Advertisement

Social Isolation: Levels of Response for Nurse Practitioners

      Highlights

      • Starting the conversation about loneliness and social isolation is important because some older adults may view these as a normal part of aging.
      • Assessing for social isolation using validated assessment tools is needed.
      • Every health care encounter is a chance to identify and intervene in social isolation.
      • Nurse practitioners are well positioned to increase awareness, educate, and intervene at all levels (local, community, state, and national) regarding loneliness and social isolation in older adults.

      Abstract

      Although social isolation occurs across the lifespan, this article focuses on the unique challenges faced by the older adult population. Older adults are particularly sensitive to the health risks of social isolation. High-risk groups within the older adult population are minorities, immigrants, LGBTQ+, and victims of elder abuse. Nurse practitioners have the education and are poised to assess and intervene appropriately on social isolation at the primary, secondary, and tertiary levels of care. This article provides evidence-based assessment tools and resources for the nurse practitioner to use in clinical practice.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal for Nurse Practitioners
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • United Nations, Department of Economic and Social Affairs, Population Division
        World Population Ageing: Highlights (ST/ESA/SER.A/430).
        (2003. Accessed May 2, 2022)
        • Rural Health Information Hub
        Demographic changes and Aging population.
        (2022. Accessed May 2, 2022)
        • Centers for Disease Control and Prevention
        Promoting health for older adults.
        (2022. Accessed May 2, 2022)
        • World Health Organization
        Social isolation and loneliness among older people: advocacy brief (License: CC BY-NC-SA 3.0 IGO).
        (2021. Accessed May 2, 2022.)
        • Fakoya O.A.
        • McCorry N.K.
        • Donnelly M.
        Loneliness and social isolation interventions for older adults: a scoping review of reviews.
        BMC Public Health. 2020; 20: 129https://doi.org/10.1186/s12889-020-8251-6
        • World Health Organization
        Social isolation and loneliness among older people: advocacy brief.
        (2021. Accessed May 2, 2022.)
        • Campaign to End Loneliness
        (Accessed May 3, 2022.)
        • Pearson T.
        Loneliness in adults: evidence-based research and interventions for NPs.
        Nurse Pract. 2019; 44: 26-34https://doi.org/10.1097/01.NPR.0000577952.12101.78
        • Centers for Disease Control and Prevention
        Loneliness and Social Isolation Linked to Serious Health Conditions.
        2021 (Accessed May 2, 2022.)
      1. Coalition to End Social Isolation & Loneliness.
        2022 (Accessed May 13, 2022.)
        • National Institutes on Aging
        Loneliness and social isolation—tips for staying connected.
        2021 (Accessed May 2, 2022.)
        • Grand Challenges for Social Work
        Eradicate social isolation.
        2022 (Accessed May 13, 2022.)
        • National Academies of Sciences, Engineering, and Medicine
        Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System.
        Washington, DC: The National Academies Press. 2020; https://doi.org/10.17226/25663
        • Galvez-Hernandez P.
        • González-de Paz L.
        • Muntaner C.
        Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review.
        BMJ Open. 2022; 12: e057729https://doi.org/10.1136/bmjopen-2021-057729
        • Cudjoe T.K.M.
        • Roth D.L.
        • Szanton S.L.
        • Wolff J.L.
        • Boyd C.M.
        • Thorpe R.J.
        The epidemiology of social isolation: National Health and Aging Trends Study.
        J Gerontol B Psychol Sci Soc Sci. 2020; 75: 107-113https://doi.org/10.1093/geronb/gby037
        • Qin W.
        • Xiang X.
        • Taylor H.
        Driving cessation and social isolation in older adults.
        J Aging Health. 2020; 32: 962-971https://doi.org/10.1177/0898264319870400
        • Mick P.
        • Kawachi I.
        • Lin F.R.
        The association between hearing loss and social isolation in older adults.
        Otolaryngol Head Neck Surg. 2014; 150: 378-384https://doi.org/10.1177/0194599813518021
        • Coyle C.E.
        • Steinman B.A.
        • Chen J.
        Visual acuity and self-reported vision status: Their associations with social isolation in older adults.
        J Aging Health. 2017; 29: 1https://doi.org/10.1177/0898264315624909
        • Zelle A.
        • Arms T.
        Psychosocial effects of health disparities of lesbian, gay, bisexual, and transgender older adults.
        Psychosoc Nurs Ment Health Serv. 2015; 53: 25-30https://doi.org/10.3928/02793695-20150623-04
        • American Psychological Association
        Lesbian, gay, bisexual and transgender aging.
        (Accessed May 6, 2022)
      2. engAGED The National Resource Center for Engaging Older Adults.
        (Accessed May 26, 2022)
        • World Health Organization
        Elder abuse.
        (. 2022. Accessed May 2, 2022.)
        • Centers for Disease Control and Prevention
        Keep on your feet—preventing older adult falls.
        (. 2020. Accessed May 2, 2022)
        • Heape A.
        A physical and mental toll: isolation goes beyond loneliness.
        Perspect ASHA Special Interest Groups. 2021; 6: 1729-1736https://doi.org/10.1044/2021_PERSP-21-00107
        • Hakulinen C.
        • Pulkki-Råback L.
        • Virtanen M.
        • Jokela M.
        • Kivimäki M.
        • Elovainio M.
        Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women [published correction appears in Heart.
        Heart. 2018; 104 (2019;105(14):e8]): 1536-1542https://doi.org/10.1136/heartjnl-2017-312663
        • Arms T.E.
        • Crane P.B.
        • McNeill C.
        • Horne C.
        • Whited M.C.
        Life-space constriction in aging adults.
        Geriatr Nurs. 2021; 42: 421-426https://doi.org/10.1016/j.gerinurse.2021.02.001
        • Mackey D.C.
        • Lui L.Y.
        • Cawthon P.M.
        • Ensrud K.
        • Yaffe K.
        • Cummings S.R.
        Life-space mobility and mortality in older women: prospective results from the Study of Osteoporotic Fractures.
        J Am Geriatr Soc. 2016; 64: 2226-2234https://doi.org/10.1111/jgs.14474
        • Freedman A.
        • Nicolle J.
        Social isolation and loneliness: the new geriatric giants: approach for primary care.
        Can Fam Physician. 2020; 66 (Accessed May 30, 2022): 176-182
        • Broome S.
        Campaign to end loneliness. Measuring your impact on loneliness in later life.
        (2015. Accessed May 27, 2022)
        • Campaign to End Loneliness
        The psychology of loneliness.
        (Accessed May 4, 2022)
        • Greenfield E.A.
        • Marks N.F.
        Formal volunteering as a protective factor for older adults’ psychological well-being.
        J Gerontol B Psychol Sci Soc Sci. 2004; 59: 5https://doi.org/10.1093/geronb/59.5.S258
        • Bound J.
        • Waidmann T.
        Estimating the health effects of retirement. Michigan Retirement Research Center Research Paper No. UM WP 2007-168.
        • Matthews K.
        • Nazroo J.
        The impact of volunteering and its characteristics on well-being after state pension age: longitudinal evidence from the English Longitudinal study of Aging.
        J Gerontol B Psychol Sci Soc Sci. 2021; 76: 3https://doi.org/10.1093/geronb/gbaa146
        • Blazer D.G.
        • Reyerson L.M.
        The health care system is an untapped resource in combating social isolation and loneliness in older adults. Health Affairs Blog.
        (April 30, 2020)
        • Center for Disease Control and Prevention
        Loneliness and social isolation linked to serious health conditions.
        • Jones W.H.
        • Carpenter B.N.
        • Quintana D.
        Personality and interpersonal predictors of loneliness in two cultures.
        J Pers Soc Psychol. 1985; 48: 6https://doi.org/10.1037/0022-3514.48.6.1503
        • Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records; Board on Population Health and Public Health Practice
        Institute of Medicine. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington, DC: National Academies Press.
        • Russell D.W.
        UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure.
        J Pers Assess. 1996; 66: 20-40https://doi.org/10.1207/s15327752jpa6601_2
        • Hughes M.E.
        • Waite L.J.
        • Hawkley L.C.
        • Cacioppo J.T.
        A short scale for measuring loneliness in large surveys: results from two population-based studies.
        Res Aging. 2004; 26: 655-672https://doi.org/10.1177/0164027504268574
        • Veazie S.
        • Gilbert J.
        • Winchell K.
        • Paynter R.
        • Guise J.-M.
        Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Review. Rapid Evidence Product (Prepared by Scientific Resource Center under Contract No. 290-2017-00003-C). AHRQ Publication No. 19-EHC009-EF.
        Rockville, MD: Agency for Healthcare Research and Quality. 2019; (Accessed June 1, 2022.)
        • Galvez-Hernandez P.
        • González-de Paz L.
        • Muntaner C.
        Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review.
        BMJ Open. 2022; 12: e057729https://doi.org/10.1136/bmjopen-2021-057729
      3. Khasnabis C, Heinicke Motsch K, Achu K, et al., eds. Community-based rehabilitation: CBR guidelines. Geneva, Switzerland: World Health Organization; 2010. Assistive devices. Accessed May 22, 2022. https://www.ncbi.nlm.nih.gov/books/NBK310951

        • Johnson S.
        • Bacsu J.
        • McIntosh T.
        • Jeffery B.
        • Novik N.
        Competing challenges for immigrant seniors: social isolation and the pandemic.
        Healthc Manage Forum. 2021; 34: 266-271https://doi.org/10.1177/08404704211009233
        • Salway S.
        • Such E.
        • Preston L.
        • et al.
        Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis.
        Public Health Res. 2020; 8 (Accessed May 31, 2022.)
        • Employment and Social Development of Canada
        Social isolation of seniors: a focus on new immigrant and refugee seniors in Canada.
        2015 (Accessed May 31, 2022.)
        • Lai D.W.L.
        • Li J.
        • Ou X.
        • et al.
        Effectiveness of a peer-based intervention on loneliness and social isolation of older Chinese immigrants in Canada: a randomized controlled trial.
        BMC Geriatr. 2020; 20: 356https://doi.org/10.1186/s12877-020-01756-9
        • Movement Advance Project & S.A.G.E.
        Understanding issues facing LBGT older adults.
        2017 (Accessed May 31, 2022.)
        • Rapid Response Service
        Interventions to reduce social isolation and loneliness among men who have sex with men. Ontario HIV Treatment Network.
        2020 (Accessed May 31, 2022.)
        • Kim H.J.
        • Fredriksen-Goldsen K.I.
        Living arrangement and loneliness among lesbian, gay, and bisexual older adults.
        Gerontologist. 2016; 56: 548-558https://doi.org/10.1093/geront/gnu083
        • McCabe A.
        • Gichrist A.
        • Harris K.
        • Afridi A.
        • Kyprianou R.
        Making the links: poverty, ethnicity and social networks.
        2013 (Accessed May 31,2022.)
        • National Academies of Science, Engineering, and Medicine
        Future of Nursing Report 2020–2030: Charting as path to achieve Health Equity.
        Washington, DC: The National Academies Press. 2021; https://doi.org/10.17226/25982
        • Hughes M.E.
        • Waite L.J.
        • Hawkley L.C.
        • Cacioppo J.T.
        A short scale for measuring loneliness in large surveys: results from two population-based studies.
        Res Aging. 2004; 26: 655-672https://doi.org/10.1177/0164027504268574
        • Berkman L.F.
        • Syme S.L.
        Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents.
        Am J Epidemiol. 1979; 109: 186-x204https://doi.org/10.1093/oxfordjournals.aje.a112674

      Biography

      Tamatha Arms, PhD, DNP, PMHNP-BC, is an associate professor at the University of North Carolina–Wilmington College of Health and Human Services, School of Nursing, Wilmington, NC, and can be contacted at [email protected] .

      Biography

      Sara McCumber, DNP, AGPCNP-BC, FNP-BC, ACNS-BC, is an associate professor and interim primary care co-program director, The College of St. Scholastica, Duluth, MN.