It may be hard to remember life without lockdowns. For the last year, virtually everyone has struggled with quarantine-related feelings of social isolation or loneliness. These emotional triggers should make everyone — regardless of their age — more sympathetic to the plight of senior citizens, who have struggled with loneliness long before COVID-19 forced us all into isolation. For decades, loneliness among seniors has led to resultant chronic conditions that were more profound than obesity, a lack of physical activity, and excessive alcohol consumption. Its impact is the equivalent of smoking 15 cigarettes every day.
Loneliness means feeling sad, being without family, friends, or company, or the emotional state tied to being unfrequented by visitors, or living in remote isolation.
Last year, many healthcare leaders, including Landmark Health, prioritized addressing the impact of loneliness among seniors. “We saw a 190 percent increase in behavioral-health consults compared to pre-COVID-19,” Michael Le, MD, Landmark’s Chief Medical Officer, and Becky Miller, Landmark’s Director of Strategy and Corporate Development, told Oliver Wyman last July. “A lot of the issues we were (and are) dealing with centered around loneliness, isolation, fear/anxiety, and depression, similar to other age groups. Our senior population’s support network was especially hard hit, though, and our patients often have greater difficulty taking advantage of technology for video sessions with friends or family,” they explained.
Le and Miller, like their peers at other healthcare providers, understand the downstream impact on seniors and their loved ones. Under ideal circumstances, it can be a challenge for family members and other caregivers to take time away from work and their families to provide care and companionship, make sure parents, in-laws, and other senior friends get to doctor visits, stay compliant with treatment plans, and refill their medications. Meanwhile, life in a pandemic has given seniors a year to hone their skills and familiarity with technology to help close the social divide.
With nearly two-thirds of seniors reporting they are more comfortable than ever with digital tools — from smartphones to tablets, smart-home tech to “wearables” — they use Zoom calls and Google Meets to find meaningful online connections with family and friends, and even having wellness checks with their physicians. Seventy percent report they are active social media users in terms of how they stay connected. While this generates positive short-term value, and maybe even long-term interpersonal benefits, it is no substitute for the face-to-face interaction that this generation was raised on. Some digital solutions can help seniors get rides to the grocery store, to wellness appointments, or other activities, and at the same time give active seniors the chance to feel empowered by helping peers in need. But the community-building digital model is predicated on helping seniors enjoy sustained in-person communal connections. These approaches can help healthcare providers and partners develop a holistic solution for seniors fighting loneliness and social isolation and searching for community connections.
Creating Strategies to Help Seniors Manage Loneliness
The US healthcare system has spent the last year delivering practical solutions to an unprecedented series of COVID-19-related challenges. We managed vaccine rollouts, mastered Zoom calls to deliver home health care, and coped with the strain of an unrelenting loss of life. But how are we handling the physical health and mental wellness of lonely patients in quarantine — and in the post-vaccine world?
From trained professionals to well-intentioned loved ones, caring for a cohort of 50 million men and women 65 and older has significant emotional consequences. Those who work with the at-risk senior population understand too well the debilitating trickle-down economic impact these issues can trigger. Lonely seniors are less likely to follow their treatment and prescription plans. They are less engaged in their resultant physical well-being and mental-wellness issues. Many are referred into therapy, further taxing an already stretched group of mental-health providers.
Apart from the personal and family impact, the compromised wellness of seniors has major financial implications on the healthcare industry. When seniors suffer from loneliness, their optimism dwindles. When they are struggling emotionally, they project dissatisfaction with many parts of their lives. For example, if they provide negative responses to questions in the CAHPS (Consumer Assessment of Healthcare Providers and Systems) surveys, this will negatively impact quality and satisfaction scores which then impact Star ratings.
By 2030, 20 percent of the US population will be over 65 years old. It’s therefore never been more essential to find solutions to help seniors and supportive healthcare partners find ways to combat the effects of aging.
By 2030, 20 percent of the US population will be over 65 years old.
Mike Weissel Q&A: How Stakeholders Can Embrace Sustainable Senior Wellness Connections
To learn more about how stakeholders can find sustainable wellness options for seniors, our Oliver Wyman Health and Life Sciences team sat down with Mike Weissel, a former Oliver Wyman Partner, now Chief Executive Officer of SecureSeniorConnections™, a digital, community-building platform designed to help seniors make new friends and celebrate engaged, empowered lives with other like-minded people.
Oliver Wyman: There are a lot of social drivers of health that plans and providers are trying to focus on. Why is loneliness important to bring to the forefront?
Mike: The “social” part of social drivers seems to often be an overlooked, but critically important, part of someone’s overall health and wellbeing. Last year, Vivek Murty published Together: The Healing Power of Human Connection in a Sometimes Lonely World, a book based on his experience as US Surgeon General from 2014 to 2017. The book speaks to the incredible need to address loneliness and social isolation in our population.
One memorable takeaway from this book is that human relationships are just as critical to our greater well-being as the food we eat and the water we drink to nourish our bodies. Feeling hungry or thirsty is a signal from our body that we need to take better care of ourselves. Loneliness, similarly, is a signal telling us it’s time to start connecting with other people so we can take care of ourselves.
I expect to see this kind of issue come more to the forefront once he is reappointed, especially in light of the impact the pandemic has had on seniors’ ability to connect.
Loneliness is an issue that really hasn’t been addressed head-on to date. Most health plans or providers don’t focus on loneliness as a metric because, while we know it’s there, the direct impact is hard to measure. This is not unlike the early days of CareMore or the Camden Health Project, when forward-thinking companies were willing to make small changes to people’s home environments — like buying air conditioners to make people physically more comfortable each day, or replacing shag carpets to prevent people from tripping over them and risking injury. Delivering solutions like those might have seemed outside the scope of traditional healthcare, but they had a strong positive impact on healthcare costs.
We have found lonely seniors are significantly less compliant with treatment plans, which puts a significant burden on the healthcare system as well as on families and caregivers. One loneliness study, from 2010, has been particularly impactful. It reviewed 148 previous studies covering more than 300,000 individuals and revealed that individuals with strong social connections have a 50 percent greater likelihood of survival than those without.
In the meantime, many other countries are well ahead of the US in addressing the issue. Consider, for example, that the United Kingdom has a Minister of Loneliness and a countrywide campaign focused on addressing the issue.
Oliver Wyman: How does one actually go about measuring the loneliness levels of their population?
Mike: Because loneliness can be a subjective feeling more than a specific clinical condition, it can sometimes be difficult to reach a consensus on how to measure its impact. But, the UCLA and De Jong Gierveld scales are the most commonly used. Each is a strong academically supported survey that focuses on the social and relational dimensions of loneliness and helps quantify in relative terms the depths of a person’s loneliness. If used consistently, each scale can give a plan or provider a good baseline measure of an individual’s level of loneliness as a way to measure whether interventions are having an impact. Forward-thinking plans and providers are starting to use these scales to specifically measure this important social driver. Of course, what they do once they have the measure is more complicated because there is not one straightforward solution today for solving the loneliness issue for seniors.
Oliver Wyman: What does the competitive landscape look like? What innovative solutions have you seen in the market? How are buyers reacting?
Mike: It is still early days for many addressing this issue, but we are seeing quite a bit of interest in the market for wanting to help seniors with the issue. There are a few different players in the market who are doing unique things to combat the issue. A few of my favorites are the Motion Picture and Television Fund (MPTF), which has set up a volunteer group of seniors making check-in calls on other seniors on a regular basis. It is based on a similar group in England called Silver Line, which is a hotline for seniors to call for companionship and conversation. Silver Line has fielded millions of calls since its inception in 2013.
My company, SecureSeniorConnections™, was created to take it a few steps further because seniors are more tech-savvy today — a trend that shows no sign of slowing down. We’ve designed a digitally enabled Senior Center that connects seniors both online and in-person. It’s been designed with all seniors in mind so we can not only reduce loneliness in those afflicted with it but work to prevent it for others in the future.
With more than 10,000 seniors aging into the Medicare-eligible population each day for the next decade, we want to embrace their comfort with technology and create for them a robust community of seniors. We will provide them with a wide range of activities they can participate in, find new friends to meet, and live more healthy, engaged lives. Informing our solution in this way lets us segment our users to create different pathways to success based on loneliness ratings. Ultimately, we see ourselves as a much broader platform that helps seniors overcome loneliness and social isolation to build a network of connected friends enjoying empowered lifestyles.
Ultimately, there’s both an urgency and an opportunity for plans to implement care-management protocols and interventions that lower the cost of care. Not much has been done to date in this space. There's a massive opportunity here.
Loneliness represents an opportunity to create and nurture human connections that ultimately improve people’s well-being but also their long-term health. Protocols and interventions are perhaps the first steps towards widespread progress. At the end of the day. It’s time to catch up and help lonely seniors who may feel separated from the world and like they don’t have the voice they truly deserve to feel connected to other people.
Addressing loneliness is the right thing to do. This is a facet of the greater social determinants of health umbrella that’s perhaps simpler to solve than helping people find housing, acquire healthy food, and the like. I urge healthcare leaders to take action regarding the challenges and opportunities we’ve outlined above. For your Medicare and Dual Eligible populations, consider how to address loneliness head-on and to what extent your organization is well-positioned to do so. This decade-long influx of Baby Boomers who are even more tech-savvy than seniors before them will undoubtedly help digital solutions gain more traction in the market. Combined with an increased commitment to personal interaction, this will ease caregiver burden and empower seniors to feel more in charge of their physical, emotional, and mental well-being.
Ultimately, now is the time to curb the loneliness epidemic by rebuilding our communities. Consider the words of Marty Makary, MD, Professor of Surgery and Health Policy at Johns Hopkins. “One of the greatest public health epidemics in our country – before COVID-19 – was loneliness. It’s now magnified. It’s rampant among our seniors,” Marty recently told WEEI radio. “We’ve got to rebuild communities to allow for a personal touch to address that loneliness that affects your physiological reserve.”