For years, Linda Fried offered older patients who complained of being lonely what seemed to be sensible guidance. “Go out and find something that matters to you,” she would say.
But her well-meaning advice didn't work most of the time. What patients really wanted were close relationships with people they care about.
We need “new societal institutions that bring meaning and purpose” to older adults' lives, Fried recently told a committee of the National Academies of Sciences investigating loneliness and social isolation among older adults. Fried is a geriatrician and dean of the Mailman School of Public Health at Columbia University.
Anthem is planning a national rollout to Medicare Advantage plans of a program addressing loneliness developed by its subsidiary CareMore Health, said Robin Caruso, CareMore's chief togetherness officer. UnitedHealthcare is making health navigators available to Medicare Advantage members at risk for social isolation. And Kaiser Permanente is starting a program that will refer lonely or isolated older adults in its Northwest region to community services, with plans to eventually bring it to other regions, said Lucy Savitz, vice president of health research at Kaiser Permanente Northwest.
“Assuaging loneliness is not just about having random human contact; it's about the quality of that contact and who you're having contact with,” said Vyjeyanthi Periyakoil, an associate professor of medicine at Stanford University School of Medicine.
A one-size-fits-all approach won't work for older adults, she and other experts agreed. Instead, varied approaches that recognize the different degrees, types and root causes of loneliness are needed.
Other contributors to loneliness are easier to address. A few examples: Someone who has lost a sense of being meaningfully connected to other people because of hearing loss can be encouraged to use a hearing aid. Someone who can't drive anymore and has stopped getting out of the house can get assistance with transportation. And someone who has lost a sibling or a spouse can be directed to a bereavement program.
“We have to be very strategic about efforts to help people, what it is they need and what we're trying to accomplish,” said Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University.