creative ways to keep older adults with their unique histories engaged in their lives with the people they love, with purpose and with joy.
As we enter the holiday season that is filled with wonderful traditions and gatherings, it is a perfect time to be aware of those around us that may have suffered the loss of their loved ones and possibly do not have family to share the holidays with. Isolated individuals are very at risk for depression, sadness and decline in their ability to function.
What can we do to minimize this isolation and the effects?
1) Group activities:
Senior Centers: Most towns and cities have senior centers with weekly activities and holiday events. Many senior centers have volunteers who will provide transportation for older adults or taxi vouchers. For many of the clients in our practice who no longer drive, we schedule companions weekly and often multiple times during the week to take them to these activities, stay with them and drive them home safely.
Day Programs: For our clients who have the goal to remain at home but can benefit physically and mentally with the consistency of social engagement, there are wonderful day programs that are very cost effective they can go to from 2-6 days a week. A client’s family reported to us that “Mom is brighter and more alert the day after she has gone to her day program.” That good feeling of connection that is so needed tends to stay with people. Some programs provide transportation. If not, we can always find a way to get our clients there and home. If they live alone, we may have their caregiver pick them up and then make dinner and spend the evening with them. This can all be personalized to the individual’s needs.
Note: Clients may be eligible for funding for day programs through their area agency on aging (https://www.mass.gov/info-details/home-care-program).
Assisted Living Communities: For many older adults, having robust structure and engagement in a residential community is truly preventative of decline for them. When it becomes too much to manage their home, meals, medications, laundry, shopping, and activities of daily living such a showering, dressing and possibly mobility impairment, assisted living can provide a high quality of life. Residents can choose what programs they want to enjoy and come and go as they choose. This proactive option can slow cognitive decline and prevent living “reactively” when problems consistently arise.
One to One Companion: Many of our clients want to remain at home. We support their goals and assist in layering in high quality caregivers and/or companions who can take them to all their activities. Continuing to do the interactive daily tasks that provide purpose and joy is key.
2) Other ways of connecting:
Support Groups
Maintaining regular communication with friends and loved ones via phone or video.
Adopt a pet: If a client will find comfort and companionship with a pet, often their caregivers will assist with the care of the pet. They can also hire a dog walker to assist them. Pets can be extremely therapeutic for anyone who has anxiety or has suffered loss.
Chaplains or religious affiliations: For some individuals, a visit from a Chaplain or religious leader that they affiliate with can provide comfort and fulfillment of their spiritual needs which are sometimes neglected.
Physical and Occupational Therapy: Often, when our clients experience weakness or functional decline, they feel empowered by having physical and/or occupational therapy visit them at home multiple times a week. Most people do not know that with a physician’s order, this can be covered under their outpatient benefits (see our blog on this: https://www.symphonycaremanagement.com/news/2024/12/21/celebrating-our-partnership-with-physical-therapists-learn-how-your-medical-benefits-will-pay-for-extended-physical-therapy-in-your-home
In conclusion ,the above suggestions are just a few ideas. No matter who our client’s interact with on a daily basis, feeling part of life and contributing to the enjoyment of others by being present improves their quality of life and slows progression of multiple disease states. We can help put a plan in place for your loved one with our client centered approach to Care Management.