COVID-19 Shines a Spotlight on the Age-Old Problem of Social Isolation

Karen Harden, DNP, AOCNS; Deborah M. Price, DNP; Heidi Mason, DNP, ACNP-BC; April Bigelow, PhD, AGPCNP-BC, ACHPN

Disclosures

Journal of Hospice and Palliative Nursing. 2020;22(6):435-441. 

In This Article

Abstract and Introduction

Abstract

In the midst of COVID-19, the nation has become increasingly aware of the impact of social isolation on physical, social, spiritual, and psychological health. Older adults, especially those who are nearing the end of life, are already at higher risk of the detrimental effects of social isolation and loneliness. Novel social distancing rules imposed by governments and agencies during the COVID-19 pandemic have caused older adults to experience a degree of social isolation and loneliness that is unprecedented. This article highlights aspects of the social isolation and loneliness literature. Three cases of elderly patients who required medical care during the COVID-19 pandemic are presented. Common themes of factors contributing to social isolation in each of the health care delivery settings are described, and opportunities for creative interventions by health care providers are identified. As the pandemic continues to unfold and evolve, providers should aim to regularly assess patient risk of isolation and be proactive in preventing negative effects. Additionally, what is learned from health care providers' experiences delivering palliative care during a pandemic can be incorporated into daily practice as social isolation and loneliness are long-standing challenges for the elderly population.

Introduction

In the midst of COVID-19, the nation has become increasingly aware of the impact of social isolation on physical, social, spiritual, and psychological health. Older adults, especially those who are nearing the end of life, are already at higher risk of the detrimental effects of social isolation and loneliness. Novel social distancing rules imposed by governments and agencies during the pandemic have caused many individuals, especially these older adults, to experience a degree of social isolation and loneliness that is unprecedented. It is important to acknowledge that social isolation is not a new problem in palliative care, but has certainly been heightened by the COVID-19 pandemic of 2020. This article highlights aspects of the social isolation and loneliness literature, including definitions to understand these concepts as separate constructs. Three cases of elderly patients who required medical care during the COVID-19 pandemic are presented, with each demonstrating how government-enforced social isolation has created barriers to care and overall well-being. Finally, themes drawn from these cases that describe challenges and gaps in the delivery of health care during the COVID-19 pandemic will highlight opportunities for potential interventions to improve palliative care for patients at high risk of social isolation and loneliness.

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