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Social isolation and loneliness are contributing to a growing public health crisis. The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community found that social isolation and loneliness increase the risk of premature death as much as smoking 15 cigarettes daily. They can also increase the risk of conditions like heart disease, stroke, dementia, anxiety, and depression.

Signify Health performed more than 2.6 million In-home Health Evaluations (IHE) in 2023, with over 550,000 IHEs conducted between December 2022 and February 2023. Social connections – religious groups, neighbors, and even clinician visits – are critical to this population and have a larger impact on health and longevity than many realize. The winter season is often a difficult time for seniors, as travel to and from family and social events may be impacted by distance, weather, and hours of daylight, and even their holiday celebrations may be different due to the passing of family members and friends.

Signify Health clinicians see firsthand how the winter months affect the health plan members they see for In-home Health Evaluations. IHEs, performed by a Signify Health clinician, are a service offered by more than 50 Medicare Advantage plans that involve a comprehensive health exam, behavioral health screening, medication review, and an assessment of current and prior health conditions–all in the comfort and convenience of a member’s home. During a typical IHE, a clinician spends 2.5 times longer with the member in their home than during a typical in-office doctor’s appointment, allowing them to assess the member’s medical health as well as important safety and social determinants of health.

“These evaluations can help members take control of their health from the comfort and convenience of their home,” said Heidi Schwarzwald, MD, MPH, Chief Medical Officer, Signify Health Home and Community Services. “Based on the individual needs from these in-home assessments, members are connected to resources, which can include medication support or assistance with social barriers to health (food insecurity, housing, etc.). By providing seniors with accessible services where they feel more comfortable, we can help create a more valuable healthcare experience overall.”

On Thanksgiving, Stephanie Simons, a Signify Health Clinician, performed IHEs for several health plan members, one of which was particularly memorable. The member was spending the holiday alone, and feeling a bit isolated, but looked forward to hosting her family a few days later. “Loneliness is an issue,” Simons said. “The holidays and cold weather are a big part of that.” But it’s not just the actual holidays. Simons sees seasonal depression as prevalent in many members she visits. “It affects a lot about the person, not just how they feel, but the way they eat, their activity level, their state of being and also their wellness.”

Permission and encouragement to stay social

It can be harder this time of year for seniors to get out of the home to socialize. When Simons sees that members are lonely, she talks to them about their interests and suggests potential solutions. That could include group fitness classes at the local gym, card or Bunco nights, or taking up a hobby.

Simons recommended considering a hobby to the member she visited on Thanksgiving. Before her husband’s recent death, this member loved to sew and quilt, making quilts for family members and friends. At the end of the visit, she showed Simons the sewing room her husband made for her. “The member had not been able to sew or even go into the room since her husband passed a year prior,” she shared.

Simons suggested that the member take up sewing again, to feel closer to her husband and to do something she enjoys. “By the end of the conversation, I thought her spirits had become much better. And she told me she was going to start sewing again.”

Sometimes, people need reassurance from another person, essentially giving them permission to restart a hobby or to go out and be social. “They feel guilty that they’re going back to normal activities too soon or feel they may not be going through the grieving process correctly,” she said. At times, members need to be encouraged to do things on their own terms. Simons hopes to see this member for her IHE next year, to see how she’s incorporated sewing back into her life.

Why socializing matters

Loneliness and social isolation in older adults is a serious public health issue. While it may lead to a weakened mental state in some, these factors have the potential to cause health risks amongst the population and lead to serious medical conditions. According to the CDC, social isolation was associated with about a 50% increased risk of dementia. 

“As humans, it’s in our nature to rely on others in times of need,” said Heidi Schwarzwald, MD, MPH, Chief Medical Officer, Signify Health Home and Community Services. “Without those connections, we can be left feeling isolated and alone. It’s important to maintain high-quality social relationships in order to live healthier lives.” 

Multigenerational households

Those living in multigenerational households may have an advantage. The number of intergenerational households in the United States is the highest it’s been in a century. Victor Mandri, DO, a Signify Health clinician, sees this in his Signify IHE visits with members in the town of Laredo, TX. Some members he sees live with family, often with three generations in the home.

He recalls one visit with a Signify member, where the member said Mandri reminded her of her son. It was an emotional moment, as it made her happy, and Mandri was touched to have that positive impact on her.

Online socializing and weak ties are good too

A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated. Regardless of how much social interaction or contact a person may have, they still may experience loneliness and isolation.

In today’s digital age, people have become increasingly more reliant on virtual meetings. Even if a person can’t get out to socialize much in person, digital connections can help older adults keep the connections that they already have intact.

Maintaining your health all year round is important, especially during the winter months. Please visit our online scheduling portal to book an IHE for you or your loved one: https://schedule.signifyhealth.com/home