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January 14, 2020

How AdventHealth and Parkland are tackling patient loneliness

Daily Briefing

    Today, health care providers are seeing more patients who are lonely and don't have a support system, prompting many to test new ways to help patients address this growing health care problem, Maria Castellucci reports for Modern Healthcare.

    Loneliness affects people's health—and addressing it could support your bottom line

    About loneliness

    An estimated one-third to nearly one half of the U.S. population is lonely, according to studies and surveys. Loneliness often affects midlife and older adults who either do not have or are not connected with their families. The 2014 General Social Survey found about 8% of baby boomers reported feeling lonely often, compared with about 7% of the silent generation and 2% of millennials.

    But Angela Augusto, AdventHealth's director of mission integration, said the problem is not limited to a specific age group. "A top trend (among our patients) is loneliness. And we are not seeing it in any particular age demographic. It's as prevalent with our young patients as our older generation of patients," Augusto said.

    And loneliness has serious impacts on health and treatment outcomes, research shows. For example, a 2010 study found people who are socially isolated have a 50% higher chance of dying compared with those who are not lonely.

    How providers are trying to help

    But the research on how providers can address loneliness in patients is limited, so health systems are testing options to figure out what works, Castellucci reports.

    AdventHealth, for instance, invested $5 million annually in a program, called Clinical Mission Integration. Under the program, AdventHealth's staff since 2018 has asked outpatients three questions to determine whether they feel isolated and lonely: Do you have someone who loves you and cares for you? Do you have a source of joy in your life? Do you have a sense of peace today?

    The staff then review the responses and leave a note in patients' medical records if their answers warrant a follow-up. If a follow-up is needed, the health system's trained chaplain is notified. The chaplain is trained to understand the causes of feelings of loneliness and the resources available to help address those feelings. For instance, the chaplain will connect patients who admit to feeling lonely with faith-based organizations, grief support groups, and volunteer opportunities.

    Physicians will receive notifications, too. Ted Hamilton, AdventHealth's chief mission integration officer, said the program has empowered physicians to talk to their patients about feelings of loneliness and other personal issues because doctors know the health system's chaplain will connect patients with resources to help them.

    Hamilton said, "Doctors were far more willing to engage in this kind of assessment of patients than we ever anticipated."

    Still, AdventHealth doesn't "know for sure what works" when it comes to treating loneliness, Hamilton said. "I hope that over time we will come to a better understanding of that by talking to our patients, by understanding their lives better, their issues better and what gives them hope and optimism."

    As AdventHealth learns more about its patients, the system plans to expand what it offers to patients who say they feel lonely, Castellucci reports. For example, Augusto said the system might create what is like a pen pal system to connect patients who express their loneliness with each other.

    At Parkland Health & Hospital System in Dallas, patients who express their loneliness are connected with adult protective services, case management agencies, homeless shelters, rehab facilities, and other non-profit and government agencies to help address the issue, Castellucci reports. Parkland's program stems from an observation: Many of the hospital's patients used the ED because they lacked a social support system and wanted to simply speak with others, receive a meal, or stay warm.

    Nicole Bernard, a complex case social worker at Parkland, said she learned one of the health system's patients would use the ED to socialize because she was no longer connected to her family. To address the issue, the health system set up an appointment with a case management agency, which then helped the woman get her driver's license, her Social Security benefits, and reconnect with her daughter. Bernard said the case management agency became the patient's "family in the time when she wasn't connected with her family." Bernard said, "Our biggest goal is to find someone who takes the place of the patient's family" (Castellucci, Modern Healthcare, 1/11).

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