Identification of Loneliness and Social Isolation Among Older Adults in a Primary Care Clinic: A Quality Improvement Project
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Authors
Driscoll, Mary Jordan
Issue Date
2023-04
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Abstract
The purpose of this quality improvement project was to implement and evaluate a screening protocol for loneliness and social isolation in older adults within the primary care environment. Social connection is vital to our wellbeing and survival (Holt-Lunstad, 2017). Social isolation is characterized by a lack of social contacts, while loneliness is the distressing feeling of being alone (CDC, 2021). Millions of Americans feel chronically lonely, or are socially isolated, which places them at higher risk for hypertension, heart disease, stroke, obesity, anxiety, depression, suicide, and cognitive decline (CDC, 2021; NIH, 2019; Holt-Lunstad, 2017). This problem has been further complicated by the Covid-19 pandemic (Krendl & Perry, 2021). This project took place at Sawtooth Family Medicine, a primary care clinic in Idaho. All patients aged 65 and over met inclusion criteria for this study. A retrospective chart review from 2021 determined the percentage of patients screened for loneliness and social isolation. Educational sessions with staff developed a loneliness and social isolation protocol. The protocol, which included the UCLA 3-Item Loneliness Scale, and follow-up interventions, was implemented during the fall of 2022. Outcomes were measured using post-intervention surveys directed at patients and providers. A post-intervention chart review recognized the number of patients identified with loneliness and social isolation. Chart reviews demonstrated that 32 patients qualified for this project, 44% of whom were screened. Of those screened, 64% scored positive for loneliness. Post-intervention surveys indicated that all participants found the protocol helpful, 86% recommended continuing the protocol, and 86% anticipated making positive lifestyle changes. Providers reported that the protocol positively influenced their clinical decision-making and encouraged conversations regarding the screening and management of loneliness and social isolation. Results of this project indicate that the identification and management of social isolation and loneliness must come to the forefront of our efforts in primary care.
Keywords: loneliness, social isolation, quality improvement project
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University