In the US, the number of seniors living alone is much higher than in other countries. In fact, according to the Pew Research Center, nearly twice as many 60 or over US citizens live alone than elsewhere in the world. Other cultures with a strong family focus will move seniors back into the family home to care for them, while the US opts for senior care facilities or nursing staff.
As we’ve all experienced over the past year, being alone can hugely negatively impact our physical and mental health. Loneliness can contribute to depression, stress and anxiety, and is hugely prevalent in the older generations. Between 2008-17, treatment for depression for Medicare beneficiaries increased from 13.1% to 18.4%, with no doubt much higher numbers during the pandemic.
Alongside the increase in mental health concerns, the aging population in the US is also leading to a huge chronic pain issue. With low mental health and additional chronic conditions, it’s no wonder why seniors are paving the way to a new health epidemic that needs addressing: Loneliness.
According to Cigna, loneliness actually has the same mortality rate as smoking 15 cigarettes a day, making it more dangerous than obesity. This means that serious work needs to be done to address the negative impacts that seniors living alone can experience.
Loneliness in the pandemic
It’s no surprise that there has been a huge increase in loneliness, depression, and anxiety throughout the uncertainty of the COVID pandemic. Elderly people have suffered from serious isolation in the hope of protecting themselves from the virus, but at the cost of their mental wellbeing. Across February and March 2020, the Disaster Distress Hotline saw a 338% increase in the number of calls to their service, while the federal government mental health texting service saw its own 1000% increase in April. While the number of calls has increased, the duration of each call has too, with more people simply wanting someone to talk to through the day.
Chronic care management can offer a lifeline connection
Medicare patients that suffer from at least two chronic conditions can benefit from enrolling in a chronic care management program. These programs focus on putting supportive and preventative services in place for patients that need them most. There is already research into the link between chronic illness and loneliness, meaning CCM programs could effectively address both epidemics.
Research has also found a distinct link between loneliness, premature mortality, and increased pressure on public health resources. By implementing a CCM program in your health organization, you could be reaping the benefits of patients self-managing their conditions while also enjoying better mental wellbeing.
Within the program, primary care providers can work with their senior patients to build connections or provide access to services within the community to reduce loneliness and the negative impacts it can have on health.
Offering companionship
What’s more, CCM services also provide their patients with a 24/7 nurse hotline. Around-the-clock access to healthcare and advice gives seniors some level of companionship when they need it most. And, when medical anxiety strikes, they can access support instantly.
CCM programs require care providers to dedicate at least 20 minutes a month dedicated to the needs of each individual patient. Clinicians will reach out to all of their patients to check on them, chat and assess their health. Sometimes, this call may be the only conversation seniors have all day – and will be more appreciated than clinicians can imagine.
Creating SMART goals
During CCM check-ins and AWV Medicare, patients work with their PCP to create SMART goals for their health. These goals will work to help the patient mentally and physically. It could include staying connected, getting active, or finding new ways to bring joy into each day. Clinicians will take on board any emotional and physical concerns the patient has and work to find solutions or preventative measures, so these issues don’t become worse.
Access to supportive services
It can be hard for seniors suffering from loneliness to connect with the services readily available to them. Either through a lack of knowledge or through anxiety or shame. However, CCM care teams can create a lifeline for seniors by providing them with links to financial assistance, senior centers, housing agencies, and exercise classes to get them back on their feet.
All of this takes on a preventative, value-based, and holistic approach to healthcare. Rather than treating single ailments as and when they arise, care teams will work to manage the spiritual, emotional, mental, and physical health of a patient on a regular basis while also taking into consideration their environment and interpersonal relationships.
Mental health checks
It is also worth remembering that a lot of seniors (and other age groups) will not actually be able to recognize mental health issues in themselves.
During the pandemic, it’s been found that despite no significant change to a patient’s physical health has occurred, there is a huge problem with isolation. General activities in senior communities have been canceled for safety, making it difficult for elderly people to get out and about or see their families – making them much more susceptible to mental health issues. Having the CCM support line really meant patients could speak to someone about all the uncertainty without feeling judged or hurried along.
CCM care teams are equipped and qualified to offer discrete depression screenings (PHQ-2) to vulnerable patients. Those that are then flagged within this initial screening will be required to have a follow-up PHQ-9 test. These screenings can be a real lifeline for those suffering, as it is the first step to getting the help they need.
The emotional toll of the pandemic will likely continue for months to come. Providers need to take action in order to prevent mental health from deteriorating further for seniors – and all other ages. Chronic care management can provide the shoulder to lean on for many citizens, making it an ideal option for organizations to implement into their schedule to provide a better service to their clients.
