scholarly journals Social Isolation and Healthcare Utilization Among Older Adults Living in Subsidized Housing

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 136-136
Author(s):  
Thomas Cudjoe ◽  
Laura Prichett ◽  
Katherine Runge ◽  
Laura Andes ◽  
Carl Latkin ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Healthcare Utilization ◽  
Social Connectedness ◽  
Subsidized Housing ◽  
Multiple Chronic Conditions ◽  
Non Profit ◽  
Socially Isolated ◽  
Home Placement ◽  
The Relationship

Abstract Older adults living in subsidized housing are often at high risk for having multiple chronic conditions and nursing home placement. Previous studies in this population have not examined the relationship between social isolation and healthcare utilization. We examine this using Lubben Social Network Scale-6 and self-reported healthcare utilization. Utilizing data from a multi-state non-profit subsidized housing provider, we performed descriptive and multivariate analyses on a sample of older adults (N=3,822). Overall, 95 % reported having a checkup within the last 12 months and an average of less than one emergency room visits (mean= 0.58) or hospitalizations (mean= 0.34). In adjusted models, Socially isolated older adults had lower levels of routine checkup (OR=0.50, CI 0.36,0.70) and higher levels of hospitalizations (IRR=1.30, CI 1.10,1.54) compared to older adults who were not socially isolated. Efforts to address healthcare utilization should identify social isolation and explore strategies to promote social connectedness to improve health.

scholarly journals Social Isolation and Well-Being Among Middle-Age and Older Adults: Before and During the COVID-19 Outbreak

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 38-38
Author(s):  
Lydia Li
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Social Connectedness ◽  
Well Being ◽  
Symptoms Of Depression ◽  
Physical Isolation ◽  
Multiple Dimensions ◽  
Aging And Health ◽  
Socially Isolated ◽  
The Relationship

Abstract This symposium brings together five studies that examined the relationship between social isolation and well-being. Two used pre-COVID data from the Health and Retirement Study (HRS). One aimed to identify patterns of social isolation trajectory in a 9-year period, where social isolation was conceptualized as a multidimensional construct. It identified four distinct patterns, and the pattern had a gradient relationship with health outcomes. Another examined the association between self-perceptions of aging (SPA) and social well-being among older adults. It found that positive SPA predicted increased social connectedness and reduced loneliness in four years. Two other studies were based on a longitudinal survey (COVID-19 Coping Survey) that began in April 2020. One reports that adults 55+ with comorbidity at pandemic onset had persistently elevated depressive symptoms in a 6-month period, regardless of their social isolation level. Another paper suggests that physical isolation at pandemic onset was associated with elevated symptoms of depression, anxiety, and loneliness throughout the following six months. The fifth paper was based on two-wave data—2019 survey and 2020 COVID supplement—from the National Aging and Health Trend Study (NAHTS). It found that older adults who were very socially isolated and completely homebound before the pandemic experienced less psychological distress during the outbreak than those who were very socially integrated and not homebound. The five studies highlight the multiple dimensions of social isolation, their antecedents and development over time, and their role in shaping mental health in a pandemic context.

scholarly journals Cumulative Effect of Loneliness and Social Isolation on Health Outcomes among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 920-920
Author(s):  
Timothy Barnes ◽  
Stephanie MacLeod ◽  
Rifky Tkatch ◽  
Manik Ahuja ◽  
Laurie Albright ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Healthcare Utilization ◽  
Cumulative Effect ◽  
Cumulative Effects ◽  
Chi Square ◽  
Socially Isolated

Abstract Loneliness and social isolation are described similarly yet are distinct constructs. Numerous studies examine each construct separately; however, less research has been dedicated to exploring their impacts together. Using survey and claims data among adults age 65+ (N=6,994), the cumulative effects of loneliness and social isolation on late-life health outcomes were examined using Chi-square and multivariate regression models. Loneliness and social isolation were measured using the UCLA-3 Loneliness Scale and the Social Network Index. Participants were grouped into four categories of loneliness and social isolation based on overlap, including: lonely only (L), socially isolated only (SI), both lonely and socially isolated (LSI), or neither (N). Outcomes included quality of life and healthcare utilization and costs. Among participants, 9.8% were considered L, 20.6% SI, 9.1% LSI, and 60.5% N. Respondents were primarily female (55.0%) and 70-74 years of age (27.1%). Those considered LSI were more likely to be older, female, less healthy, depressed, with lower quality of life and greater healthcare utilization patterns. Participants who were L or LSI had higher rates of emergency room visits compared to the N group; LSI had the highest medical costs. Results demonstrate the cumulative effects of loneliness and social isolation among older adults. Findings not only fill a gap in research exploring the impacts of these constructs later in life, but also confirm the need for approaches targeting older adults who are both lonely and socially isolated. As the COVID-19 pandemic continues, this priority will continue to be urgent for older adults.

scholarly journals Aging in Place: Social Connectedness and the Health of Older Subsidized Housing Residents

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 135-135
Author(s):  
Thomas Cudjoe ◽  
Judith Gonyea ◽  
Robyn Stone
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Social Connectedness ◽  
Aging In Place ◽  
Subsidized Housing ◽  
Life Course Perspective ◽  
High Risk Population ◽  
Social Connection

Abstract Findings on the prevalence and impacts of loneliness and social isolation on the lives of older adults have led to the lack of social connectedness being viewed as a major public health issue. Although an understudied population, emerging evidence suggests that for the nearly 3 million older low-income adults living in subsidized housing the impacts of lack of social connection may be especially profound. From a life course perspective, “cumulative economic disadvantage,” if combined with a “cumulative connectedness disadvantage,” may heighten exposure to health risk factors and negative health outcomes. Addressing social risk factors in this population thus may have the potential to reduce health disparities as well as improve quality of life. Decades of epidemiologic evidence suggest that social isolation is a key factor in disparate outcomes. Evidence-based interventions are needed to improve aging in place for this population, but little is known about the individual or contextual factors that influence social connectedness and health among this high-risk population of older adults. This symposium includes interdisciplinary perspectives and methods as well as present results from four studies that examine 1) perspectives on aging in place in subsidized housing, 2) relationship between social connection and food insecurity 3) relationship between social isolation and healthcare utilization and 4) between resident ties and links to health outcomes. Papers in this symposium will highlight the implications of study findings for informing future interventions to improve aging in place for older adults living in subsidized housing.

Addressing COVID-19 Worry and Social Isolation in Home-Based Primary Care

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Social Workers ◽  
Social Isolation ◽  
Mental Health Providers ◽  
Health Providers ◽  
Home Based Primary Care ◽  
Home Based ◽  
Socially Isolated

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

A Model of Risk Reduction for Older Adults Vulnerable to Nursing Home Placement

2014 ◽  
Vol 28 (2) ◽  
pp. 162-192 ◽  
Author(s):  
Janice L. Palmer ◽  
Joanne C. Langan ◽  
Jean Krampe ◽  
Mary Krieger ◽  
Rebecca A. Lorenz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Nursing Home ◽  
Health Care Providers ◽  
Functional Disability ◽  
Nursing Home Placement ◽  
Nursing Home Care ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
Home Placement

Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.

scholarly journals THE INFLUENCE OF SOCIAL ISOLATION AND NEIGHBORHOOD DANGER ON OLDER ADULTS’ FUNCTIONAL STATUS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S529-S530
Author(s):  
Ilana J Engel ◽  
Tamara A Baker
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Functional Status ◽  
Social Isolation ◽  
Social Life ◽  
Functional Decline ◽  
Total Sample ◽  
As Stress ◽  
Perceived Social Isolation ◽  
The Relationship

Abstract Social isolation is often associated with smaller social networks, bereavement, and chronic health problems. In addition, underserved neighborhoods, without the resources and social support of other areas, may further promote social isolation among older adults. This study utilized data from the 2nd wave of the nationally representative National Social Life, Health, and Aging Project (NSHAP) to examine if perceived neighborhood danger mediates the relationship between social isolation and functional impairment. We hypothesized that those who are less socially connected and feel less safe in their communities may experience worse health outcomes. Data for the total sample (N=1,804; 62-91 years of age) showed that partial mediation was supported, (F 2, 1801 = 22.91, p<0.01). Similar statistics were found by gender (men, F 2, 985 = 8.20, p<0.01; women, F 2, 813 = 14.79, p<0.01). This relationship, however, showed a stronger association among women (β = -.39, p<.01) than men (β = -.26, p<.05). Findings indicate that the relationship between perceived social isolation and impaired functional status may be partially explained by perceived neighborhood danger. These findings suggest that older adults who perceive their neighborhoods as dangerous, may be more socially isolated, and at risk for functional decline. These results support the Reserve Capacity Model, which posits that social resources are of increased importance for socioeconomically disadvantaged individuals. Additional research is needed to examine how such factors as stress, environment, and access to care contribute to our understanding of health outcomes among this population of adults.

Neighborhood Deterioration and Social Isolation in Later Life

1993 ◽  
Vol 36 (1) ◽  
pp. 9-38 ◽  
Author(s):  
Neal Krause
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Social Isolation ◽  
Strong Support ◽  
Nationwide Survey ◽  
Later Life ◽  
Neighborhood Characteristics ◽  
Financial Difficulties ◽  
Low Levels ◽  
Socially Isolated

The purpose of this study is to test a conceptual model that attempts to show how selected neighborhood characteristics are related to social isolation in later life. This model specifies that older adults with low levels of educational attainment are more likely to experience financial problems and that elderly people who are confronted by financial difficulties are more likely to reside in dilapidated neighborhoods. The model further predicts that deteriorated neighborhoods in turn tend to promote distrust of others and older adults who are more distrustful of others tend to be more socially isolated. Based on data provided by a nationwide survey of elderly people, subsequent analyses revealed strong support for the theoretical sequence described above.

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